Morphometry of Latissimus Dorsi in Fetal Cadavers for Prenatal Spina Bifida Surgery

To investigate latissimus dorsi morphometry, innervation, vascularization, and variational situations in fetuses.

Forty-nine fetuses, aged between 15 and 40 weeks of gestation, were examined for the morphological development of the latissimus dorsi. The horizontal lengths of the thoracolumbar fascia, the dimensions of the latissimus dorsi and its tendon were measured. Additionally, the attachments of the latissimus dorsi and the branching pattern of the thoracodorsal nerve were evaluated. The development of all measured parameters during gestational age (trimester) and their interrelationships were assessed. Data were compared across sides (right and left) and genders.

The study found that the increase in all parameters was proportional to gestational age. No significant differences were observed between sides or genders. The latissimus dorsi was directly attached (via muscle fiber) to the iliac crest in 60.2% of cases. An 88.5% attachment rate to the inferior angle of the scapula was noted, with 4.1% of these attachments being muscular. Additionally, 9.8% of latissimus dorsi tendons were found to adhere to the teres major tendon. The thoracodorsal nerve was observed to divide into 2 to 8 branches before entering the latissimus dorsi.

We believe this study will provide valuable insights into the development of intrauterine invasive fetal procedures for tendon, muscle, and nerve transfer repair and assist in determining the most appropriate timing for intervention.