The frequency of vertebral artery sulcus ossification, grades III and IV, in patients with Kimmerle’s anomaly: A systematic review and meta-analysis

Lvov I.S.; Lukyanchikov V.A.; Grin A.A.; Alekhin E.E.; Roschin S.Yu.; Talypov A.E.; Ramazanov G.R.; Krylov V.V.

doi:https://doi.org/10.17116/jnevro202212209137

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OBJECTIVE

To conduct a systematic review and meta-analysis to determine the frequency of Kimmerle’s anomaly (KA) in patients with grades III and IV vertebral artery (VA) sulcus ossification.

MATERIAL AND METHODS

We searched the PubMed and eLIBRARY.RU databases, identified 68 articles in English, and obtained data of 29.770 patients. To date, no study in Russia has reported KA. The incidence of KA was determined using single-group meta-analysis. We used odds ratios (OR) to investigate the association between sex and the frequency of KA. Publication bias was assessed using the Egger test.

RESULTS

The pooled prevalence of complete KA was 8.6% (95%, confidence interval (CI) 7.8—9.5%); however, the Egger test confirmed publication bias (t=2.102, p=0.022), which was eliminated by dividing the patient sample by geographic macroregions. The incidence of KA in Europe and Asia was 10.1% and 6.5%, respectively. The pooled prevalence of KA associated with grade III ossification was 7.2% (95% CI 4.9—10.4%). The OR of KA in men vs. women was 1.23 (95% CI 1.098—1.389).

CONCLUSION

The incidence of KA was significantly associated with the macroregion. Nearly 15.8% of the population may show grades III and IV VA sulcus ossification, and surgical treatment is required in some patients. KA formation is more typical for males. A population study is warranted to clarify the frequency of KA in the Russian population.

Keywords:

meta-analysis

Kimmerle’s anomaly

arcuate foramen

ponticulus posticus

frequency of Kimmerle’s anomaly

Authors:

Lvov I.S.

Sklifosovsky Research Institute of Emergency Care

Lukyanchikov V.A.

Sklifosovsky Research Institute for Emergency Care;
Peoples’ Friendship University of Russia

Grin A.A.

Sklifosovsky Research Institute for Emergency Care

ORCID: 0000-0003-3515-8329

Alekhin E.E.

Sklifosovsky Research Institute for Emergency Medicine

Roschin S.Yu.

Sklifosovsky Research Institute for Emergency Medicine

Talypov A.E.

Sklifosovsky Research Institute of Emergenscy Medicine

Ramazanov G.R.

Sklifosovsky Research Institute for Emergency Care

Krylov V.V.

A.I. Evdokimov Moscow State Medical University;
N.V. Sklifosovsky Scientific and Research Institute of Emergency Medicine

SPIN RSCI: 6115-4291
ORCID: 0000-0002-2706-3496

Received:

29.08.2021

Accepted:

05.09.2021

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