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Volume 46 Number 7, 2009
   Pages 973 — 984

Abstract – Fascicular anatomy of human femoral nerve: Implications for neural prostheses using nerve cuff electrodes

Kenneth J. Gustafson, PhD;1-2* Gilles C. J. Pinault, MD;2-3 Jennifer J. Neville, MD;4 Ishaq Syed, MD;4John A. Davis Jr, MD;5 Jesse Jean-Claude, MD;2-3 Ronald J. Triolo, PhD1-2,5

1Department of Biomedical Engineering, Case Western Reserve University, Cleveland, OH; 2Louis Stokes Cleveland Department of Veterans Affairs Medical Center, Cleveland, OH; 3Department of Surgery, 4School of Medicine, and 5Department of Orthopedics, Case Western Reserve University, Cleveland, OH

Abstract — Clinical interventions to restore standing or stepping by using nerve cuff stimulation require a detailed knowledge of femoral nerve neuroanatomy. We harvested eight femoral nerves with all distal branches and characterized the branching patterns and diameters. The fascicular representation of each distal nerve was identified and traced proximally to create fascicle maps of the compound femoral nerve in four cadaver specimens. Distal nerves were consistently represented as individual fascicles or distinct groups of fascicles in the compound femoral nerve. Branch-free length of the compound femoral nerve was 1.50 +/- 0.47 cm (mean +/- standard deviation). Compound femoral nerve cross sections were noncircular with major and minor diameters of 10.50 +/- 1.52 mm and 2.30 +/- 0.63 mm, respectively. In vivo intraoperative measurements in six subjects were consistent with cadaver results. Selective stimulation of individual muscles innervated by the femoral nerve may therefore be possible with a single neural prosthesis able to selectively stimulate individual groups of fascicles.

Key words: fascical map, femoral nerve, functional electrical stimulation, nerve cuff electrode, nerve morphology, neuro-anatomy, rehabilitation, spinal cord injury, standing, surgical anatomy.

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