Turkish neurosurgery最新文献

{"title":"Advantages and Limitations of Zero-Profile Spacers in the Treatment of Cervical Spinal Cord Injury Without Fracture or Dislocation: A 5-Year Retrospective Analysis.","authors":"Ling Wang, Aoting Wang, Qiang Xu, Ding Li, Yi Liu, Dehong Feng, Junfang Wang, Yu Guo","doi":"10.5137/1019-5149.JTN.48791-25.2","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.48791-25.2","url":null,"abstract":"<p><strong>Aim: </strong>Treatment options for cervical spinal cord injury without fracture or dislocation (CSCIWFD) remain varied. Although zero-profile spacers are widely used in degenerative cervical conditions, their long-term efficacy in CSCIWFD is underexplored. This study compared the five-year outcomes of zero-profile spacers and plate-cage constructs in CSCIWFD.</p><p><strong>Material and methods: </strong>A retrospective review was conducted on patients undergoing anterior cervical discectomy and fusion (ACDF) for CSCIWFD using zero-profile spacers (n=46) (ZP group) or plate-cage constructs (n=59) (PC group) between June 2014 and December 2019. Neurological function was assessed using the American Spinal Injury Association Impairment Scale (AIS), motor score (AMS), and Japanese Orthopaedic Association (JOA) score. Radiographic parameters included intervertebral height (IH), cervical lordosis, adjacent segment degeneration (ASD), and fusion rate.</p><p><strong>Results: </strong>The ZP group had shorter operative times and less blood loss than the PC group (P 0.05). Both groups showed comparable neurological improvement. Postoperative IH and cervical lordosis were restored in both groups but declined over time, with greater decline in the ZP group (IH loss: 31.12% vs. 16.38%; cervical lordosis loss: 40.20% vs. 14.98%, P 0.05). The incidence of early and moderate-to-severe dysphagia was significantly lower in the ZP group. Subsidence occurred in 5 of 78 levels in the ZP group and in 1 of 106 levels in the PC group (P 0.05). ASD was observed in 6 ZP vs. 14 PC patients (P 0.05). Both groups achieved complete fusion.</p><p><strong>Conclusion: </strong>In the long-term follow-up of ACDF for CSCIWFD, zero-profile spacers demonstrated comparable clinical outcomes to plate-cage constructs. While offering advantages like shorter surgical time, reduced intraoperative blood loss, and a lower incidence of ASD, zero-profile spacers had significantly greater loss of correction for IH and cervical lordosis. Surgeons must carefully weigh these risks and benefits when selecting the optimal treatment for CSCIWFD.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144839656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Posterior Dynamic/Semi-Rigid Stabilization as an Effective Treatment for Cervical Spinal Stenosis.","authors":"Kemal Paksoy, Idris Avci, Salim Senturk, Onur Yaman, Ali Fahir Ozer","doi":"10.5137/1019-5149.JTN.45158-23.3","DOIUrl":"10.5137/1019-5149.JTN.45158-23.3","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the short- term results of dynamic/semi-rigid stabilization in patients with cervical spinal stenosis and compare them with patients for which decompression and pos-terior cervical fusion was performed.</p><p><strong>Material and methods: </strong>28 patients were included in this study. Group 1 was the semi-rigid group (four male, ten female), group 2 was the fusion group (nine male, five female). We compared the clinical status of the patients pre-operatively, first and twelfth month post-operatively using the Visual Analog Scale (VAS) and Neck Disability Index (NDI). Also radiologically, the pre-operative and on the postoperative first and twelfth month, cervical sagittal vertical axis (cSVA), cervical lordosis (C0-2) (C2-7) and T1 slope were measured.</p><p><strong>Results: </strong>Our results showed that there was a significant improvement on the VAS and NDI score after semi-rigid and fusion surgery (p < 0.001). Also the cervical lordosis was obtained in both groups (p=0.033). Although, no significant differences was found between both groups regarding the change of variables over time between post-operative first and twelfth month.