Abstract
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.
Highlights
BackgroundThe sciatic nerve (SN), the longest and widest nerve of the human body, is formed from the L4-S3 ventral roots and normally exits the pelvis, via a single trunk, through the great sciatic foramen below the piriformis muscle (PM)
The current systematic review and meta-analysis was conducted in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines [5]
After exclusion of duplicates (211), articles not in English, and those irrelevant to the objectives of the present systematic review (5,210), 120 publications were retrieved in full text
Summary
The sciatic nerve (SN), the longest and widest nerve of the human body, is formed from the L4-S3 ventral roots and normally exits the pelvis, via a single trunk, through the great sciatic foramen below the piriformis muscle (PM). The SN courses in the posterior thigh compartment and divides into the tibial and the common peroneal trunk at the popliteal fossa. The tibial and common peroneal nerves (TN and CPN) are surrounded by a common epineural sheath into the SN main trunk. Tibial and peroneal fascicular groups are separated by a connective tissue, known as the Compton-Cruveilheir septum [1]. The SN innervates the muscles of the posterior thigh compartment and all the lower leg and foot compartments. Review began 10/25/2020 Review ended 11/05/2020 Published 11/17/2020
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