Location
Suwanee, GA
Start Date
17-4-2026 12:00 PM
End Date
17-4-2026 1:00 PM
Description
INTRODUCTION: Denervation injuries result from an interruption of the neural input necessary for the normal contraction and maintenance of skeletal muscle. Without proper innervation, skeletal muscles atrophy and are replaced by adipose and fibrous tissue. Prolonged denervation can result in gross anatomical changes, such as reduced muscle mass, muscle pallor, and fatty tissue replacement, which are easily observed during dissection of the cadaveric body. This case presents bilateral muscular degeneration of the lower extremities observed in a 98-year-old cadaveric donor.
OBJECTIVES: The primary objectives of this case study are to document the gross anatomical findings associated with chronic denervation in the lower extremities and to describe the distribution of muscular degeneration observed during this particular cadaveric dissection.
METHODS: Routine anatomical dissection was performed in an academic anatomy laboratory. The donor was a 98-year-old individual whose documented cause of death was listed as hypertension without heart failure. Standard dissection techniques were used to expose the musculature of both lower extremities. Following exposure of the skeletal muscle, we performed bilateral evaluation of muscle bulk, coloration, and tissue change. Observations were based solely on gross anatomical findings during dissection and no histological analysis was performed.
RESULTS: Bilateral muscular degeneration with fatty tissue infiltration, consistent with chronic denervation was observed in varying degrees between the right and left lower extremities. In the right lower extremity, the adductor longus, tensor fascia lata, and biceps femoris muscles showed noticeable atrophy with fatty infiltration. The medial aspect of the right gastrocnemius showed significant atrophy and adipose tissue infiltrate, while the lateral aspect showed mild to moderate atrophy and mild adipose tissue infiltrate. The proximal aspect of the right soleus showed degeneration with adipose tissue replacement. In the left lower extremity, more pronounced changes were observed in the posterior thigh musculature. The flexors of the left thigh, including the biceps femoris, semitendinosus, and semimembranosus muscles, showed severe atrophy with fatty and connective tissue infiltration. The gastrocnemius and soleus muscles of the left lower extremity showed atrophic muscle tissue with fatty and connective tissue infiltration.
CONCLUSION: The pattern of muscle degeneration points towards a pattern of chronic denervation involving several peripheral nerves of the lower limb. Several of the muscles, including the biceps femoris, gastrocnemius, and soleus, are innervated by the nerves originating from the sciatic nerve (L4-S3). In addition, the involvement of the tensor fasciae latae and adductor longus points towards the potential dysfunction of the superior gluteal nerves (L4-S1) and the obturator nerves (L2-L4), respectively. The involvement of several muscles innervated by varying peripheral nerves in a bilateral pattern points towards a neuropathic process involving either the lumbosacral plexus or several lumbar and sacral nerve roots. Causes of this could be cauda equina syndrome or spinal stenosis of the lumbar and sacrum. Larger comparative studies would be beneficial in honing in on the patterns of denervation injuries in the lower limb.
Embargo Period
5-29-2026
Included in
Denervation Injuries in the Lower Limbs: A Cadaver-Based Case Study
Suwanee, GA
INTRODUCTION: Denervation injuries result from an interruption of the neural input necessary for the normal contraction and maintenance of skeletal muscle. Without proper innervation, skeletal muscles atrophy and are replaced by adipose and fibrous tissue. Prolonged denervation can result in gross anatomical changes, such as reduced muscle mass, muscle pallor, and fatty tissue replacement, which are easily observed during dissection of the cadaveric body. This case presents bilateral muscular degeneration of the lower extremities observed in a 98-year-old cadaveric donor.
OBJECTIVES: The primary objectives of this case study are to document the gross anatomical findings associated with chronic denervation in the lower extremities and to describe the distribution of muscular degeneration observed during this particular cadaveric dissection.
METHODS: Routine anatomical dissection was performed in an academic anatomy laboratory. The donor was a 98-year-old individual whose documented cause of death was listed as hypertension without heart failure. Standard dissection techniques were used to expose the musculature of both lower extremities. Following exposure of the skeletal muscle, we performed bilateral evaluation of muscle bulk, coloration, and tissue change. Observations were based solely on gross anatomical findings during dissection and no histological analysis was performed.
RESULTS: Bilateral muscular degeneration with fatty tissue infiltration, consistent with chronic denervation was observed in varying degrees between the right and left lower extremities. In the right lower extremity, the adductor longus, tensor fascia lata, and biceps femoris muscles showed noticeable atrophy with fatty infiltration. The medial aspect of the right gastrocnemius showed significant atrophy and adipose tissue infiltrate, while the lateral aspect showed mild to moderate atrophy and mild adipose tissue infiltrate. The proximal aspect of the right soleus showed degeneration with adipose tissue replacement. In the left lower extremity, more pronounced changes were observed in the posterior thigh musculature. The flexors of the left thigh, including the biceps femoris, semitendinosus, and semimembranosus muscles, showed severe atrophy with fatty and connective tissue infiltration. The gastrocnemius and soleus muscles of the left lower extremity showed atrophic muscle tissue with fatty and connective tissue infiltration.
CONCLUSION: The pattern of muscle degeneration points towards a pattern of chronic denervation involving several peripheral nerves of the lower limb. Several of the muscles, including the biceps femoris, gastrocnemius, and soleus, are innervated by the nerves originating from the sciatic nerve (L4-S3). In addition, the involvement of the tensor fasciae latae and adductor longus points towards the potential dysfunction of the superior gluteal nerves (L4-S1) and the obturator nerves (L2-L4), respectively. The involvement of several muscles innervated by varying peripheral nerves in a bilateral pattern points towards a neuropathic process involving either the lumbosacral plexus or several lumbar and sacral nerve roots. Causes of this could be cauda equina syndrome or spinal stenosis of the lumbar and sacrum. Larger comparative studies would be beneficial in honing in on the patterns of denervation injuries in the lower limb.