DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20213074

Assessment of the iliolumbar artery: its structural variations and applied aspect

Parul Upadhayay, Ranjeeta Hansdak, Sneh Agarwal

Abstract


Background: The Iliolumbar artery normally arises from the posterior division of Internal iliac artery. The main artery and its two branches supply the iliacus and lumbar region and other vital structures in that area. However, various studies conducted depict the differences in the pattern of its origin and course. Thus, the goal of this study was to discover the various origins of the iliolumbar artery, as well as its relationships with other surgically significant anatomical structures; the importance of which can prevent any intraoperative hemorrhages during surgery.

Methods: The study was conducted in Department of Anatomy Lady Hardinge Medical College between 2019-2021. Pelvis of 12 formalin fixed adult cadavers (8 females, 4 males) were dissected to observe the iliolumbar artery. Its origin, caliber and course were measured using a digital vernier caliper. The relationship of iliolumbar artery was established with obturator nerve, lumbosacral trunk and sympathetic chain.

Results: Iliolumbar artery was originating from trunk of internal iliac artery in 70.83% cases in which the mean distance of origin and mean caliber was more on right side. In the remaining 29.17% cases where the Iliolumbar artery was arising from posterior division of internal iliac artery, the mean distance of origin and mean caliber was higher on left side. The truncal origin of iliolumbar artery was predominant in females.

Conclusions: The variant origin of the iliolumbar artery and its clinic-anatomical relationships have been highlighted to reduce iatrogenic artery trauma during surgery. 


Keywords


Hemorrhage, Iliolumbar artery, Obturator nerve, Variation

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References


Standring S. Gray’s Anatomy: The Anatomical Basis of Clinical Practice. 41st ed. Edinburgh (UK): Elsevier Churchill Livingstone. 2016;1226.

Harrington JF Jr. Far lateral disc excision at L5-S1 complicated by iliolumbar artery incursion: case report. Neurosurg. 2001;48:1377-80.

Ebraheim NA, Lu J, Biyani A, Yang H. Anatomic considerations of the principal nutrient foramen and artery on internal surface of the ilium. Surg Radiol Anat. 1997;19:237.

Yiming A, Baque P, Rahili A, Mayer J, Braccini AL, Fontaine A, et al. Anatomical study of the blood supply of the coxal bone: radiological and clinical application. Surg Radiol Anat. 2002;24:81-6.

Chen RS, Liu YX, Liu CB, Hu YS, Xu DC, Zhong SZ, et al. Anatomic basis of iliac crest flap pedicled on the iliolumbar artery. Surg Radiol Anat. 1999;21:103-7.

Kiray A, Akcalı O, Tayefi H, Kosay C, Ergur I. Anatomical variations of the iliolumbar artery and its relation with surgical landmarks. Acta Orthop Traumatol Turc. 2010;44:464-8.

Weatherley CR, Emran IM, Newell RL. A modification of the standard midline posterior approach to intervertransverse area of the lumbar spine. Ann R Coll Surg 2010;92:19-22.

Rusu MC, Cergan R, Demengiu D, Curcă GC, Folescu R, Motoc AG, et al. The iliolumbar artery-anatomic considerations and details on the common iliac trifurcation. Clin Anat. 2010;23:93-100.

Heye S. Preoperative internal iliac artery coil embolization for aneurysms involving the iliac bifurcation. Acta Chir Belg. 2006;106:144-8.

Naguib NN, Nour-Eldin NE, Hammerstingl RM, Lehnert T, Floeter J, Zangos S, et al. Three-dimensional reconstructed contrast-enhanced MR angiography for internal iliac artery branch visualization before uterine artery embolization. J Vasc Interv Radiol. 2008;19:1569-75.

Koc T, Gilan IY, Aktekin M, Kurtoglu Z, Dagtekin A, Aytaç G, Coşgun E. Evaluation of the origin and branching patterns of the iliolumbar artery and its implications on pelvic and vertebral surgery. Saudi Med J 2016;37:457-60.

Al Talalwah W, Al Dorazi SA, Soames R. The origin variability of the iliolumbar artery and iatrogenic sciatica. Eur J Orthop Surg Traumatol. 2015;25(1):199-204.

Sadler TW. Langman’s Medical embryology. 13th ed. Philedelphia (USA): Wolters Kluver. 2015;217.

Moore KL, Persaud TVN, Torchia GM. The Developing Human: Clinically Oriented Embryology. 10th ed. Philedelphia (USA): Wolter’s Kluver. 2013;330.

Sakthivelavan S, Aristotle S, Sivanandan A, Sendiladibban S, Felicia Jebakani C. Variability in the branching pattern of the internal iliac artery in Indian population and its clinical importance. Anat Res Int. 2014;2014:1-6.

Winters HA, van Harten SM, van Royen BJ. The iliolumbar artery as the nutrient pedicle for an iliac crest graft: a new technique in reconstruction of the lumbar spine. Plast Reconstr Surg. 2002;109:249-52.

Zindrick MR, Wiltse LL, Widell EH, Thomas JC, Holland WR, Field BT, et al. A biomechanical study of intrapeduncular screw fixation in the lumbosacral spine. Clin Orthop Relat Res. 1986;203:99-112.

Ergur, Akcal O, Kiray A, Koflay C, Tayefi H. Neurovascular risks of sacral screws with bicortical purchase: an anatomical study. Eur Spine J. 2007;16:1519-23.

Kelly HA. Ligation of both internal arteries for hemorrhage in hysterectomy for carcinoma uteri. Bull Johns Hopkins Hosp. 1894;5:53-4.

Bleich AT, Rahn DD, Wieslander CK, Wai CY, Roshanravan SM, Corton MM. Posterior division of the internal iliac artery: Anatomic variations and clinical applications. Am J Obstet Gynecol. 2007;197:1-5.