Anatomy and landmarks for the superior and middle cluneal nerves: application to posterior iliac crest harvest and entrapment syndromes

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Abstract
Object To date, only scant descriptions of the cluneal nerves are available. As these nerves, and especially the superior group, may be encountered and injured during posterior iliac crest harvest for spinal arthrodesis procedures, the present study was performed to better elucidate their anatomy and to provide anatomical landmarks for their localization. Methods The superior and middle cluneal nerves were dissected from their origin to termination in 20 cadaveric sides. The distance between the posterior superior iliac spine (PSIS) and superior cluneal nerves at the iliac crest and the distance between this bony prominence and the origin of the middle cluneals were measured. The specific course of each nerve was documented, and the diameter and length of all cluneal nerves were measured. Results Superior and middle cluneal nerves were found on all sides. An intermediate superior cluneal nerve and lateral superior cluneal nerve were not identified on 4 and 5 sides, respectively. The superior cluneal nerve...