</p><p><strong>Conclusion: </strong>Although, posterior dynamic stabilization has been previously used in thoracic and lumbar pathologies before, there is no crucial evidence about their effects in cervical stenosis. This study states, that semi-rigid instrumentation is as effective in clinical and radiologic out-comes as posterior fusion surgery in periods of one year. Also, the lower risk of adjacent-segment disease and pseudoarthrosis and preservation of cervical sagittal alignment are the main advantages of the new method.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"112-119"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prognostic Utility of Albumin-to-gamma-Glutamyltransferase Ratio in Patients with High-Grade Glioma and the Development of a Nomogram for Overall Survival.","authors":"Yunlong Pei, Haixiao Jiang, Enpeng Zhang, Lun Dong, Yan Dai","doi":"10.5137/1019-5149.JTN.46130-23.2","DOIUrl":"10.5137/1019-5149.JTN.46130-23.2","url":null,"abstract":"<p><strong>Aim: </strong>To assess the prognostic utility of the albumin-to-gamma-glutamyltransferase ratio (AGR) in patients with high-grade glioma [World Health Organization (WHO) grade III and IV] and to develop a predictive nomogram.</p><p><strong>Material and methods: </strong>Data from 185 patients diagnosed with high-grade gliomas, who underwent surgical treatment between March 2013 and December 2022, were retrospectively analysed. Patients were randomly divided into training and validation cohorts. The nomogram was developed using multivariate Cox regression analysis according to selected risk factors using least absolute shrinkage and selection operator (i.e., ?LASSO?) regression. The area under the receiver operating characteristic curve, calibration curve, and C-index were used to assess the performance of the prediction model.</p><p><strong>Results: </strong>This study included data from 185 patients; six independent risk factors were identified and used to generate a prognostic nomogram: WHO grade, body mass index (BMI), smoking, platelet (PLT) count, fibrinogen (FIB) level, and AGR. The nomogram demonstrated considerable prognostic consistency and discrimination. The prognostic utility of AGR was identified in patients with glioma [hazard ratio 0.7876 (95% confidence interval 0.6471?0.9585); p=0.0172].</p><p><strong>Conclusion: </strong>AGR was found to be a potential risk factor for predicting overall survival in patients with glioma after surgery. The nomogram integrated WHO grade, BMI, smoking status, PLT count, and FIB level. AGR provided clinical guidance for surgeons to predict survival rates in patients with glioma.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"34-45"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143019258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of Subaxial Cervical Spine Injury with Unilateral Locked Facet: An Institutional Experience.","authors":"Gyani Birua, A R Prabhuraj, Gaurav Tyagi, Manish Beniwal, Dwarakanath Srinivas","doi":"10.5137/1019-5149.JTN.46843-24.4","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.46843-24.4","url":null,"abstract":"<p><strong>Aim: </strong>To describe a series of 31 surgically managed cases in a single center.</p><p><strong>Material and methods: </strong>We retrospectively collected data from 31 surgically managed cases that occurred between October 2014 and July 2019. We used the PubMed database to conduct a systematic literature search.</p><p><strong>Results: </strong>Out of 31 patients, 24 (77.4%) were male and seven (22.6%) were female, with a male-to-female ratio of 3.42:1. The mean age of injury was 45.81 years (range: 25?67 years). In 20 (64.51%) cases, the mode of injury was a fall, followed by a road traffic accident (RTA) in nine (29.03%) cases. The average duration from trauma to admission in the hospital was 8.13 days (range: 0?63 days), and the average duration of hospital stay was 13.03 days (range: 2?36 days). The most commonly involved vertebral level was C5?C6, affecting 16 (51.6%) cases. In 22 (70.96%) cases, closed reduction was achieved, while in nine (29.03%) cases, the reduction was achieved by open reduction. Of the 31 cases, 22 (70.96%) were managed by the anterior approach only, whereas seven were managed by the combined approach.