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Anatomical Location of the Bifurcation of the Sciatic Nerve in the Posterior Thigh in Infants and Children: A Formula Derived From MRI Imaging for Nerve Localization
  1. Santhanam Suresh, M.D., F.A.A.P.,
  2. Carmen Simion, M.D.,
  3. Mary Wyers, M.D.,
  4. Melissa Swanson, M.D.,
  5. Melissa Jennings, R.N. and
  6. Aditya Iyer, B.S.
  1. Childrenx2019;s Memorial Hospital, Northwestern University, Feinberg School of Medicine, Chicago, IL
  2. Department of Anesthesiology, Northwestern University, Feinberg School of Medicine, Chicago, IL
  3. Department of Pediatrics, Northwestern University, Feinberg School of Medicine, Chicago, IL
  4. Department of Radiology, Northwestern University, Feinberg School of Medicine, Chicago, IL
  5. Cornell University, Ithaca, NY.
  1. Reprint requests: Santhanam Suresh, M.D., F.A.A.P., Childrenx2019;s Memorial Hospital, Northwestern University, Department of Pediatric Anesthesiology, 2300 Childrenx2019;s Plaza, Chicago, IL 60614. E-mail: ssuresh{at}childrensmemorial.org

Abstract

Background and Objectives: Sciatic nerve block is performed at the popliteal fossa for various surgical procedures in infants and children. The aim of this study is to review magnetic resonance imaging scans in children of various ages to assess the location of the division of the nerve in the posterior thigh.

Methods: After Institutional Review Board approval was obtained, measurements of the bifurcation of the sciatic nerve in the posterior thigh were recorded from magnetic resonance images that were previously obtained in children of various ages. Data were recorded in a database and parametric and nonparametric statistical analysis was performed.

Results: Measurements were recorded from 59 patient images. Using a linear regression model, we were able to arrive at a formula for determining the point of bifurcation of the sciatic nerve at the posterior thigh. The mathematical formula derived from the linear regression equation was:

Distance of the sciatic nerve division cephalad to the popliteal crease (mm) = 27+4 · age (y).

Conclusions: We speculate that this knowledge will assist practitioners who use nerve stimulation techniques for sciatic nerve blocks in children of all ages.

  • Popliteal fossa
  • Sciatic nerve
  • Bifurcation
  • Children

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