Surgical Anatomy of the Lumbar Plexus

Thorough knowledge of the lumbar plexus and its branches is crucial to achieving positive patient outcomes, especially with newer surgical approaches. Many of the nerve branches are formed within the psoas major muscle and careful dissection is necessary to free them during surgery to prevent damage. Moreover, the iliac vessels are medial to some of the larger branches of the plexus, such as the femoral and obturator nerves. In the retroperitoneal space, the kidney and ureter are nearby. In addition, due to the overlying peritoneal cavity and its contents, accessing the lumbar plexus presents considerable challenges.