What is the course of the posterior femoral cutaneous nerve (PFCN)?

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From the Research

The posterior femoral cutaneous nerve arises from the sacral plexus and descends along the posterior thigh, providing sensory innervation to the skin of the lower buttock, posterior thigh, and upper posterior calf, as confirmed by the most recent study in 2023 1. The course of the posterior femoral cutaneous nerve is crucial to understand, especially in the context of posterior thigh pain, as compression or injury to this nerve can result in sensory deficits in the areas it supplies.

  • The nerve emerges from the pelvis through the greater sciatic foramen below the piriformis muscle, alongside the sciatic nerve.
  • It then descends beneath the gluteus maximus muscle along the posterior thigh, running between the biceps femoris and semitendinosus muscles.
  • The posterior femoral cutaneous nerve provides sensory innervation to the skin of the lower buttock, posterior thigh, and upper posterior calf, and also gives off perineal branches that supply the skin of the perineum and external genitalia.
  • This nerve is purely sensory and contains no motor fibers, making its preservation critical during surgical approaches to the posterior thigh or gluteal region to prevent postoperative sensory complications, as highlighted in the study published in Skeletal Radiology in 2015 2. The most recent study in 2023 1 provides the most up-to-date information on the origin, course, and distribution of the posterior femoral cutaneous nerve, making it the primary reference for understanding the course of this nerve.
  • The study found that the nerve descends lateral to the ischial tuberosity and comprises the thigh, gluteal, and perineal branches.
  • The dorsoventral order of the branches originating from the sacral plexus corresponds to the lateromedial order of their distribution.
  • The perineal branch originates from the ventral branch of the nerve roots, and the pudendal nerve branches run medially to the ischial tuberosity, distributing in the medial part of the inferior gluteal region.

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