Advertisement

Anatomical variations of the principal nutrient pedicle for iliac crest graft: the ilio-lumbar artery

  • G. Sankaranarayanan
  • S. S. S. N. Rajasekhar
Original Article

Abstract

Purpose

The purpose of this study is to observe the origin, course, length, diameter and termination of the ilio-lumbar artery (ILA) and its variations in south Indian population.

Materials and methods

The study was carried out in 34 sides in 19 cadavers (R-18, L-16) used for routine dissection for undergraduate students during the period of 2017–2018 in Department of Anatomy, JIPMER, Puducherry. On each side of the pelvis, the origin, length, diameter, course of the ILA and its relations to the surrounding anatomical structures was observed and documented.

Results

Out of 34 formalin-fixed pelvis halves of human cadavers, the ILA originated from the common iliac artery (CIA), the trunk of the internal iliac artery (IIA) and posterior division of IIA in around 0%, 61.76%, and 38.23% of the cases, respectively. In all the cadavers, the ILA passes in between the obturator nerve anteriorly and the lumbosacral trunk posteriorly and ILA terminates by giving iliac and lumbar arteries medial to the psoas major muscle.

Conclusions

In our study, we observed that the mean distance between the origin of ILA and the bifurcation of the CIA is significantly less than the study done previously. The knowledge about the variations in the origin, course, length, diameter, and termination of ILA is very important to the surgeon to avoid iatrogenic injury during surgeries in lumbosacral region and moreover, it will be easy to access the ILA for clamping or embolization. A similar study can be done with more sample size in different population to increase the knowledge base regarding ILA anatomy.

Keywords

Common iliac artery Ilio-lumbar artery Ilium Internal iliac artery 

Notes

Author contributions

SG: data collection, data analysis. RSSSN: protocol/project development, manuscript writing/editing.

Compliance with ethical standards

Conflict of interest

Authors declare no conflict of interest.

References

  1. 1.
    Al Talalwah W, Al Dorazi SA, Soames R (2015) The origin variability of the iliolumbar artery and iatrogenic sciatica. Eur J Orthop Surg Traumatol 25(S1):199–204CrossRefGoogle Scholar
  2. 2.
    Bleich AT, Rahn DD, Wieslander CK, Wai CY, Roshanravan SM, Corton MM (2007) Posterior division of the internal iliac artery: anatomic variations and clinical applications. Am J Obstet Gynecol 197(6):658.e1-658.e5CrossRefGoogle Scholar
  3. 3.
    Chen RS, Liu YX, Liu CB, Hu YS, Xu DC, Zhong SZ et al (1999) Anatomic basis of iliac crest flap pedicled on the iliolumbar artery. Surg Radiol Anat 21:103–107CrossRefGoogle Scholar
  4. 4.
    Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap LC 3rd, Wenstrom KD (2005) Obstetrical hemorrhage. Williams obstetrics, 22nd edn. McGraw-Hill, New York, pp 828–829Google Scholar
  5. 5.
    Cunningham FG, Leveno KJ, Bloom SL, Hauth JC, Gilstrap LC 3rd, Wenstrom KD (2005) Obstetrics in broad perspective. Williams obstetrics, 22nd edn. McGraw-Hill, New York, pp 79–81Google Scholar
  6. 6.
    Harrington JF (2001) Far lateral disc excision at L5-S1 complicated by iliolumbar artery incursion: case report. Neurosurgery 48:1377–1379PubMedGoogle Scholar
  7. 7.
    Havaldar PP, Taz S, VA A, Saheb SH (2014) Study of posterior division of internal iliac artery. Int J Anat Res 2:375–379Google Scholar
  8. 8.
    Hayashi A, Maruyama Y, Okajima Y, Motegi M (1994) Vascularized iliac bone graft based on a pedicle of upper lumbar vessels for anterior fusion of the thoraco-lumbar spine. Br J Plast Surg 47:425–430CrossRefGoogle Scholar
  9. 9.
    Keibel F, Mall FP (1912) Manual of human embryology II. J. B. Lippincott Company, PhiladelphiaGoogle Scholar
  10. 10.
    Kiray A, Akçalı O, Tayefi H, Koşay C, Ergür I (2010) Anatomical variations of the iliolumbar artery and its relation with surgical landmarks. Acta Orthop Traumatol Turc 44:464–468CrossRefGoogle Scholar
  11. 11.
    Koc T, Gilan IY, Aktekin M, Kurtoglu Z, Dagtekin A, Aytac G, Cosgun E (2016) Evaluation of the origin and branching patterns of the iliolumbar artery and its implications on pelvic and vertebral surgery. Saudi Med J 37(4):457–460CrossRefGoogle Scholar
  12. 12.
    Kumari S, Gowda MT (2016) The branching pattern of the internal iliac artery in south Indian population. Int J Anat Res 4(4):2907–2913CrossRefGoogle Scholar
  13. 13.
    Quain R (1844) The anatomy of the arteries of the human body. Taylor and Walton, LondonGoogle Scholar
  14. 14.
    Rusu MC, Cergan R, Demengiu D, Curcă GC, Folescu R, Motoc AG et al (2010) The iliolumbar artery-anatomic considerations and details on the common iliac trifurcation. Clin Anat 23: 93–100CrossRefGoogle Scholar
  15. 15.
    Souza AD, Ankolekar VH, Manjappa AB, Souza ASD, Hosapatna M (2015) Variations and morphometry of iliolumbar artery and its relations with surgical landmarks. Acta Biomed Sci 2:212–214Google Scholar
  16. 16.
    Spurway J, Logan P, Pak S (2012) The development, structure and blood flow within the umbilical cord with particular reference to the venous system. Australas J Ultrasound Med 15(3):97–102CrossRefGoogle Scholar
  17. 17.
    Strandring S, Ellis H, Wigley C (2005) Gray’s anatomy: the anatomical basis of clinical practice, 39th edn. Elsevier Churchill Livingstone, Edingburgh, p 1360Google Scholar
  18. 18.
    Szpinda M, Szpinda A, WoŸniak A et al (2012) The normal growth of the common iliac arteries in human fetuses—an anatomical, digital and statistical study. Med Sci Monit 18(3):BR109–B16CrossRefGoogle Scholar
  19. 19.
    Teli CG, Kate NN, Kothandaraman U (2013) Morphometry of the iliolumbar artery and the iliolumbar veins and their correlations with the lumbosacral trunk and the obturator nevre. J Clin Diagn Res 7:422–426PubMedPubMedCentralGoogle Scholar
  20. 20.
    Weatherley CR, Emran IM, Newell RL (2010) A modification of the standard midline posterior approach to intervertransverse area of the lumbar spine. Ann R Coll Surg 92:19–22CrossRefGoogle Scholar
  21. 21.
    Winters HA, van Harten SM, van Royen BJ (2002) The iliolumbarartery as the nutrient pedicle for an iliac crest graft: a new technique in reconstruction of the lumbar spine. Plast Reconstr Surg 109:249–252CrossRefGoogle Scholar
  22. 22.
    Yiming A, Baqué P, Rahili A, Mayer J, Braccini AL, Fontaine A et al (2002) Anatomical study of the blood supply of the coxal bone: radiological and clinical application. Surg Radiol Anat 24:81–86CrossRefGoogle Scholar

Copyright information

© Springer-Verlag France SAS, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of AnatomyJIPMERPuducherryIndia

Personalised recommendations