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Surgical and Radiologic Anatomy

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05.01.2024 | Anatomic Variations

Reappraisal of the anatomical diversities of the pyramidalis muscle with their potential clinical applicability: cadaveric analysis

verfasst von: N. B. Pushpa, Apurba Patra, K. S. Ravi, S. Viveka, K. Pushpalatha, M. C. Smitha

Erschienen in: Surgical and Radiologic Anatomy | Ausgabe 2/2024

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Abstract

Introduction

The present study examined the morphology and morphometric parameters of the pyramidalis muscle (PM) in detail with their potential applicability in making midline infra-umbilical incisions and biomechanics of the linea alba.

Methods

PM was examined in 51 formalin-fixed cadavers (36 males and 15 females), and based on the mode of insertion or the level of apex, the formation or shape of the muscle was classified into nine types (Mori’s classification).

Results

Bilateral PM was more prevalent (39.21%) than unilateral (1.96%) (p = 0.001). All the cases showed side symmetry except one. Mori’s type 7 (right PM is higher apex and the left PM with elongated origin) was the most common form. The mean length of PM in males and females was 4.51 ± 0.14 and 3.33 ± 0.12 cm on the right and 4.51 ± 0.11 and 3.26 ± 0.16 cm on the left side. The mean width of right-sided PMs in males and females was 1.90 ± 0.17 and 1.58 ± 0.13 cm and left-sided 1.88 ± 0.14 and 1.55 ± 0.38 cm. The mean of pyramidalis–pubo-umbilical index (PPI) in males and females was 32.82 ± 1.65 and 27.50 ± 1.08, respectively. The mean insertion angle was 24.56 ± 3.07 on right side and 23 ± 2.03 on the left side (p = 0.03). Male predominance existed on right- and left-sided PM length (p < 0.001 and p < 0.001), width (p = 0.001) and PPI (p = 0.001). The strong positive correlation (r = 0.83) between length and width indicates a symmetrical muscle augmentation in the two dimensions.

Conclusion

PM is an inconsistent anatomical structure with persistent morphology. The level and angle of insertion into the linea are crucial in the biomechanics of linea alba. PPI, determining the termination level would be useful to surgeons making midline infra-umbilical incisions.

Adachi B (1909) Beiträge zur Anatomie der Japaner. XII. Die Statistik der Muskelvarietäten. Z Für Morphol Anthropol 12:261–312

Ancel P (1901) Documents receuillies à la salle de dissection de la Fac. de Médecine de Nancy. Bibliogr Anatom 9:133–160

Chang C (1955) Some observations on the pyramidalis muscle. Acta Anat Sin 6. https://pesquisa.bvsalud.org/portal/resource/pt/wpr-560852

Cirocchi R, Cheruiyot I, Henry BM et al (2021) Anatomical variations of the pyramidalis muscle: a systematic review and meta-analysis. Surg Radiol Anat 43(4):595–605CrossRefPubMed

Das SS, Saluja S, Vasudeva N (2017) Biometrics of pyramidalis muscle and its clinical importance. J Clin Diagn Res. https://doi.org/10.7860/JCDR/2017/24179.9276CrossRefPubMedPubMedCentral

Deeken CR, Lake SP (2017) Mechanical properties of the abdominal wall and biomaterials utilized for hernia repair. J Mech Behav Biomed Mater 74:411–427. https://doi.org/10.1016/j.jmbbm.2017.05.008CrossRefPubMed

Dickson MJ (1999) The pyramidalis muscle. J Obstet Gynaecol 9(3):300. https://doi.org/10.1080/01443619965138CrossRef

Didia B, Loveday O, Christian I (2009) Variation and frequency of agenesis of the pyramidalis muscles in Nigerian males. J Exp Clin Anat. https://doi.org/10.4314/jeca.v8i1.48031CrossRef

Garvey JF (2012) Computed tomography scan diagnosis of occult groin hernia. Hernia 2012:307–314. https://doi.org/10.1007/s10029-011-0899-5CrossRef

10.

