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Valenzuela-Fuenzalida JJ, Inostroza-Wegner A, Osorio-Muñoz F, Milos-Brandenberg D, Santana-Machuca A, Nova Baeza P, Donoso MO, Bruna-Mejias A, Iwanaga J, Sanchis-Gimeno J, Gutierrez-Espinoza H. The Association between Anatomical Variants of Musculoskeletal Structures and Nerve Compressions of the Lower Limb: A Systematic Review and Meta-Analysis. Diagnostics (Basel) 2024; 14:695. [PMID: 38611609 PMCID: PMC11011940 DOI: 10.3390/diagnostics14070695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 03/14/2024] [Accepted: 03/21/2024] [Indexed: 04/14/2024] Open
Abstract
Objective: The aim of this study was to describe the main anatomical variants and morphofunctional alterations in the lower limb that compress surrounding nervous structures in the gluteal region, thigh region, and leg and foot region. Methods: We searched the Medline, Scopus, Web of Science, Google Scholar, CINAHL, and LILACS databases from their inception up to October 2023. An assurance tool for anatomical studies (AQUA) was used to evaluate methodological quality, and the Joanna Briggs Institute assessment tool for case reports was also used. Forest plots were generated to assess the prevalence of variants of the gluteal region, thigh, and leg. Results: According to the forest plot of the gluteal region, the prevalence was 0.18 (0.14-0.23), with a heterogeneity of 93.52%. For the thigh region, the forest plot presented a prevalence of 0.10 (0.03-0.17) and a heterogeneity of 91.18%. The forest plot of the leg region was based on seven studies, which presented a prevalence of 0.01 (0.01-0.01) and a heterogeneity of 96.18%. Conclusions: This review and meta-analysis showed that, in studies that analyzed nerve compressions, the prevalence was low in the thigh and leg regions, while in the gluteal region, it was slightly higher. This is mainly due to the PM region and its different variants. We believe that it is important to analyze all the variant regions defined in this study and that surgeons treating the lower limb should be attentive to these possible scenarios so that they can anticipate possible surgical situations and thus avoid surgical complications.
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Affiliation(s)
- Juan José Valenzuela-Fuenzalida
- Department of Morphology and Function, Faculty of Health Sciences, Universidad De Las Américas, Santiago 7500000, Chile; (J.J.V.-F.); (A.S.-M.)
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8320000, Chile; (A.I.-W.); (F.O.-M.); (P.N.B.); (M.O.D.); (A.B.-M.)
| | - Alfredo Inostroza-Wegner
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8320000, Chile; (A.I.-W.); (F.O.-M.); (P.N.B.); (M.O.D.); (A.B.-M.)
| | - Francisca Osorio-Muñoz
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8320000, Chile; (A.I.-W.); (F.O.-M.); (P.N.B.); (M.O.D.); (A.B.-M.)
| | - Daniel Milos-Brandenberg
- Escuela de Medicina, Facultad Ciencias de la Salud, Universidad del Alba, Santiago 8320000, Chile;
| | - Andres Santana-Machuca
- Department of Morphology and Function, Faculty of Health Sciences, Universidad De Las Américas, Santiago 7500000, Chile; (J.J.V.-F.); (A.S.-M.)
| | - Pablo Nova Baeza
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8320000, Chile; (A.I.-W.); (F.O.-M.); (P.N.B.); (M.O.D.); (A.B.-M.)
| | - Mathias Orellana Donoso
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8320000, Chile; (A.I.-W.); (F.O.-M.); (P.N.B.); (M.O.D.); (A.B.-M.)
- Escuela de Medicina, Universidad Finis Terrae, Santiago 7501015, Chile
| | - Alejandro Bruna-Mejias
- Departament de Morfología, Facultad de Medicina, Universidad Andrés Bello, Santiago 8320000, Chile; (A.I.-W.); (F.O.-M.); (P.N.B.); (M.O.D.); (A.B.-M.)
| | - Joe Iwanaga
- Department of Oral and Maxillofacial Anatomy, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan;
- Department of Neurosurgery, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA 70112, USA
- Department of Neurology, Tulane Center for Clinical Neurosciences, Tulane University School of Medicine, New Orleans, LA 70112, USA
- Department of Structural & Cellular Biology, Tulane University School of Medicine, New Orleans, LA 70112, USA
| | - Juan Sanchis-Gimeno
- GIAVAL Research Group, Department of Anatomy and Human Embryology, Faculty of Medicine, University of Valencia, 46001 Valencia, Spain;
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de Ruiter GCW, Oosterhuis JWA, Vissers TFH, Kloet A. Unusual causes for meralgia paresthetica: systematic review of the literature and single center experience. Neurosurg Rev 2023; 46:107. [PMID: 37148363 PMCID: PMC10162905 DOI: 10.1007/s10143-023-02023-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 04/06/2023] [Accepted: 05/01/2023] [Indexed: 05/08/2023]
Abstract
Meralgia paresthetica is often idiopathic, but sometimes symptoms may be caused by traumatic injury to the lateral femoral cutaneous nerve (LFCN) or compression of this nerve by a mass lesion. In this article the literature is reviewed on unusual causes for meralgia paresthetica, including different types of traumatic injury and compression of the LFCN by mass lesions. In addition, the experience from our center with the surgical treatment of unusual causes of meralgia paresthetica is presented. A PubMed search was performed on unusual causes for meralgia paresthetica. Specific attention was paid to factors that may have predisposed to LFCN injury and clues that may have pointed at a mass lesion. Moreover, our own database on all surgically treated cases of meralgia paresthetica between April 2014 and September 2022 was reviewed to identify unusual causes for meralgia paresthetica. A total of 66 articles was identified that reported results on unusual causes for meralgia paresthetica: 37 on traumatic injuries of the LFCN and 29 on compression of the LFCN by mass lesions. Most frequent cause of traumatic injury in the literature was iatrogenic, including different procedures around the anterior superior iliac spine, intra-abdominal procedures and positioning for surgery. In our own surgical database of 187 cases, there were 14 cases of traumatic LFCN injury and 4 cases in which symptoms were related to a mass lesion. It is important to consider traumatic causes or compression by a mass lesion in patients that present with meralgia paresthetica.
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Affiliation(s)
- G C W de Ruiter
- Department of Neurosurgery, Haaglanden Medical Center, Lijnbaan 32, 2501, CK, The Hague, The Netherlands.
| | - J W A Oosterhuis
- Department of Surgery, Haaglanden Medical Center, The Hague, The Netherlands
| | - Th F H Vissers
- Medical Library, Haaglanden Medical Center, The Hague, The Netherlands
| | - A Kloet
- Department of Neurosurgery, Haaglanden Medical Center, Lijnbaan 32, 2501, CK, The Hague, The Netherlands
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