Full-Endoscopic Extraforaminal Decompression for Far-Out Syndrome Due to Lumbosacral Transitional Vertebra: A Technical Note.

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.