Lumbar plexus
The lumbar plexus is a nerve plexus in the lumbar region of the body which forms part of the 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. Additionally, the ventral rami of the fourth lumbar nerve pass communicating branches, the lumbosacral trunk, to the sacral plexus. The nerves of the lumbar plexus pass in front of the hip joint and mainly support the anterior part of the thigh.
The plexus is formed lateral to the intervertebral foramina and passes through psoas major. Its smaller motor branches are distributed directly to psoas major, while the larger branches leave the muscle at various sites to run obliquely downward through the pelvic area to leave the pelvis under the inguinal ligament, with the exception of the obturator nerve which exits the pelvis through the obturator foramen.
The lateral femoral cutaneous nerve is a branch of the lumbar plexus, exiting the spinal cord between the L2 and L3 vertebrae.
Books
Surgical Anatomy of the Lumbar Plexus
Dedicated guide to the lumbar plexus provides invaluable anatomical and surgical insights
Thorough knowledge of the lumbar plexus and its branches is crucial to achieving positive patient outcomes, especially with newer surgical approaches. Many of the nerve branches are formed within the psoas major muscle and careful dissection is necessary to free them during surgery to prevent damage. Moreover, the iliac vessels are medial to some of the larger branches of the plexus, such as the femoral and obturator nerves. In the retroperitoneal space, the kidney and ureter are nearby. In addition, due to the overlying peritoneal cavity and its contents, accessing the lumbar plexus presents considerable challenges.
Surgical Anatomy of the Lumbar Plexus is the only book on the market devoted to the lumbar plexus and its branches, focusing on anatomy and clinical applications, pathology, surgery, and imaging. Internationally known authors R. Shane Tubbs, Marios Loukas, Amgad Hanna, Rod Oskouian and a cadre of esteemed specialists provide unique insights, clinical pearls, knowledge based on thousands of spine surgeries, and a well-rounded multidisciplinary perspective.
Key Highlights
Nine separate chapters dedicated to impacted nerves: subcostal, iliohypogastric, ilioinguinal, lateral femoral cutaneous, genitofemoral, femoral, obturator, furcal, and accessory obturator History and overview of dermatomal anatomy of branches derived from the lumbar plexus Anesthetic blockade of the femoral, lateral femoral cutaneous, iliohypogastric, ilioinguinal, and genitofemoral nerves Tips for preventing complications and achieving positive outcomes for lateral transpsoas approaches to the lumbar spine and other procedures More than 100 novel illustrations provide clarity and understanding of a complex anatomical area as it relates to surgery involving the lumbar plexus and branches This one-of-a-kind resource provides crucial surgical and anatomical information on the lumbar plexus. It is a must-have reference for neurosurgeons, orthopaedic surgeons, and general surgeons. Reading it cover-to-cover will ultimately benefit patients undergoing lumbar spine surgery.