Goss CM (1948) Fasciae and muscles of the abdomen. Gray’s anatomy, 29th edn. Lea & Febiger, Philadelphia, pp 424–427

11.

Haba D, Emura K, Watanabe Y et al (2018) Constant existence of the sensory branch of the nerve to the pyramidalis distributing to the upper margin of the pubic ramus. Anat Sci Int 93(4):405–413. https://doi.org/10.1007/s12565-018-0428-zCrossRefPubMed

12.

Hojaij FC, Kogima RO, Moyses RA (2020) Morphometry and frequency of the pyramidalis muscle in adult humans: a pyramidalis muscle’s anatomical analysis. Clinics (Sao Paulo) 75:e1623. https://doi.org/10.6061/clinics/2020/e1623CrossRefPubMed

13.

Jeong W, Lee S, Kim J (2018) Meta-analysis of flap perfusion and donor site complications for breast reconstruction using pedicled versus free TRAM and DIEP flaps. Breast 38:45–51. https://doi.org/10.1016/j.breast.2017.12.003CrossRefPubMed

14.

Kaur H, Singla RK, Brar RS et al (2016) Study of the morphometry of the pyramidalis muscle and its incidence in the Indian population. Int J Anat Res 4(2):2207–2211. https://doi.org/10.16965/ijar.2016.179CrossRef

15.

Kipkorir V, Olabu B, Ongeti K et al (2021) Prevalence and pubo-umbilical index of pyramidalis muscle in a select Kenyan population. Surg Radiol Anat 43(9):1461–1466. https://doi.org/10.1007/s00276-021-02733-6CrossRefPubMed

16.

Koulouris G (2008) Imaging review of groin pain in elite athletes: an anatomic approach to imaging findings. AJR Am J Roentgenol 191:962–972. https://doi.org/10.2214/AJR.07.3410CrossRefPubMed

17.

Landuyt KV, Hamdi M, Blondeel P, Monstrey S (2003) The pyramidalis muscle free flap. Br J Plast Surg 56:585–592. https://doi.org/10.1016/s0007-1226(03)00211-xCrossRefPubMed

18.

Le Double AF (1897) Traité des Variations du Système Musculaire de l’Homme et de Leur Signification au Point de vue de l’Anthropologie, Zoologique, vol 2. Scheicher Frères, Paris

19.

Loth E (1919) Anthropomorphologie des muscles. Bull Mem Soc Anthropol Paris 10(1):116–133CrossRef

20.

Lovering RM, Anderson LD (2008) Architecture and fiber type of the pyramidalis muscle. Anat Sci Int 83(4):294–297. https://doi.org/10.1111/j.1447-073X.2007.00226.xCrossRefPubMedPubMedCentral

21.

Malcic Gürbüz J, Özdoğmuş Ö, Yüksel M (2001) Unusual rectus abdominis and pyramidalis muscles: clinical significance-a case report. Marmara Med J 14(2):107–109

22.

Matushima H (1927) Beitrage zur Muskelvarietaten. Kliniker Klinik Bd 4:34–37 (cited by Mori)

23.

Michalska A, Rokita W, Wolder D, Pogorzelska J, Kaczmarczyk K (2018) Diastasis recti abdominis—a review of treatment methods. Ginekol Pol 89(2):97–101. https://doi.org/10.5603/GP.a2018.0016CrossRefPubMed

24.

Montagu AMF (1939) Anthropological significance of the musculus pyramidalis and its variability in man. Am J Physical Anthopol 15:435–490CrossRef

25.

Mori M (1964) Statistics on the musculature of the Japanese. Okajimas Folia Anat Jpn 40:195–300. https://doi.org/10.2535/ofaj1936.40.3_195CrossRefPubMed

26.

Natsis K, Piagkou M, Repousi E et al (2016) Morphometric variability of pyramidalis muscle and its clinical significance. Surg Radiol Anat 38(3):285–292. https://doi.org/10.1007/s00276-015-1550-4CrossRefPubMed

27.

