Superior Gluteal Cutaneous Nerves

Origin

There are three superior gluteal cutaneous nerves, or superior cluneal nerves, which innervate the skin of the upper part of the buttocks. These are the terminal ends of the lateral branches of the posterior rami of lumbar spinal nerves L1—L3. The medial superior gluteal cutaneous nerve originates from L1, the intermediate superior gluteal cutaneous nerve ordinates from L2, and the lateral superior gluteal cutaneous nerve originates from L3 (Tubbs et al., 2010).

Course

The superior gluteal cutaneous nerves pass through the psoas major and paraspinal muscles. They are located just posterior to the quadratus lumborum, in the plane between this muscle and the anterior layer of thoracolumbar fascia. The nerves either pierce the thoracolumbar fascia or pass through an orifice in the fascia cephalad to the level of the iliac crest. These nerves then cross over the iliac crest as they run parallel and behind other nerves, such as lateral cutaneous branches of the subcostal and the iliohypogastric nerves.

Branches

The superior gluteal cutaneous nerves arising from L1 and L2 gives rise to intermediate branches of the posterior rami of the lumbar nerves, which supply the lumbar fibers of the longissimus thoracis muscle (Bogduk, Wilson and Tynan, 1982).

Supplied Structures

The superior gluteal cutaneous nerves serve as the sensory innervation of the areas over the posterior iliac crest and the upper buttock (overlying the upper half of gluteus maximus and medius muscles). The lateral superior gluteal cutaneous nerve often extends distally to the level of the greater trochanter of the femur.

List of Clinical Correlates

—Posterior iliac crest harvesting procedure

—Cluneal neuralgia (Talu, Ozyalcin and Talu, 2000)

References

Bogduk, N., Wilson, A. S. and Tynan, W. (1982) 'The human lumbar dorsal rami', J Anat, 134(Pt 2), pp. 383-97.

Talu, G. K., Ozyalcin, S. and Talu, U. (2000) 'Superior cluneal nerve entrapment', Reg Anesth Pain Med, 25(6), pp. 648-50.

Tubbs, R. S., Levin, M. R., Loukas, M., Potts, E. A. and Cohen-Gadol, A. A. (2010) 'Anatomy and landmarks for the superior and middle cluneal nerves: application to posterior iliac crest harvest and entrapment syndromes', J Neurosurg Spine, 13(3), pp. 356-9.