Anatomical Detail and Accuracy of the Pernkopf Atlas and Examples of Clinical Impact.

Abstract

The high fidelity anatomical structural detail seen in the Pernkopf atlas remains unmatched in other references, including surgical anatomy atlases. An example of serial dissection illustrations are examined herein, in relation to an anatomically based clinical question. The question is about radiofrequency nerve ablation, an image-guided procedure that provides a non-opioid alternative to treat joint pain. To perform these image-guided procedures effectively, the location and course of the nerve(s) being targeted is very important. Although the patient had good pain relief, the clinician was concerned about the patient's loss of sensation around the anus following an ablation procedure of the nerves innervating the sacroiliac joint, and asked for more information about the clunial nerves and their relevance to this procedure. The anatomical illustrations in the Pernkopf atlas are highly detailed and drawn from serially dissected specimens from the skin superficially to the level of the origin of the nerves from the vertebral column deeply. Tracing the clunial nerves through five serial illustrations provided the necessary anatomical insight required to answer this clinical question for development of the ablation procedure. This atlas could play a significant role in educating future clinicians and surgeons and provide answers to anatomically related clinical quandaries. However, the atlas must always be used by first acknowledging its origins and history.