{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T16:52:59Z","timestamp":1781715179596,"version":"3.54.5"},"reference-count":20,"publisher":"Hindawi Limited","license":[{"start":{"date-parts":[[2016,1,1]],"date-time":"2016-01-01T00:00:00Z","timestamp":1451606400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BioMed Research International"],"published-print":{"date-parts":[[2016]]},"abstract":"<jats:p><jats:italic>Purpose<\/jats:italic>. Extraforaminal decompression of the L5 nerve root remains a challenge due to anatomic constraints, severe level-degeneration, and variable anatomy. The purpose of this study is to introduce the use of navigation for transmuscular transtubular decompression at the L5\/S1 level and report on radiological features and clinical outcome.<jats:italic>Methods<\/jats:italic>. Ten patients who underwent a navigation-assisted extraforaminal decompression of the L5 nerve root were retrospectively analyzed.<jats:italic>Results<\/jats:italic>. Six patients had an extraforaminal herniated disc and four had a foraminal stenosis. The distance between the L5 transverse process and the para-articular notch of the sacrum was 12.1\u2009mm in patients with a herniated disc and 8.1\u2009mm in those with a foraminal stenosis. One patient had an early recurrence and another developed dysesthesia that resolved after 3 months. There was a significant improvement from preoperative to postoperative NRS with the results being sustainable at follow-up. ODI was also significantly improved after surgery. According to the Macnab grading scale, excellent or good outcomes were obtained in 8 patients and fair ones in 2.<jats:italic>Conclusions<\/jats:italic>. The navigated transmuscular transtubular approach to the lumbosacral junction allows for optimal placement of the retractor and excellent orientation particularly for foraminal stenosis or in cases of complex anatomy.<\/jats:p>","DOI":"10.1155\/2016\/3487437","type":"journal-article","created":{"date-parts":[[2016,4,4]],"date-time":"2016-04-04T21:47:12Z","timestamp":1459806432000},"page":"1-6","source":"Crossref","is-referenced-by-count":11,"title":["Navigated Transtubular Extraforaminal Decompression of the L5 Nerve Root at the Lumbosacral Junction: Clinical Data, Radiographic Features, and Outcome Analysis"],"prefix":"10.1155","volume":"2016","author":[{"given":"P.","family":"Stavrinou","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, University Hospital of Cologne, 50937 Cologne, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"H\u00e4rtl","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, 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