Microendoscopic decompression of conjoined lumbosacral nerve roots

Area of Science:

• Neurosurgery
• Spinal Surgery
• Minimally Invasive Spine Surgery

Background:

• Nerve root anatomical variations can complicate surgical planning and execution.
• Preoperative imaging may not fully reveal complex nerve root morphologies.
• S1 radiculopathy can be refractory to conservative treatments.

Observation:

• A case of a woman in her 50s with refractory left S1 radiculopathy.
• MRI revealed an L5-S1 disc herniation causing lateral recess stenosis.
• Spinal endoscopy identified conjoined lumbosacral nerve roots.

Findings:

• Endoscopic decompression facilitated visualization and manipulation of conjoined nerve roots.
• Laminotomies and discectomy achieved circumferential decompression.
• The patient experienced immediate and sustained relief from radiculopathy.

Implications:

• Spinal endoscopy enhances intraoperative understanding of nerve root anomalies.
• This technique offers novel insights into safe and effective decompressive strategies.
• Evolving endoscopic platforms improve surgical precision for complex spinal pathologies.