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Sonographic imaging of the sciatic nerve division in the popliteal fossa
U Schwemmer1, C K Markus, C A Greim
1Department of Anesthesiology, University Hospital Wuerzburg, Germany. Schwemmer_U@klinik.uni-wuerzburg.de
Background:
We studied the anatomy of the sciatic nerve and its division into the tibial and peroneal part using handheld ultrasound in adults. We wanted to evaluate the feasibility of ultrasound-guided identification of the sciatic nerve in the popliteal fossa and the correlation of the findings by ultrasound with patients' characteristics.
Methods:
74 volunteers were randomly selected. Using a handheld ultrasound system with a 5-10 MHz linear array probe the popliteal fossa and the back of the thigh were examined and measured. Using a caliper the distance of the joint line to the nerve division was measured. The sciatic nerve and its division were depicted by ultrasound.
Results:
We could depict the sciatic nerve in all volunteers and its division in 53 of 74 (72%) volunteers. The position of nerve division showed large anatomic variation. A significant correlation between the width of the knee-joint line and the depth of the nerve division could be demonstrated. We conclude that handheld ultrasound is able to depict the sciatic nerves division. To block the nerve by one injection a more proximal access or visualization by mobile ultrasound is recommended. In addition the surrounding anatomic structures can be depicted as well.
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