The sacrospinous ligament connects the lateral sacrum to the ischial spine, converting the greater sciatic notch into the greater sciatic foramen and, together with the sacrotuberous ligament, creating the lesser sciatic foramen. The pudendal nerve hooks around the ischial spine (the sacrospinous ligament attachment point) as a key anatomical landmark for pudendal nerve block. It is the primary attachment point in sacrospinous colpopexy for pelvic organ prolapse.
| Origin | Lateral sacrum and coccyx |
|---|---|
| Insertion | Ischial spine |
| Actions | Prevents sacral counternutation; together with the sacrotuberous ligament forms the greater and lesser sciatic foramina |
|---|
Sacrospinous colpopexy (vaginal vault suspension to the sacrospinous ligament) is the surgical treatment for vaginal vault prolapse after hysterectomy — sutures placed through the sacrospinous ligament 2 cm medial to the ischial spine suspend the vaginal cuff. The sciatic nerve, inferior gluteal, and pudendal nerves all pass close to the sacrospinous ligament, requiring careful placement to avoid neurovascular injury.
Sacrospinous ligament used as the fixation point for sacrospinous colpopexy to correct vaginal vault prolapse.
