Abstract：
BACKGROUND: Obturator nerve entrapment or idiopathic obturator neuralgia is an unfamiliar pathology for many physicians which can lead to diagnostic errancy. This study aims to identify the potential compression areas of the obturator nerve to improve therapeutic management.
METHODS: 18 anatomical dissections of lower limbs from 9 anatomical cadavers were performed. Endopelvic and exopelvic surgical approaches were utilized to study the anatomical variations of the nerve and to identify areas of entrapment.
RESULTS: On 7 limbs, the posterior branch of the obturator nerve passed through the external obturator muscle. A fascia between the adductor brevis and longus muscles was present in 9 of the 18 limbs. The anterior branch of the obturator nerve was highly adherent to the fascia in 6 cases. In 3 limbs, the medial femoral circumflex artery was in close connection with the posterior branch of the nerve.
CONCLUSIONS: Idiopathic obturator neuropathy remains a difficult diagnosis. Our cadaveric study did not allow us to formally identify one or more potential anatomical entrapment zones. However, it allowed the identification of zones at risk. A clinical study with staged analgesic blocks would be necessary to identify an anatomical area of compression and would allow targeted surgical neurolysis.
METHODS: 18 anatomical dissections of lower limbs from 9 anatomical cadavers were performed. Endopelvic and exopelvic surgical approaches were utilized to study the anatomical variations of the nerve and to identify areas of entrapment.
RESULTS: On 7 limbs, the posterior branch of the obturator nerve passed through the external obturator muscle. A fascia between the adductor brevis and longus muscles was present in 9 of the 18 limbs. The anterior branch of the obturator nerve was highly adherent to the fascia in 6 cases. In 3 limbs, the medial femoral circumflex artery was in close connection with the posterior branch of the nerve.
CONCLUSIONS: Idiopathic obturator neuropathy remains a difficult diagnosis. Our cadaveric study did not allow us to formally identify one or more potential anatomical entrapment zones. However, it allowed the identification of zones at risk. A clinical study with staged analgesic blocks would be necessary to identify an anatomical area of compression and would allow targeted surgical neurolysis.
摘要：
背景：闭孔神经卡压或特发性闭孔神经痛是许多医生不熟悉的病理，可能导致诊断错误。这项研究旨在确定闭孔神经的潜在压迫区域，以改善治疗管理。
方法：对9具解剖尸体进行18次下肢解剖解剖。利用肾盂内和肾盂外手术方法研究神经的解剖变化并确定截留区域。
结果：在7个肢体上，闭孔神经的后支穿过闭孔外肌。在18个肢体中的9个中存在短收肌和长肌之间的筋膜。闭孔神经前支与筋膜高度粘附6例。在三个肢体中，旋股内侧动脉与神经后支紧密相连。
结论：特发性闭孔神经病仍然是一个困难的诊断。我们的尸体研究不允许我们正式确定一个或多个潜在的解剖截留区。然而,它允许识别处于危险中的区域。有必要进行分阶段镇痛块的临床研究，以确定压迫的解剖区域，并允许有针对性的手术神经溶解。
方法：对9具解剖尸体进行18次下肢解剖解剖。利用肾盂内和肾盂外手术方法研究神经的解剖变化并确定截留区域。
结果：在7个肢体上，闭孔神经的后支穿过闭孔外肌。在18个肢体中的9个中存在短收肌和长肌之间的筋膜。闭孔神经前支与筋膜高度粘附6例。在三个肢体中，旋股内侧动脉与神经后支紧密相连。
结论：特发性闭孔神经病仍然是一个困难的诊断。我们的尸体研究不允许我们正式确定一个或多个潜在的解剖截留区。然而,它允许识别处于危险中的区域。有必要进行分阶段镇痛块的临床研究，以确定压迫的解剖区域，并允许有针对性的手术神经溶解。
