The Superior Hypogastric Plexus and its Surgical Implications During Spine Surgery: A Review.

Document Type


Publication Date



autonomic nervous system; hypogastric nerves; pelvic pain; superior hypogastric plexus; superior hypogastric plexus block; Denervation; Humans; Hypogastric Plexus/injuries; Hypogastric Plexus/pathology; Hypogastric Plexus/physiopathology; Intraoperative Complications/etiology; Intraoperative Complications/prevention & control; Lumbar Vertebrae/innervation; Lumbar Vertebrae/surgery; Pelvic Pain/surgery; Postoperative Complications/etiology; Postoperative Complications/prevention & control; Sacrum/innervation; Sacrum/surgery; Spinal Diseases/surgery


The superior hypogastric plexus (SHP) is a complex nervous collection located at the lumbosacral region below the level of the aortic bifurcation. As a part of the autonomic nervous system, it is an extension of the preaortic plexuses and continues bilaterally as the hypogastric nerves that ultimately contribute to the inferior hypogastric plexus. Although commonly described as a plexiform structure, several morphological variations exist. Damage to the SHP can occur during anterior and anterolateral approaches to the lumbosacral spine leading to dysfunction of the abdominopelvic viscera. Visceral afferents travel in the SHP and are responsible for transmitting pain. Management therapies such as SHP blockade or presacral neurectomy can reduce pelvic pain due to cancer and nonmalignant etiologies. This review highlights some of the recent findings regarding the nature of the SHP.

Clinical Institute

Neurosciences (Brain & Spine)