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Anatomical variations of the pyramidalis muscle: a systematic review and meta-analysis

  • Anatomic Variations
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Surgical and Radiologic Anatomy Aims and scope Submit manuscript

Abstract

Purpose

To provide a comprehensive evidence-based assessment of the anatomical characteristics of the pyramidalis muscle (PM).

Materials and methods

A thorough systematic search of the literature through August 31st 2020 was conducted on major electronic databases PubMed, Scopus and Web of Science (WOS) to identify studies eligible for inclusion. Data were extracted and pooled into a meta-analysis using MetaFor package in R and MetaXL. A random-effects model was applied. The primary outcome of interest was the prevalence of PM. The secondary outcomes were the dimensions (length and width) of the PM.

Results

A total of 11 studies (n = 787 patients; 1548 sides) were included in the meta-analysis. The multinomial pooled prevalence estimate (PPE) for a bilateral absence of the PM was 11.3% (95% CI [7.2%, 16.2%], 82.3% (95% CI [76.2%, 87.6%]) for a bilateral presence, and 6.3% (95% CI [3.3%, 10.2%]) for a unilateral presence. Of four studies (n = 37 patients) that reported the side of a unilateral presence, the PPE of a unilateral right-side presence was 42.2% (95% CI [23.0%, 62.3%]) compared to 57.8% for a unilateral left-side presence (95% CI [37.7%, 77.0%]). The mean length of the PM displayed high levels of heterogeneity, ranging from 3.12 to 12.50 cm.

Conclusion

The pyramidalis muscle is a rather constant anatomical structure being present in approximately 90% of individuals.

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Notes

  1. QM refers to a statistic measuring the omnibus statistical significance of the moderators.

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Funding

None was sought for this study.

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Authors and Affiliations

  1. Department of Surgical Science, University of Perugia, Piazza dell’Universitá, 1, 06123, Perugia, PG, Italy

    Roberto Cirocchi & Sara Gioia

  2. Department of Human Anatomy, University of Nairobi, P.O. Box 30197, 00100, Nairobi, Kenya

    Isaac Cheruiyot, Brandon Michael Henry & Vincent Kipkorir

  3. International Evidence-Based Anatomy Working Group, 12 Kopernika St., 31-034, Krakow, Poland

    Isaac Cheruiyot

  4. Cincinnati Children’s Hospital Medical Center, 3333 Burnet Ave, Cincinnati, OH, 45229, USA

    Brandon Michael Henry

  5. Department of Human Anatomy, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185, Rome, RM, Italy

    Marco Artico

  6. Department of General Surgery, Sapienza University of Rome, Piazzale Aldo Moro, 5, 00185, Rome, RM, Italy

    Piergaspare Palumbo & Vito D’Andrea

  7. Georgia Baptist College of Nursing, Mercer University, 3001 Mercer University Drive, Atlanta, GA, 30341, USA

    Justus Randolph

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  1. Roberto Cirocchi
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Contributions

Protocol/project development: RC. Data collection or management: RC, IC. Data analysis: RC, IC, JR. Manuscript writing/editing: all authors.

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Correspondence to Isaac Cheruiyot.

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Cirocchi, R., Cheruiyot, I., Henry, B.M. et al. Anatomical variations of the pyramidalis muscle: a systematic review and meta-analysis. Surg Radiol Anat 43, 595–605 (2021). https://doi.org/10.1007/s00276-020-02622-4

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  • DOI: https://doi.org/10.1007/s00276-020-02622-4

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