Variations of Lumbar Plexus in 30 Adult Human Cadavers- a Unilateral Prefixed Plexus

Looking to the applied significance of lumbar plexus in the form of its involvement in various injuries and entrapment, it is imperative to have a thorough knowledge about its formation, branching pattern and variations. A recent increase in the retroperitoneal laparoscopic surgeries inspired us to revisit the anatomy of lumbar plexus. The purpose of this study was to describe the anatomical variations in the lumbar plexus. Comparing our findings to anatomical variations described elsewhere in the literature, we have also suggested possible clinical implications with regard to diagnosis of anatomical variations of the lumbar plexus. The study was conducted on 30 formalin embalmed cadavers in the Department of Anatomy, Govt. Medical College, Patiala. Following the removal of abdominal viscera and peritoneum, the lumbar plexus was approached by an anterior approach. The branches were identified and any variations were recorded and photographs were taken. An unusual pattern of lumbar plexus was observed in a male case. On the left side, the plexus was prefixed as there was a contribution from T12. Iliohypogastric and Ilioinguinal nerves were seen arising from T12 and L1. Three loops in the form of continuous trunks were formed from ventral rami of T12 to L3 nerves. The Genitofemoral nerve was seen arising from second loop whereas the Lateral femoral cutaneous nerve was seen arising from the third loop. Ultimately the whole trunk divided into obturator and femoral nerves. On the right side, the Ilioinguinal nerve originated from L2. Genitofemoral nerve was seen arising from ventral ramus of L2 and L3. The well-protected structure and safe location give the plexus more security. Lumbar plexopathies are therefore less common peripheral nerve lesions affecting the lower extremities. Knowledge of the anatomy of the lumbar plexus is essential for the surgeon who wishes to perform a surgical intervention to this plexus