Poth EJ (1960) A basic concept in the use of the rectus-pyramidalis sheath and transplants in the repair of hernias. Surg Gynecol Obstet 111:514–516PubMed

28.

Ranjan R, Taru M, Lakshmi S (2014) Pyramidalis muscle variations pattern study: qualitative study. Ind J Basic and Appl Med Res 4(1):541–543

29.

Schilders E, Bharam S, Golan E et al (2017) The pyramidalis-anterior pubic ligament-adductor longus complex (PLAC) and its role with adductor injuries: a new anatomical concept. Knee Surg Sports Traumatol Arthrosc 25(12):3969–3977. https://doi.org/10.1007/s00167-017-4688-2CrossRefPubMedPubMedCentral

30.

Skandalakis L, Skandalakis J (eds) (2014) Surgical anatomy and technique a pocket manual, 4th edn. Springer-Verlag, New York, p p113

31.

Skręt-Magierło J, Soja P et al (2015) Two techniques of pyramidalis muscle dissection in Pfannenstiel incision for cesarean section. Ginekol Pol 86(7):509–513. https://doi.org/10.17772/gp/57840CrossRefPubMed

32.

Standring S, Borley NR, Gray H (2008) Gray’s anatomy: the anatomical basis of clinical practice, 40th edn. Elsevier, Edinburgh

33.

Sumalatha S, Rao S, Ankolekar VH (2022) prevalence and variations of the pyramidalis muscle in adults and fetuses: relevance and clinical implications. J Pharm Negat Results 3(10):197–204. https://doi.org/10.47750/pnr.2022.13.S10.18CrossRef

34.

Sumino Y, Hirata Y, Hanada M, Akita Y, Sato F, Mimata H (2011) Long-term cryopreservation of pyramidalis muscle specimens as a source of striated muscle stem cells for treatment of post-prostatectomy stress urinary incontinence. Prostate 71(11):1225–1230. https://doi.org/10.1002/pros.21338CrossRefPubMed

35.

Tokita K (2006) Anatomical significance of the nerve to the pyramidalis muscle: a morphological study. Anat Sci Int 81(4):210–224. https://doi.org/10.1111/j.1447-073X.2006.00148.xCrossRefPubMed

36.

Tomita A (1937–1939) Study on the M. pyramidalis. Kyushu Igakusenmongakko Igakkai Zasshi (Cited by Mori)

37.

Vadgaonkar R, Prameela MD, Murlimanju BV et al (2018) Morphometric study of the semitendinosus muscle and its neurovascular pedicles in South Indian cadavers. Anat Cell Biol 51(1):1–6. https://doi.org/10.5115/acb.2018.51.1.1CrossRefPubMedPubMedCentral

38.

Vallois HV (1926) Valeur et signification du muscle pyramidal de l’abdomen. Arch Anat Histol Embryol 5:497–525

39.

Wagenseil F (1927) Muskelbefunde bei Chinesen. Verh Ges Phys Anthrop Anthropol Anz Stuttgart 2:42–50

Titel: Reappraisal of the anatomical diversities of the pyramidalis muscle with their potential clinical applicability: cadaveric analysis
verfasst von: N. B. Pushpa
Apurba Patra
K. S. Ravi
S. Viveka
K. Pushpalatha
M. C. Smitha
Publikationsdatum: 05.01.2024
Verlag: Springer Paris
Erschienen in: Surgical and Radiologic Anatomy / Ausgabe 2/2024
Print ISSN: 0930-1038
Elektronische ISSN: 1279-8517
DOI: https://doi.org/10.1007/s00276-023-03278-6

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Reappraisal of the anatomical diversities of the pyramidalis muscle with their potential clinical applicability: cadaveric analysis

Abstract

Introduction

Methods

Results

Conclusion

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Springer Medizin

Abstract

Introduction

Methods

Results

Conclusion

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