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Related Experiment Video

Updated: Sep 17, 2025

Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation
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Full-Endoscopic Extraforaminal Decompression for Far-Out Syndrome Due to Lumbosacral Transitional Vertebra: A

Pratyush Shahi1, Sang-Ha Shin, Sang-Ho Lee

  • 1Department of Neurosurgery, Wooridul Spine Hospital, Seoul, South Korea.

JBJS Case Connector
|July 3, 2025
PubMed
Summary

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Posterolateral Full-Endoscopic Thoracic Foraminotomy for Foraminal Stenosis Causing Radiculopathy: A Report of 3 Cases.

JBJS case connector·2025

A minimally invasive endoscopic surgery effectively treated far-out syndrome caused by lumbosacral transitional vertebrae. This procedure decompressed the L5 nerve, resolving radiculopathy symptoms in a patient who did not respond to conservative care.

Area of Science:

  • Neurosurgery
  • Spinal Surgery
  • Minimally Invasive Procedures

Background:

  • Radiculopathy can arise from nerve impingement due to anatomical variations.
  • Lumbosacral transitional vertebrae (LSTV) can cause far-out syndrome by abnormally positioning bony structures.
  • Conservative treatments may fail for severe nerve compression in the extraforaminal region.

Purpose of the Study:

  • To evaluate the efficacy of posterolateral full-endoscopic extraforaminal decompression for far-out syndrome.
  • To present a case of successful surgical intervention for L5 nerve root compression secondary to LSTV.

Main Methods:

  • A patient with L5 radiculopathy due to LSTV underwent posterolateral full-endoscopic extraforaminal decompression.
  • The procedure was performed under local anesthesia with endoscopic visualization.
Keywords:
Bertolotti syndromeendoscopyextraforaminal decompressionfar-out syndromefull endoscopytransitional anatomy

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  • Enlarged transverse process (TP) was identified and drilled using a high-speed diamond burr, followed by decompression of perineural soft tissues.

    • Main Results:

    • Endoscopic visualization confirmed the enlarged TP was stenosing the extraforaminal space.
    • Surgical decompression of the L5 nerve root was achieved.
    • The patient experienced complete resolution of radiculopathy symptoms post-operatively.

    Conclusions:

    • Posterolateral full-endoscopic extraforaminal decompression is a viable surgical approach for far-out syndrome.
    • This technique offers a less invasive, safe, and effective treatment option.
    • Endoscopic decompression provides adequate relief for nerve root compression caused by LSTV.