{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,30]],"date-time":"2026-05-30T02:52:09Z","timestamp":1780109529000,"version":"3.54.0"},"reference-count":25,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,3,2]]},"published-print":{"date-parts":[[2022,3]]},"abstract":"<jats:p>Nerve root morphological variability is often incompletely appreciated on preoperative imaging and can complicate intraoperative decision-making. This case demonstrates the utility of spinal endoscopy in the visualisation and manipulation of conjoined nerve roots and includes procedural images to promote better understanding and awareness of this anatomical anomaly. A woman in her 50s presented with 1\u2009year of progressive left S1 radiculopathy refractory to non-operative modalities. History and examination were notable for S1 dermatomal paresthesias, positive ipsilateral straight leg raise and grade 4\/5 gastrocnemius strength. MRI demonstrated an L5\u2013S1 left paracentral disc herniation causing severe lateral recess stenosis. Endoscopic decompression revealed conjoined lumbosacral nerve roots. Laminotomies and discectomy provided circumferential decompression. The patient experienced immediate and sustained relief of her preoperative radiculopathy as manifested in patient-reported outcome measures. Evolving endoscopic spine platforms provide novel visualisation of nerve root anomalies yielding new insight on safe and effective decompressive techniques.<\/jats:p>","DOI":"10.1136\/bcr-2021-248680","type":"journal-article","created":{"date-parts":[[2022,3,16]],"date-time":"2022-03-16T12:12:00Z","timestamp":1647432720000},"page":"e248680","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Microendoscopic decompression of conjoined lumbosacral nerve roots"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6729-2798","authenticated-orcid":false,"given":"Harry M","family":"Lightsey","sequence":"first","affiliation":[{"name":"Harvard Combined Orthopaedic Residency Program, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace X","family":"Xiong","sequence":"additional","affiliation":[{"name":"Harvard Combined Orthopaedic Residency Program, 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