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Iliohypogastric Nerve Lumbar Origin

nervus iliohypogastricus (origo lumbalis)

The iliohypogastric nerve arises from the L1 nerve root (with a contribution from T12) as the most superior branch of the lumbar plexus, emerging from the lateral border of psoas major and running anterior to the quadratus lumborum. At this lumbar level it is vulnerable to injury during retroperitoneal and posterior lumbar approaches before it reaches the anterior abdominal wall.

Region: Lower Back

Clinical Relevance

Clinical Notes

The iliohypogastric nerve at its lumbar origin is at risk during posterior lumbar surgery, LLIF approaches, and retroperitoneal dissection for lumbar vascular procedures. Injury produces groin and suprapubic pain and numbness in the upper inguinal and hypogastric skin territories. It must be distinguished from L1 radiculopathy at the disc level. Iliohypogastric nerve block at the posterior iliac spine targets the nerve proximal to its abdominal wall branching.

Pathology

Common Injuries & Conditions

Iliohypogastric Nerve Injury at Lumbar Level

Traction or compression of the iliohypogastric nerve during retroperitoneal lumbar surgery producing groin pain and suprapubic numbness, managed with nerve hydrodissection or decompression.