Superior Gluteal Nerve Entrapment

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Anatomy

The superior gluteal nerve is derived from the L4-S1 nerve roots. It passes through the sciatic notch superior to the piriformis muscle. It innervates the gluteus medius, gluteus minimus, and tensor fascia lata muscles. The inferior gluteal nerves on the other hand is derived from the L5-S2 nerve roots and only supplies the gluteus maximus muscle.

Pathophysiology

Injury is usually iatrogenic. The superior gluteal nerve can be injured by an incorrectly placed intramuscular injection. It can also be compressed by pelvic masses for example colorectal cancer or an iliac artery aneurysm.

Clinical Features

Patients have atrophy and weakness of the gluteus medius, minimus, and tensor fascia lata. This manifests as weakness of hip abduction and external rotation. The patient will have a Trendelenburg gait. Physical examination findings may be subtle in milder cases. Inferior gluteal nerve injury by contrast, only results of atrophy of the gluteus maximus, manifesting as weakness of leg extension.

There isn't usually any sensory change, unless there is additional injury to the posterior femoral cutaneous nerve. There may be a deep aching pain, especially in the presence of a pelvic tumour.

Investigations

Electrophysiology studies may be helpful.

Literature Review

Literature Review

Reviews from the last 7 years: review articles, free review articles, systematic reviews, meta-analyses, NCBI Bookshelf

Articles from all years: PubMed search, Google Scholar search.

TRIP Database: clinical publications about evidence-based medicine.

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