A Three-Headed Piriformis Muscle With Splitting of the Common Fibular Nerve

Although the division of the piriformis muscle by the sciatic nerve or its branches is fairly common, other anatomical variations of this muscle are relatively uncommon. Here, we present a cadaveric case found to have an atypical composition of the piriformis muscle. During the routine dissection of the right gluteal region in an adult male cadaver, an unusual finding of the piriformis muscle was observed. Three distinct heads of the muscle were identified. In addition, one of these heads split the common fibular nerve. The anatomy and relationships of this case are presented here. Any variation in neurovasculature and musculature can be relevant for diagnosing or surgically intervening in the gluteal region. The present case is apparently unique and of archival value.

[1]  P. Pękala,et al.  A three-headed piriformis muscle: an anatomical case study and narrative review of literature. , 2022, Folia Morphologica.

[2]  J. G. Alexander,et al.  The absence of piriformis muscle, combined muscular fusion, and neurovascular variation in the gluteal region , 2021, Autopsy & case reports.

[3]  M. Piagkou,et al.  Sciatic Nerve Variants and the Piriformis Muscle: A Systematic Review and Meta-Analysis , 2020, Cureus.

[4]  R. Tubbs,et al.  The majority of piriformis muscles are innervated by the superior gluteal nerve , 2019, Clinical anatomy.

[5]  E. Brenner,et al.  Case report: absence of the right piriformis muscle in a woman , 2019, Surgical and Radiologic Anatomy.

[6]  C. Beaulieu,et al.  Is it painful to be different? Sciatic nerve anatomical variants on MRI and their relationship to piriformis syndrome , 2018, European Radiology.

[7]  James C. Anderson.  Common Fibular Nerve Compression: Anatomy, Symptoms, Clinical Evaluation, and Surgical Decompression. , 2016, Clinics in podiatric medicine and surgery.

[8]  L. Pérez-Carro,et al.  Deep gluteal syndrome: anatomy, imaging, and management of sciatic nerve entrapments in the subgluteal space , 2015, Skeletal Radiology.

[9]  D. K. Satpathi,et al.  clinical importance of anatomical variants of sciatic nerve in relation to the piriformis muscle , 2012 .

[10]  S. H. Lee,et al.  Piriformis Muscle: Clinical Anatomy with Computed Tomography in Korean Population , 2011, The Korean journal of pain.

[11]  N. Smoll.  Variations of the piriformis and sciatic nerve with clinical consequence: A review , 2010, Clinical anatomy.

[12]  G. Windisch,et al.  Piriformis muscle: clinical anatomy and consideration of the piriformis Syndrome , 2007, Surgical and Radiologic Anatomy.

[13]  S. Anselmi.  Common peroneal nerve compression. , 2006, Journal of the American Podiatric Medical Association.

[14]  M. Porta.  A comparative trial of botulinum toxin type A and methylprednisolone for the treatment of myofascial pain syndrome and pain from chronic muscle spasm , 2000, Pain.

[15]  S. Schutzer,et al.  Myositis ossificans of the piriformis muscle: an unusual cause of piriformis syndrome. A case report. , 1997, The Journal of bone and joint surgery. American volume.

[16]  B. Anson,et al.  THE SCIATIC NERVE AND THE PIRIFORMIS MUSCLE: THEIR INTERRELATION A POSSIBLE CAUSE OF COCCYGODYNIA , 1938 .

[17]  D. Hunt,et al.  Piriformis Syndrome: A Narrative Review of the Anatomy, Diagnosis, and Treatment , 2019, PM & R : the journal of injury, function, and rehabilitation.

[18]  S. Herdman.  Functional Anatomy of the Limbs and Back , 1977 .