</p><p><strong>Conclusion: </strong>Subaxial cervical spine subluxation with a unilateral locked facet is an unstable injury; it should be managed surgically. For single-level subluxation with a unilateral locked facet, fixation and fusion from the anterior approach alone are sufficient if the closed reduction is achieved. In case of failed closed reduction, fixation and fusion using the anterior approach alone are sufficient after completing an open reduction from the posterior approach.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"35 3","pages":"403-411"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Atlantoaxial Intra-Articular Fusion on Cervical Spine Curvature and Sagittal Balance.","authors":"Ji Wu, Yang Li, Xiaolin Li, Fei Chen, Zhenji Xu, Yiyang Ding, Bin Ni, Xuhua Lu, Qunfeng Guo","doi":"10.5137/1019-5149.JTN.46421-24.2","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.46421-24.2","url":null,"abstract":"<p><strong>Aim: </strong>To investigate whether atlantoaxial intra-articular fusion (AIF) can maintain sagittal balance stability in the cervical spine during follow-up.</p><p><strong>Material and methods: </strong>The data of 39 patients with anterior atlantoaxial dislocation who underwent AIF and 21 patients who underwent structural bone grafting (SBG) fusion were retrospectively reviewed. Radiographic variables, including T1 slope (T1S), C1?C2 angle, C2?C7 angle, C2?C7 sagittal vertical axis (SVA), and lateral atlantoaxial joint space height (LAAJSH), were measured preoperatively, postoperatively, and at the last follow-up. Analyzing the differences in cervical spine curvature and sagittal balance during the preoperative, postoperative, and follow-up periods, as well as identifying the influencing factors.</p><p><strong>Results: </strong>In the AIF Group, compared to the preoperative measurements, there was a statistically significant increase in both the C1?C2 angle (p < 0.001) and LAAJSH (p < 0.001) at the final follow-up, while a significant decrease was observed in the C2?C7 angle (p < 0.001). At the final follow-up, there was a decrease in LAAJSH compared to immediately post-surgery (p < 0.001), but there were no significant changes in the C1?C2 angle (p=0.366), C2?C7 angle (p=0.502), T1S (p=0.082) and C2?C7 SVA (p=0.209).</p><p><strong>Conclusion: </strong>Posterior AIF technique can effectively reconstruct the alignment of the atlantoaxial complex and avoid secondary imbalance and loss of lordosis of the subaxial cervical spine.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"35 3","pages":"388-394"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Non-Root Exit Zone Exploration during Facial Nerve Microvascular Decompression: A Discussion of the Pathogenesis in Atypical Cases of Hemifacial Spasm.","authors":"Gaochao Song, Yuanyang Wu, Qi Yao, Guiping Ni, Jianhong Shen","doi":"10.5137/1019-5149.JTN.46394-24.2","DOIUrl":"10.5137/1019-5149.JTN.46394-24.2","url":null,"abstract":"<p><strong>Aim: </strong>To summarise atypical cases of hemifacial spasm (HFS) found during microvascular decompression (MVD), and to investigate its pathogenesis and range of exploration.</p><p><strong>Material and methods: </strong>We retrospectively analysed cases of HFS performed in our department in recent years and summarised the intraoperative electrophysiological monitoring findings, vascular and nerve exploration, and postoperative symptoms. We then discussed the pathogenesis of and treatment for atypical HFS.</p><p><strong>Results: </strong>In total, 85 cases of facial nerve MVD were performed in the past 3 years, of which 77 (90.6%) were responsible factors in the root exit zone (REZ) and eight (9.4%) in the non-REZ. For patients without vascular compression of the REZ, the compression factors outside the REZ were separated, and the arachnoid band around the facial nerve was released; subsequently, the amplitude of the abnormal muscle response of the facial nerve diminished or disappeared. Facial twitch symptoms disappeared or improved significantly after surgery. Most symptoms disappeared after 3 months of postoperative follow-up.