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Updated: Sep 17, 2025

Transtubular Endoscopic Posterolateral Decompression for L5-S1 Lumbar Lateral Disc Herniation
Published on: October 14, 2022
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.
Case:
A 44-year-old woman presented with radiculopathy due to pinching of the L5 nerve between enlarged transverse process (TP) and sacral ala in lumbosacral transitional vertebra (LSTV) (far-out syndrome). On failure of conservative treatment, the patient underwent posterolateral full-endoscopic extraforaminal decompression under local anesthesia. Under endoscopic visualization, the enlarged TP was seen stenosing the extraforaminal area. A high-speed diamond burr was used to drill the TP. Following bony decompression, the perineural soft tissue in the extraforaminal region was dissected to decompress the nerve adequately. Symptoms resolved completely after surgery.
Conclusion:
Posterolateral full-endoscopic extraforaminal decompression is a less invasive, safe, and effective surgical option for far-out syndrome due to LSTV.

