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The lumbar plexus block is an advanced technique indicated for hip, anterior thigh, and knee surgery. [54] The lumbar plexus is composed of nerves originating from L1 to L4 spinal roots such as the iliohypogastric, ilioinguinal, genitofemoral, lateral femoral cutaneous, femoral, and obturator nerves. [54]
The lumbar plexus is a web of nerves (a nerve plexus) in the lumbar region of the body which forms part of the larger lumbosacral plexus. It is formed by the divisions of the first four lumbar nerves (L1-L4) and from contributions of the subcostal nerve (T12), which is the last thoracic nerve .
The different types of neurolysis include celiac plexus neurolysis, endoscopic ultrasound guided neurolysis, and lumbar sympathetic neurolysis. Chemodenervation and nerve blocks are also associated with neurolysis. Additionally, there is external neurolysis. Peripheral nerves move (glide) across bones and muscles.
The obturator nerve is responsible for the sensory innervation of the skin of the medial aspect of the thigh.. The nerve is also responsible for the motor innervation of the adductor muscles of the lower limb (external obturator, [4] adductor longus, adductor brevis, adductor magnus, gracilis) and the pectineus (inconstant).
The lateral cutaneous nerve of the thigh is a nerve of the lumbar plexus. [ 2 ] [ 1 ] It arises from the anterior rami of the second and third lumbar nerves (L2-L3). [ 2 ] [ 3 ]
The lateral cutaneous branch ("iliac branch") pierces the internal oblique muscles and the external oblique muscles immediately above the iliac crest. [4] It is distributed to the skin of the gluteal region, behind the lateral cutaneous branch of the subcostal nerve; the size of this branch bears an inverse proportion to that of the lateral cutaneous branch of the subcostal nerve.
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