What are the spinal nerve root contributions of the sacral plexus nerves: sciatic, superior gluteal, inferior gluteal, posterior femoral cutaneous, and pudendal?

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Raíces Nerviosas del Plexo Sacro

El plexo sacro se forma por las ramas ventrales de las raíces espinales L4-S4, y sus nervios terminales tienen las siguientes contribuciones radiculares específicas:

Nervio Ciático

  • Raíces: L4-S3 1
  • Es la rama terminal más grande del plexo sacro 1
  • Sale de la pelvis a través del foramen ciático mayor, típicamente pasando por debajo del músculo piriforme 1
  • Proporciona inervación motora y sensorial a los territorios de los nervios peroneo y tibial 1

Nervio Glúteo Superior

  • Raíces: L4-S1 (contribución predominante del plexo sacro) 2, 1
  • Proporciona inervación motora exclusiva a la región glútea 1
  • No tiene componente sensorial 1

Nervio Glúteo Inferior

  • Raíces: L5-S2 (contribución del plexo sacro) 2, 1
  • Inerva la musculatura de la región glútea 1
  • Función exclusivamente motora 1

Nervio Cutáneo Femoral Posterior

  • Raíces: S1-S3 (contribución predominante del plexo sacro) 2, 1
  • Proporciona inervación sensorial a la cara posterior del muslo 1
  • No tiene función motora 1

Nervio Pudendo

  • Raíces: S2-S4 (contribución del plexo sacro) 2, 1
  • El nivel de origen depende del tipo de plexo individual 3
  • Proporciona inervación sensorial y motora a la región perineal 2

Consideraciones Anatómicas Importantes

Tronco Lumbosacro:

  • Formado por contribuciones de L4-L5 2, 1
  • Conecta el plexo lumbar con el plexo sacro 2
  • Puede presentar variaciones en grosor; en 19% de los casos está engrosado, y en 11% la contribución de L4 es más gruesa que L5 3

Variaciones Anatómicas Comunes:

  • La raíz L5 puede tener ascenso doble desde el foramen intervertebral en 25% de los casos 3
  • La raíz S1 puede tener ascenso doble desde los forámenes sacros en 16% de los casos 3
  • El nivel de fusión entre L4 y L5 puede ocurrir por encima, a nivel, o por debajo de la parte más anterior de la articulación sacroilíaca 4
  • La fusión de las raíces S1 y S2 a nivel de la parte más inferior de la articulación sacroilíaca ocurre en 10% de los casos 4

Implicaciones Clínicas

Plexopatía Sacra Completa:

  • Produce debilidad, pérdida sensorial y pérdida de reflejos tendinosos en los segmentos espinales L5-S3 1
  • Afecta los territorios motores glúteos y las distribuciones de los nervios peroneo y tibial 1
  • El diagnóstico clínico se confirma mediante estudios electrodiagnósticos 1

Evaluación por Imagen:

  • La resonancia magnética del plexo lumbosacro es la modalidad preferida, con calificación 9/9 del American College of Radiology 5
  • El protocolo óptimo incluye planos coronales directos y axiales directos para evaluar todos los componentes del plexo sacro 6
  • Debe incluir secuencias T1, T2 y T2 con supresión grasa en planos ortogonales y oblicuos 2, 5

References

1
Guideline

Anatomy and Clinical Implications of the Sacral Plexus

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

2
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

3
Research

Anatomical variations of lumbosacral plexus.

Surgical and radiologic anatomy : SRA, 2010

4
Research

Anatomy of L4 to S3 nerve roots.

Journal of orthopaedic surgery (Hong Kong), 2010

5
Guideline

Sciatic Nerve Motor and Sensory Innervation, Injury Mechanisms, and Diagnostic Evaluation

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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