Co-presentation of unilateral femoral and bilateral sciatic nerve variants in one cadaver: A case report with clinical implications

OBJECTIVE: To present a group of anatomical findings that may have clinical significance. DESIGN: This study is an anatomical case report of combined lumbo-pelvic peripheral nerve and muscular variants. SETTING: University anatomy laboratory. PARTICIPANTS: One cadaveric specimen. METHODS: During routine cadaveric dissection for a graduate teaching program, unilateral femoral and bilateral sciatic nerve variants were observed in relation to the iliacus and piriformis muscle, respectively. Further dissection of both the femoral nerve and accessory slip of iliacus muscle was performed to fully expose their anatomy. RESULTS: Piercing of the femoral nerve by an accessory iliacus muscle combined with wide variations in sciatic nerve and piriformis muscle presentations may have clinical significance. CONCLUSIONS: Combined femoral and sciatic nerve variants should be considered when treatment for a lumbar disc herniation is refractory to care despite positive orthopedic testing.