Prevalence of Variations of Lumbar Plexus in the Cadavers of the South Gujarat Region

Background: Anatomical variations are common, benign, and result from embryological development errors. Variations in the lumbar plexus matter when injuries or entrapments occur due to trauma or surgery. Objectives: This study assessed the prevalence of anatomical variations in the lumbar plexus nerves in South Gujarat (India) cadavers. Results were compared to previous findings, and clinical implications were discussed. Material and methods: The study was done on 23 formalin-embalmed human cadavers (46 lumbar plexuses) donated to the department of anatomy, Surat Municipal Institute of Medical Education & Research (SMIMER) over a period of 3 years. The variations in the formation, course and branching patterns of the lumbar plexuses were observed and their course and relationship to the ilio-psoas muscles, if any, were photographed and documented. Results: Our study identified that 69.56% of lumbar plexuses examined showed at least one anatomical variation. Specifically, we found absence of the iliohypogastric nerve in 10.86% of cases, genitofemoral nerve variations in 39.13%, lateral femoral cutaneous nerve variations in 15.21%, and femoral nerve rootlet and branching variations in 32.60%. Postfixed plexuses were present in 13.04%, the accessory obturator nerve in 13.04%, and the psoas minor muscle in 17.37%. These findings highlight the diversity and frequency of anatomical variations in the lumbar plexuses of the South Gujarat cadaver population. Conclusion: Knowledge of variations prevailing in the demography of the South Gujarat region will help the surgeons, orthopaedics, or anaesthetists working in this area to access them during posterior abdominal wall surgeries and lumbar plexus block to avoid iatrogenic injuries. KEY WORDS: Lumbar Plexus variations, Ilioinguinal Nerve, Iliohypogastric Nerve, Femoral Nerve, Obturator Nerve, Lateral Femoral Cutaneous Nerve, Genitofemoral Nerve, Accessory Obturator Nerve.