Tracking of Fascicles of Sartorius and Pectineus Nerves-A Key to Neurosurgery AC01-AC08
Dr. Rajani Singh,
Professor, Department of Anatomy, Veerbhadra Marg, AIIMS, Rishikesh-249203, Uttaranchal, India.
Introduction: Sartorius and pectineus are muscles of thigh innervated by Nerve to Sartorius (NS) and Nerve to Pectineus (NP) respectively. If pectineus and sartorius muscles are paralysed or weakened due to injury to nerves to pectineus and NS or their fascicles, these injured nerves and/or fascicles are to be repaired or stimulated to restore the functions of these muscles.
Aim: An experimental histological study of the NP and NS was designed to explore the configuration of fascicles and their identification for repair at fascicular level. This microscopic work has been done at such a close sample interval (1-2 mm) for the first time.
Materials and Methods: The slides from 24 blocks of 4/5 mm tissue of femoral nerve were observed under microscope and photographs were taken. The fascicles were identified at emergence of NS and NP and mapped/tracked cranially in presence of transformational processes in their pathways. The group of fascicles contributing to these nerves were also mapped cranially up to the top of cropped femoral nerve.
Results: Fascicles 10, 11 and 12 were main contributors to nerve to sartorius. These fascicles underwent 49 transformational processes transforming into fascicles 298, 299, 307, 308 and 309 forming NS in S1 1. Similarly the fascicles 7, 8 and 9 constituted NP having undergone 33 transformational processes forming fascicles 220, 305 and 306 in A24 1 matching with the fascicles of P1 1. The clear picture of pathways of above mentioned fascicles from point of emergence of NS and NP upto top of femoral nerve and vice versa is presented in table Models NP and NS.
Conclusion: The pictures of composite fascicles will revolutionise not only diagnosis and treatment of injured fascicles but also interpretation of MRI along with the identification. The study will add new dimension to future diagnosis and treatment of injured nerve or fascicle.