{"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":1781715179693,"version":"3.54.5"},"reference-count":34,"publisher":"Japan Neurosurgical Society","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neurol. Med. Chir.(Tokyo)"],"published-print":{"date-parts":[[2025,12,15]]},"DOI":"10.2176\/jns-nmc.2025-0168","type":"journal-article","created":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T22:08:38Z","timestamp":1760998118000},"page":"583-589","source":"Crossref","is-referenced-by-count":3,"title":["Full-endoscopic Spine Surgery for the Treatment of Far-out Syndrome: A Case Series"],"prefix":"10.2176","volume":"65","author":[{"given":"Ryuichi","family":"WATANABE","sequence":"first","affiliation":[{"name":"Department of Orthopaedic Surgery, Iwai Orthopaedic Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryoji","family":"TOMINAGA","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Iwai Orthopaedic Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kento","family":"TAKEBAYASHI","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Iwai Orthopaedic Hospital"},{"name":"Department of Neurosurgery, Iwai FESS Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasushi","family":"OSHIMA","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, The University of Tokyo"},{"name":"Department of Orthopaedic Surgery, Inanami Spine and Joint Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hiroki","family":"IWAI","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Iwai Orthopaedic Hospital"},{"name":"Department of Orthopaedic Surgery, Inanami Spine and Joint Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisashi","family":"KOGA","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Iwai Orthopaedic Hospital"},{"name":"Department of Neurosurgery, Iwai FESS Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"971","reference":[{"key":"1","doi-asserted-by":"publisher","unstructured":"1) Wiltse LL, Guyer RD, Spencer CW, et al. Alar transverse process impingement of the L5 spinal nerve: the far-out syndrome. Spine. 1984;9 (1):31-41. doi: 10.1097\/00007632-198401000-00008","DOI":"10.1097\/00007632-198401000-00008"},{"key":"2","doi-asserted-by":"publisher","unstructured":"2) Matsumoto M, Chiba K, Ishii K, et al. Microendoscopic partial resection of the sacral ala to relieve extraforaminal entrapment of the L-5 spinal nerve at the lumbosacral tunnel. Technical note. J Neurosurg Spine. 2006;4 (4):342-6. doi: 10.3171\/spi.2006.4.4.342","DOI":"10.3171\/spi.2006.4.4.342"},{"key":"3","doi-asserted-by":"publisher","unstructured":"3) Matsumoto M, Watanabe K, Ishii K, et al. Posterior decompression surgery for extraforaminal entrapment of the fifth lumbar spinal nerve at the lumbosacral junction. J Neurosurg Spine. 2010;12 (1):72-81. doi: 10.3171\/2009.7.SPINE09344","DOI":"10.3171\/2009.7.SPINE09344"},{"key":"4","doi-asserted-by":"publisher","unstructured":"4) Zhou Y, Zheng WJ, Wang J, et al. The clinical features of, and microendoscopic decompression for, extraforaminal entrapment of the L5 spinal nerve. Orthop Surg. 2009;1 (1):74-7. doi: 10.1111\/j.2757-7861.2008.00013.x","DOI":"10.1111\/j.2757-7861.2008.00013.x"},{"key":"5","doi-asserted-by":"publisher","unstructured":"5) Yang F, Feng C, Li K, et al. Percutaneous paravertebral endoscopic decompression for the treatment of far-out syndrome involving the L5 nerve root: technical report and preliminary results. BMC Musculoskelet Disord. 