Dual Innervation to the Gluteus Maximus: A Case Report with Clinical Implications

Abstract

Anatomical variations of the gluteus maximus have significant clinical implications. The gluteus muscle is commonly innervated by the Inferior Gluteal Nerve (IGN). However, this innervation could be affected by its embryological development. An anomalous innervation of the gluteus maximus by the Sciatic Nerve (SN) was identified during a bilateral dissection of the gluteal region. Dissection was performed on an elderly female cadaver, preserved with 10% formalin, and performed following the guidelines given in Grant’s Dissector 16th edition. The left and right gluteus maximus were innervated by their corresponding IGN. However, both demonstrated an additional innervation by the SN. This branch by the SN was located proximal to the IGN and emerged near the inferior border of the piriformis muscle. Patients with dual gluteus maximus innervation can present with clinical signs and symptoms which might be easily misdiagnosed. Therefore, physicians need to be aware of this abnormal innervation to accurately diagnose and avoid potential iatrogenic nerve injuries during interventions.

Keywords

• botulinum toxin
• inferior gluteal nerve
• muscle relaxants
• piriform syndrome
• sciatic nerve