• Shogo Kikuta, Joe Iwanaga, Koichi Watanabe, Robert Haładaj, Grzegorz Wysiadecki, Aaron S Dumont, and R Shane Tubbs.
• Dental and Oral Medical Center, Kurume University School of Medicine, Kurume, Fukuoka, Japan.
• World Neurosurg. 2020 Mar 1; 135: e567-e572.

ObjectiveThe sacral dorsal rami form the posterior sacrococcygeal plexus (PSCP), which has been scantly studied. This study's goal was to clarify the PSCP s detailed anatomy and discuss its clinical relevance.MethodsTen sides of 5 fresh-frozen cadavers were dissected for this research. After the muscles covering the sacrum were removed, the PSCP was identified and traced under the operating microscope until the entire plexus was exposed. The contributions to this plexus and its relations to surrounding anatomic structures were recorded.ResultsThe PSCP was found on all sides and was composed of a medial trunk (MT), communicating branches, and a lateral trunk. Each sacral dorsal ramus's MT formed a series of loops created by adjacent sacral dorsal rami placed between the transverse tubercles and the posterior sacral foramina. The MT, communicating branches, and lateral trunk demonstrated potential entrapment sites.ConclusionsTo our knowledge, this is the first anatomic study that provides detailed images that indicate 3 potential sites where surrounding structures could entrap the PSCP. Knowledge of its detailed anatomy might help in better understanding low-back pain, targeting pain sources and guide spine surgeons for avoiding injury to these nerves.Copyright © 2019 Elsevier Inc. All rights reserved.

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