</p><p><strong>Conclusion: </strong>Factors responsible for non-REZ observed during MVD of the facial nerve are not rare. It is suggested that fulllength exploration should be performed during facial nerve MVD under electrophysiological monitoring.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"587-591"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144512946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Prognostic Value of Serum ET-1, MCP-1, and Lactic Acid Levels in Patients with Ruptured Intracranial Aneurysm After Interventional Embolization.","authors":"Heng Lin, Zhuang Bin Liao, Qing Wang Yu, Tao Wen, Zi Xiong Huang","doi":"10.5137/1019-5149.JTN.45960-24.3","DOIUrl":"10.5137/1019-5149.JTN.45960-24.3","url":null,"abstract":"<p><strong>Aim: </strong>To evaluate the prognostic value of serum endothelin-1 (ET-1), monocyte chemotactic protein-1 (MCP-1), and lactic acid (LA) levels in patients with ruptured intracranial aneurysm (IA) after interventional embolization.</p><p><strong>Material and methods: </strong>Patients with ruptured IA were divided into mild, moderate, and severe groups according to Hunt-Hess grades, and the correlation between serum parameters and disease severity was analyzed. Multivariate logistic regression was employed to analyze the influence of serum ET-1, MCP-1, and LA levels on the prognosis of patients, and ROC curves were plotted to analyze the predictive value of these parameters.</p><p><strong>Results: </strong>There were 29 cases in the mild group (grade ?), 49 cases in the moderate group (grade ?-?), and 25 cases in the severe group (grade ?-?). In the severe group, serum ET-1, MCP-1, and LA were elevated compared to the moderate and mild groups, with the moderate group showing higher levels than the mild group. Serum ET-1, MCP-1, and LA levels were positively correlated with the severity of IA (p < 0.05). The Hunt-Hess grade, Fisher grade, and serum ET-1, MCP-1, and LA levels in patients with poor prognosis were higher than those with good prognosis. Hunt-Hess grade ?-?, Fisher grade 3 to 4, ET-1 ? 41.78 pg/mL, MCP-1 ? 229.05 ng/L, and LA ? 7.13 mmol/L were risk factors affecting the prognosis of patients after interventional embolization. The AUC values of serum ET-1, MCP-1, and LA levels to evaluate the prognosis of patients were 0.772, 0.871, and 0.791, respectively.</p><p><strong>Conclusion: </strong>Serum ET-1, MCP-1, and LA levels correlate with disease severity in patients with ruptured IA and have predictive values for the prognosis of patients after interventional embolization. They are risk factors for poor prognosis of patients after interventional embolization.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":" ","pages":"742-748"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genetic Characterization of Turkish Patients with Pituitary Neuroendocrine Tumors.","authors":"Ceren Alavanda, Ozcan Sonmez, Bilgen Bilge Geckinli, Fatih Bayrakli, Ahmet Ilter Guney","doi":"10.5137/1019-5149.JTN.45761-23.2","DOIUrl":"10.5137/1019-5149.JTN.45761-23.2","url":null,"abstract":"<p><strong>Aim: </strong>To examine the genetic results of patients diagnosed with pituitary neuroendocrine tumors (PitNETs) with respect to clinical, radiological, and pathological findings.</p><p><strong>Material and methods: </strong>A total of 53 patients (30 men and 23 women) diagnosed with PitNETs were included in the study. The clinical findings, family history, imaging, and pathology results were recorded. The DNA was isolated from the peripheral blood. A customized panel test with the highest number of genes (28 genes associated with PitNET) found in the literature was used. Sequencing was conducted using the next-generation sequencing method, and the variants were analyzed according to current guidelines.</p><p><strong>Results: </strong>A total of 22 variants were identified in 20 patients, two of which were determined to be pathogenic. Pathogenic variants were detected in AIP (c.468+1G > A) and MEN1 (c.1102_1104del) genes, which showed the most common pathogenic variant. Variants of unknown clinical significance were most frequently detected in the MSH6, RET, and CDH23 genes.