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Inferior Cluneal Nerves

nervi clunium inferiores

The inferior cluneal nerves arise from the posterior femoral cutaneous nerve (S1-S3) as it exits below the inferior border of the gluteus maximus, curling superiorly to supply the skin over the inferior and medial buttock, including the infra-gluteal fold. They are purely sensory and have no motor function.

Region: Pelvis & Hip

Clinical Relevance

Clinical Notes

The inferior cluneal nerves are at risk during posterior hip approaches (Kocher-Langenbeck, posterior approach for hip arthroplasty) where the lower border of gluteus maximus is elevated. Their injury produces numbness and hypersensitivity at the inferior buttock crease, which patients often find surprising and report as perineal numbness. They are also injured during hamstring origin surgery at the ischial tuberosity. Clinical awareness of these nerves improves patient counselling regarding the sensory deficits that frequently follow posterior hip surgery.

Pathology

Common Injuries & Conditions

Posterior Hip Approach Neuropraxia

Stretch or division of the inferior cluneal nerves during posterior hip arthroplasty or Kocher-Langenbeck approach produces numbness of the inferior buttock, often permanent, for which patients should be counselled preoperatively to set expectations regarding the sensory change.