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Deep Dissection Of The Gluteal Region With Multiple Muscle And Nerve Variations And A Brief Literature Review

Introduction

Deep dissection of the gluteal region with multiple muscle and nerve variations and a brief literature review. Explore a unique deep gluteal region dissection revealing six muscle and two nerve variations in a 73-year-old cadaver. Understand their clinical impact.

Abstract

The anatomy of the gluteal region is prone to numerous variations that can significantly impact the biomechanics of the hip joint and influence clinical presentation and therapeutic solutions. This case report documents a routine dissection of the right gluteal region performed on a 73-year-old male cadaver, which revealed six muscle variations and two nerve variations. The left gluteal region was unremarkable. The cadaveric-based work was supplemented by a brief literature review to contextualize these findings within the broader anatomical landscape. T he muscle variations were: gluteus medius with two distinct parts, anterior and posterior, each part with a distinct insertion on the greater trochanter; piriformis muscle with two distinct bellies, superior and inferior, separated by the common fibular division of sciatic nerve, with each muscle belly having a distinct tendon and insertion; absence of superior gemellus; an enlarged obturator internus tendon; and quadratus femoris muscle with a serrated and broadened appearance. Additionally, the posterior cutaneous nerve of the thigh had two trunks that originated from the common fibular and tibial divisions of sciatic nerve, respectively. While anatomical variations in the deep gluteal region are well documented, the presented case is unique due to the abundance of muscle and nerve variations, all co-existing together. T his case report adds to the body of literature on the significance of anatomical variations in the deep gluteal region and their clinical implications.

Review

This case report, titled "Deep Dissection Of The Gluteal Region With Multiple Muscle And Nerve Variations And A Brief Literature Review," presents a compelling account of an unusually high number of anatomical variations discovered during a routine cadaveric dissection. The authors meticulously document a confluence of six muscle and two nerve variations within the right gluteal region of a single 73-year-old male cadaver, a finding that significantly enriches the existing literature on regional anatomical diversity. Such detailed observations are crucial for a comprehensive understanding of human anatomy and hold substantial implications for various clinical disciplines, particularly in diagnosis, surgical planning, and interventional procedures concerning the hip and gluteal area. The report details specific anomalies, including a bicephalic gluteus medius with distinct insertions, a piriformis muscle with two separate bellies separated by the common fibular division of the sciatic nerve, the complete absence of the superior gemellus muscle, an enlarged obturator internus tendon, and a uniquely serrated and broadened quadratus femoris. Furthermore, the posterior cutaneous nerve of the thigh exhibited an unusual double-trunk origin from both the common fibular and tibial divisions of the sciatic nerve. What truly distinguishes this case is not merely the presence of these variations individually, but their simultaneous co-existence within the same anatomical region of one cadaver, especially given that the contralateral side was unremarkable. The authors judiciously complement their cadaveric findings with a brief literature review, effectively contextualizing these unique observations within the broader spectrum of reported gluteal variations and highlighting their rarity in such a combined presentation. The clinical relevance of these findings cannot be overstated. Variations in the deep gluteal region can profoundly impact the biomechanics of the hip joint, influence the manifestation of pain syndromes (such as deep gluteal syndrome or piriformis syndrome), and pose significant challenges during surgical interventions, regional anesthesia, or intramuscular injections. The detailed anatomical mapping provided in this report serves as an invaluable resource for orthopedic surgeons, neurosurgeons, pain specialists, and physical therapists, underscoring the necessity for a thorough appreciation of anatomical unpredictability. This case report is a timely reminder that while anatomical variations are common, their extensive co-occurrence as presented here offers vital insights that can ultimately improve diagnostic accuracy and therapeutic outcomes for patients.

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