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Lateral Sacral Arteries

arteriae sacrales laterales

The lateral sacral arteries arise from the posterior division of the internal iliac artery and descend anterior to the piriformis to enter the anterior sacral foramina, supplying the sacral nerve roots, the sacral spinal cord covering, and the posterior pelvic wall. They anastomose with the median sacral artery and with the lumbar arteries to form the sacral arterial network.

Region: Pelvis & Hip

Clinical Relevance

Clinical Notes

The lateral sacral arteries are encountered during posterior pelvic approaches, sacral fixation procedures, and sacrectomy. In transpedicular screw fixation of S1 and sacral nerve root decompression, the lateral sacral arteries may be at risk when the anterior sacral cortex is violated. In partial sacrectomy for chordoma or primary sacral tumours, the lateral sacral arteries define the vascular limit of tumour extent and must be individually ligated to achieve haemostasis during en bloc resection. The arteries are responsible for the vascular supply of presacral neurofibroma.

Pathology

Common Injuries & Conditions

Lateral Sacral Artery Haemorrhage in Sacrectomy

Partial or total sacrectomy for primary sacral tumours encounters the lateral sacral arteries at each sacral foraminal level; failure to pre-operatively embolise these vessels or to individually ligate them during surgery produces major haemorrhage from the rich sacral vascular network that is difficult to control in the confined presacral operative field.