ABSTRACT
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.
