The effect of obesity on the anatomical relationship of the popliteal artery and tibial nerve in the proximal and distal popliteal fossa: relevance to popliteal sciatic nerve block and a traceback technique using the popliteal artery

Glenn Woodworth, Jason Trujillo, Erik Foss, Michael Semenza

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Study Objective To determine the effect of body mass index (BMI) on the relationship of the popliteal artery to the sciatic and tibial nerves in the popliteal fossa. Design Prospective, observational study. Setting University medical center. Subjects One hundred patients scheduled for magnetic resonance imaging scans of the knee. Measurements BMI was recorded and magnetic resonance imaging scans were assessed at 3 different measurement points along the femur for the distance and angle between the popliteal artery and tibial nerve, or sciatic nerve if the sciatic nerve had not bifurcated at the measurement point. Main Results At the distal femur, the tibial nerve was a mean of 2.9 mm from the popliteal artery. The nerve was consistently posterior to the artery; however, it was variably located medial or lateral to the artery. At the 5- and 8-cm measurement points, the nerve was 10.0 and 16.1 mm (SD, 4.1 and 5.2 mm), and 31° and 44° (SD, 15° and 16°) lateral to the popliteal artery, respectively. Zero degree was defined as directly posterior to the artery. Increasing BMI was correlated with increasing distance between the nerve and the artery at the 5- and 8-cm measurement points (r= 0.36 P> |t| .000 and .45 P> |t| .002). Conclusions At 5 cm proximal to the distal femoral condyles, the popliteal artery is a reliable sonographic landmark to locate the tibial nerve due to the close proximity and consistent location of the nerve 1 cm posterolateral to the artery, with only a moderate effect of BMI.

Original languageEnglish (US)
Pages (from-to)540-546
Number of pages7
JournalJournal of Clinical Anesthesia
Volume34
DOIs
StatePublished - Nov 1 2016

Fingerprint

Popliteal Artery
Tibial Nerve
Nerve Block
Sciatic Nerve
Arteries
Obesity
Body Mass Index
Femur
Magnetic Resonance Imaging
Thigh
Observational Studies
Knee
Prospective Studies
Bone and Bones

Keywords

  • Popliteal artery
  • Sciatic nerve

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

@article{f00724ec33fd4422be2e3ccea9776e50,
title = "The effect of obesity on the anatomical relationship of the popliteal artery and tibial nerve in the proximal and distal popliteal fossa: relevance to popliteal sciatic nerve block and a traceback technique using the popliteal artery",
abstract = "Study Objective To determine the effect of body mass index (BMI) on the relationship of the popliteal artery to the sciatic and tibial nerves in the popliteal fossa. Design Prospective, observational study. Setting University medical center. Subjects One hundred patients scheduled for magnetic resonance imaging scans of the knee. Measurements BMI was recorded and magnetic resonance imaging scans were assessed at 3 different measurement points along the femur for the distance and angle between the popliteal artery and tibial nerve, or sciatic nerve if the sciatic nerve had not bifurcated at the measurement point. Main Results At the distal femur, the tibial nerve was a mean of 2.9 mm from the popliteal artery. The nerve was consistently posterior to the artery; however, it was variably located medial or lateral to the artery. At the 5- and 8-cm measurement points, the nerve was 10.0 and 16.1 mm (SD, 4.1 and 5.2 mm), and 31° and 44° (SD, 15° and 16°) lateral to the popliteal artery, respectively. Zero degree was defined as directly posterior to the artery. Increasing BMI was correlated with increasing distance between the nerve and the artery at the 5- and 8-cm measurement points (r= 0.36 P> |t| .000 and .45 P> |t| .002). Conclusions At 5 cm proximal to the distal femoral condyles, the popliteal artery is a reliable sonographic landmark to locate the tibial nerve due to the close proximity and consistent location of the nerve 1 cm posterolateral to the artery, with only a moderate effect of BMI.",
keywords = "Popliteal artery, Sciatic nerve",
author = "Glenn Woodworth and Jason Trujillo and Erik Foss and Michael Semenza",
year = "2016",
month = "11",
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doi = "10.1016/j.jclinane.2016.06.020",
language = "English (US)",
volume = "34",
pages = "540--546",
journal = "Journal of Clinical Anesthesia",
issn = "0952-8180",
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TY - JOUR

T1 - The effect of obesity on the anatomical relationship of the popliteal artery and tibial nerve in the proximal and distal popliteal fossa

T2 - relevance to popliteal sciatic nerve block and a traceback technique using the popliteal artery

AU - Woodworth, Glenn

AU - Trujillo, Jason

AU - Foss, Erik

AU - Semenza, Michael

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Study Objective To determine the effect of body mass index (BMI) on the relationship of the popliteal artery to the sciatic and tibial nerves in the popliteal fossa. Design Prospective, observational study. Setting University medical center. Subjects One hundred patients scheduled for magnetic resonance imaging scans of the knee. Measurements BMI was recorded and magnetic resonance imaging scans were assessed at 3 different measurement points along the femur for the distance and angle between the popliteal artery and tibial nerve, or sciatic nerve if the sciatic nerve had not bifurcated at the measurement point. Main Results At the distal femur, the tibial nerve was a mean of 2.9 mm from the popliteal artery. The nerve was consistently posterior to the artery; however, it was variably located medial or lateral to the artery. At the 5- and 8-cm measurement points, the nerve was 10.0 and 16.1 mm (SD, 4.1 and 5.2 mm), and 31° and 44° (SD, 15° and 16°) lateral to the popliteal artery, respectively. Zero degree was defined as directly posterior to the artery. Increasing BMI was correlated with increasing distance between the nerve and the artery at the 5- and 8-cm measurement points (r= 0.36 P> |t| .000 and .45 P> |t| .002). Conclusions At 5 cm proximal to the distal femoral condyles, the popliteal artery is a reliable sonographic landmark to locate the tibial nerve due to the close proximity and consistent location of the nerve 1 cm posterolateral to the artery, with only a moderate effect of BMI.

AB - Study Objective To determine the effect of body mass index (BMI) on the relationship of the popliteal artery to the sciatic and tibial nerves in the popliteal fossa. Design Prospective, observational study. Setting University medical center. Subjects One hundred patients scheduled for magnetic resonance imaging scans of the knee. Measurements BMI was recorded and magnetic resonance imaging scans were assessed at 3 different measurement points along the femur for the distance and angle between the popliteal artery and tibial nerve, or sciatic nerve if the sciatic nerve had not bifurcated at the measurement point. Main Results At the distal femur, the tibial nerve was a mean of 2.9 mm from the popliteal artery. The nerve was consistently posterior to the artery; however, it was variably located medial or lateral to the artery. At the 5- and 8-cm measurement points, the nerve was 10.0 and 16.1 mm (SD, 4.1 and 5.2 mm), and 31° and 44° (SD, 15° and 16°) lateral to the popliteal artery, respectively. Zero degree was defined as directly posterior to the artery. Increasing BMI was correlated with increasing distance between the nerve and the artery at the 5- and 8-cm measurement points (r= 0.36 P> |t| .000 and .45 P> |t| .002). Conclusions At 5 cm proximal to the distal femoral condyles, the popliteal artery is a reliable sonographic landmark to locate the tibial nerve due to the close proximity and consistent location of the nerve 1 cm posterolateral to the artery, with only a moderate effect of BMI.

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