Poutoglidou Frideriki, Piagkou Maria, Totlis Trifon, Tzika Maria, Natsis Konstantinos
Orthopaedics, Aristotle University of Thessaloniki, Thessaloniki, GRC.
Anatomy and Surgical Anatomy, National and Kapodistrian University of Athens, Athens, GRC.
Cureus. 2020 Nov 17;12(11):e11531. doi: 10.7759/cureus.11531.
The present systematic review and meta-analysis provides a comprehensive assessment of the sciatic nerve (SN) variants relative to the piriformis muscle (PM) and compares those variants' prevalence among different geographical populations with respect to gender and laterality. A database search was conducted to identify cadaveric studies pertinent to SN variants relative to the PM. A total of 44 articles were included. The typical morphological pattern (type A, with the SN passing undivided below the PM) was found to be the most common variant, with 90% pooled prevalence. SN variants were more common among East Asians, with a 31% pooled prevalence of total variants. No significant differences were established with respect to gender and laterality. In greater than 10% of the population, the SN coursed through or above piriformis. Patients' epidemiological characteristics may predispose them to certain variants. The common peroneal nerve (CPN) is more susceptible to injury during a total hip arthroplasty or a hip arthroscopy where anomalies are encountered. As anatomical variants are commonly associated with piriformis syndrome, they should always be considered during diagnosis and treatment.
本系统评价和荟萃分析全面评估了坐骨神经（SN）相对于梨状肌（PM）的变异情况，并比较了这些变异在不同地理人群中按性别和左右侧别的患病率。通过数据库检索来识别与SN相对于PM的变异相关的尸体研究。共纳入44篇文章。发现典型的形态模式（A型，坐骨神经在梨状肌下方完整通过）是最常见的变异，合并患病率为90%。SN变异在东亚人中更为常见，总变异的合并患病率为31%。在性别和左右侧别方面未发现显著差异。在超过10%的人群中，坐骨神经穿过梨状肌或在其上方走行。患者的流行病学特征可能使他们易出现某些变异。在全髋关节置换术或髋关节镜检查中遇到异常情况时，腓总神经（CPN）更容易受到损伤。由于解剖变异通常与梨状肌综合征相关，在诊断和治疗过程中应始终予以考虑。
