Modern concepts of the anatomy of the greater sciatic foramen

Objective: to demonstrate the existence of various morphological variants of neurovascular relationships in Background. The greater sciatic foramen is a region of practical interest to a wide range of specialists due to the numerous nerve trunks that pass through it, which may be subjected to compression in this area or be damaged during invasive medical procedures. Aim. To analyze the sources of literature on the anatomy of the greater sciatic foramen and its related anatomical structures to identify underexplored issues. Materials and Methods. A literature search was conducted in electronic databases (PubMed, Scopus, Web of Science, eLibrary) and monographs available in scientific medical libraries. Inclusion criteria: publications in Russian and English containing original data on the anatomy of the greater sciatic foramen, piriformis muscle, sciatic nerve, and pelvic bones. Search period – 1937–2024. Results. The literature analysis showed that the most studied structure of the greater sciatic foramen is the piriformis muscle. Various classifications of this muscle have been proposed, taking into account the sites of its attachment to the sacrum, the length of its muscle bellies, and the position of the sciatic nerve relative to this muscle. The data presented demonstrate that the question of the influence of the morphology of this muscle on the development of piriformis syndrome remains a topic of discussion and is unresolved. At the same time, the bony structures forming the edges of the sciatic foramen are insufficiently studied. The greater sciatic notch of the pelvic bone shows pronounced sexual dimorphism in size and shape; however, its influence on the parameters of the foramen as a whole is not covered in the literature. Conclusion. There is a need to determine the sizes and shapes of the greater sciatic foramen in relation to the sizes of the piriformis muscle, taking into account individual characteristics of the body (sex, age, anthropometric and ethnic parameters).