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The success rate of the paradigm of lumbar MRI and disk resection for treatment of sciatica is therefore about 15%(Filler 2005). Neurography has been applied increasingly to evaluate the distal nerve roots, lumbo-sacral plexus and proximal sciatic nerve in the pelvis and thigh to find other causes of sciatica.
The lumbar plexus is a web of nerves (a nerve plexus) in the lumbar region of the body which forms part of the larger lumbosacral plexus. It is formed by the divisions of the first four lumbar nerves (L1-L4) and from contributions of the subcostal nerve (T12), which is the last thoracic nerve .
The first three lumbar nerves, and the greater part of the fourth together form the lumbar plexus. The smaller part of the fourth joins with the fifth to form the lumbosacral trunk, which assists in the formation of the sacral plexus. The fourth nerve is named the furcal nerve, from the fact that it is subdivided between the two plexuses.
The ventral rami of L1–L5 spinal nerves with a contribution of T12 form lumbar plexus. This plexus lies within the psoas major muscle. Nervi of the plexus serve the skin and the muscles of the lower abdominal wall, the thigh and external genitals. The largest nerve of the plexus is the femoral nerve.
The anterior divisions of the lumbar nerves, sacral nerves, and coccygeal nerve form the lumbosacral plexus, the first lumbar nerve being frequently joined by a branch from the twelfth thoracic. For descriptive purposes this plexus is usually divided into three parts: lumbar plexus; sacral plexus; pudendal plexus
Lumbar Plexus, Schema: File usage. The following page uses this file: ... Image width: 679 px: Image height: 687 px: Date and time of digitizing: 05:02, 4 November 2006:
The genitofemoral nerve is a mixed branch of the lumbar plexus derived from anterior rami of L1-L2.It splits a genital branch and a femoral branch.It provides sensory innervation to the upper anterior thigh, as well as the skin of the anterior scrotum in males and mons pubis in females.
The ilioinguinal nerve is a branch of the first lumbar nerve (L1). It separates from the first lumbar nerve along with the larger iliohypogastric nerve.It emerges from the lateral border of the psoas major just inferior to the iliohypogastric, and passes obliquely across the quadratus lumborum and iliacus.