Anatomical variations of the principal nutrient pedicle for iliac crest graft: the ilio-lumbar artery.

PURPOSE: The purpose of this study is to observe the origin, course, length, diameter and termination of the ilio-lumbar artery (ILA) and its variations in south Indian population.

MATERIALS AND METHODS: The study was carried out in 34 sides in 19 cadavers (R-18, L-16) used for routine dissection for undergraduate students during the period of 2017-2018 in Department of Anatomy, JIPMER, Puducherry. On each side of the pelvis, the origin, length, diameter, course of the ILA and its relations to the surrounding anatomical structures was observed and documented.

RESULTS: Out of 34 formalin-fixed pelvis halves of human cadavers, the ILA originated from the common iliac artery (CIA), the trunk of the internal iliac artery (IIA) and posterior division of IIA in around 0%, 61.76%, and 38.23% of the cases, respectively. In all the cadavers, the ILA passes in between the obturator nerve anteriorly and the lumbosacral trunk posteriorly and ILA terminates by giving iliac and lumbar arteries medial to the psoas major muscle.

CONCLUSIONS: In our study, we observed that the mean distance between the origin of ILA and the bifurcation of the CIA is significantly less than the study done previously. The knowledge about the variations in the origin, course, length, diameter, and termination of ILA is very important to the surgeon to avoid iatrogenic injury during surgeries in lumbosacral region and moreover, it will be easy to access the ILA for clamping or embolization. A similar study can be done with more sample size in different population to increase the knowledge base regarding ILA anatomy.