</p><p><strong>Conclusion: </strong>Although the number of studies that conducted multigene testing in patients with PitNETs is limited, all studies, including ours, have shown that the patient?s age at diagnosis and family history are the most important determinants of germline variant detection.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"35 2","pages":"319-320"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigation of Clinical, Surgical, and Histopathological Findings of Pediatric Intracranial Meningiomas: A Single-Center Study.","authors":"Eldaniz Mammadli, Can Kivrak, Mustafa Sakar, Kadriye Ebru Akar, Suheyla Bozkurt, Adnan Dagcinar","doi":"10.5137/1019-5149.JTN.46861-24.2","DOIUrl":"https://doi.org/10.5137/1019-5149.JTN.46861-24.2","url":null,"abstract":"<p><strong>Aim: </strong>To report a series of pediatric intracranial meningiomas operated in a single institution, and to compare their features with the literature.</p><p><strong>Material and methods: </strong>Using our hospital?s automation system, patients under the age of 18 who had been operated in the last 11 years were identified. Data from these patients were collected and compared with the literature.</p><p><strong>Results: </strong>The mean age was 7.9 years old. Of the 10 patients, 8 (80%) were males, 2 were females (20%). The most common symptoms were cranial nerve palsies. When all MR and CT images were evaluated, peritumoral oedema was observed in 6 of the patients (60%), dural tail in 7 patients (70%), bone destruction in 3 patients (30%), and intratumoral calcification in 2 patients (20%). Histopathological diagnosis was made according to the World Health Organisation classification (2021) into grades 1, 2, and 3. Three patients (30%) had a typical meningioma (grade 1), and 7 patients (70%) had an atypical type (grade 2). Recurrence occurred in one of four patients with residual tumours.</p><p><strong>Conclusion: </strong>Subtle and careful surgical approaches are the main treatment option and postoperative prognosis for pediatric meningiomas. Contrary to previous studies, the association of meningiomas with radiation exposure and NF was not common in our series. Further research is needed to understand the reasons for the differences between the pathophysiology of pediatric meningiomas and the adult form to ensure successful treatment.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"35 3","pages":"429-438"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144153148","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Anatomical Variation to Consider for a Safe Carpal Tunnel Surgery: Transverse Carpal Muscle.","authors":"Saygi Uygur, Tolga Akbiyik, Ayse Esin Polat, Celal Bagdatoglu","doi":"10.5137/1019-5149.JTN.46709-24.2","DOIUrl":"10.5137/1019-5149.JTN.46709-24.2","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the incidence of transverse carpal muscle (TCM) occurrence around carpal tunnel which may lead to carpal tunnel syndrome (CTS), and cause disorientation of surgeons during the surgery.</p><p><strong>Material and methods: </strong>We reviewed patients in our department between January 2007 and March 2021 to identify those who underwent surgical treatment for CTS. A total of 62 carpal tunnel release surgeries were investigated, and the frequency of TCM occurrence was evaluated.</p><p><strong>Results: </strong>There were 3 (4.8%) accessory TCM overlying transverse carpal ligament (TCL). All variations occurred in the left hand of the patients. Of the three cases, two were female and one was male.</p><p><strong>Conclusion: </strong>There is currently insufficient evidence in the literature to suggest that TCM is causing CTS. To further investigate the origin of these muscles, cadaveric dissections should be performed. Even if this variation isn?t causing CTS, especially during minimal invasive surgeries, this variation should be kept in mind to not lose orientation.</p>","PeriodicalId":94381,"journal":{"name":"Turkish neurosurgery","volume":"35 2","pages":"233-236"},"PeriodicalIF":0.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}