2025;26 (1):24. doi: 10.1186\/s12891-024-08251-x","DOI":"10.1186\/s12891-024-08251-x"},{"key":"6","doi-asserted-by":"publisher","unstructured":"6) Kavishwar RA, Liang Y, Lee D, et al. O-arm navigation-guided unilateral biportal endoscopic decompression of far-out syndrome. Neurospine. 2024;21 (4):1149-53. doi: 10.14245\/ns.2449140.570","DOI":"10.14245\/ns.2449140.570"},{"key":"7","doi-asserted-by":"publisher","unstructured":"7) Ha JS, Sakhrekar R, Han HD, et al. Unilateral biportal endoscopy for L5-S1 extraforaminal stenosis (far out syndrome) - technical note with literature review. J Orthop Case Rep. 2024;14 (3):187-93. doi: 10.13107\/jocr.2024.v14.i03.4336","DOI":"10.13107\/jocr.2024.v14.i03.4336"},{"key":"8","doi-asserted-by":"publisher","unstructured":"8) Park MK, Son SK, Park WW, et al. Unilateral biportal endoscopy for decompression of extraforaminal stenosis at the lumbosacral junction: surgical techniques and clinical outcomes. Neurospine. 2021;18 (4):871-9. doi: 10.14245\/ns.2142146.073","DOI":"10.14245\/ns.2142146.073"},{"key":"9","doi-asserted-by":"publisher","unstructured":"9) Heo DH, Sharma S, Park CK. Endoscopic treatment of extraforaminal entrapment of L5 nerve root (far out syndrome) by unilateral biportal endoscopic approach: technical report and preliminary clinical results. Neurospine. 2019;16 (1):130-7. doi: 10.14245\/ns.1938026.013","DOI":"10.14245\/ns.1938026.013"},{"key":"10","doi-asserted-by":"publisher","unstructured":"10) Agha RA, Sohrabi C, Mathew G, et al. The PROCESS 2020 guideline: updating consensus preferred reporting of CasESeries in surgery (PROCESS) guidelines. Int J Surg. 2020;84:231-5. doi: 10.1016\/j.ijsu.2020.11.005","DOI":"10.1016\/j.ijsu.2020.11.005"},{"key":"11","doi-asserted-by":"publisher","unstructured":"11) Kitamura M, Eguchi Y, Inoue G, et al. A case of symptomatic extra-foraminal lumbosacral stenosis ( &quot;far-out syndrome&quot; ) diagnosed by diffusion tensor imaging. Spine. 2012;37 (14):E854-7. doi: 10.1097\/BRS.0b013e318249537f","DOI":"10.1097\/BRS.0b013e318249537f"},{"key":"12","doi-asserted-by":"publisher","unstructured":"12) Rodriguez CS. Pain measurement in the elderly: a review. Pain Manag Nurs. 2001;2 (2):38-46. doi: 10.1053\/jpmn.2001.23746","DOI":"10.1053\/jpmn.2001.23746"},{"key":"13","doi-asserted-by":"publisher","unstructured":"13) Macnab I. Negative disc exploration. An analysis of the causes of nerve-root involvement in sixty-eight patients. J Bone Joint Surg Am. 1971;53 (5):891-903. doi: 10.2106\/00004623-197153050-00004","DOI":"10.2106\/00004623-197153050-00004"},{"key":"14","doi-asserted-by":"publisher","unstructured":"14) Takebayashi K, Fujita M, Inui T, et al. Large-scale comparative study between microendoscopic laminectomy and full-endoscopic laminectomy for the treatment of single-level lumbar spinal canal stenosis. Cureus. 2024;16 (1):e52842. doi: 10.7759\/cureus.52842","DOI":"10.7759\/cureus.52842"},{"key":"15","doi-asserted-by":"publisher","unstructured":"15) Fujita M, Inui T, Oshima Y, et al. Comparison of outcomes of lumbar interbody fusion and full-endoscopic laminectomy for L5 radiculopathy caused by lumbar foraminal stenosis. Neurol Med Chir (Tokyo). 2022;62 (6):270-7. doi: 10.2176\/jns-nmc.2021-0381","DOI":"10.2176\/jns-nmc.2021-0381"},{"key":"16","doi-asserted-by":"publisher","unstructured":"16) Matsumoto M, Chiba K, Nojiri K, et al. Extraforaminal entrapment of the fifth lumbar spinal nerve by osteophytes of the lumbosacral spine: anatomic study and a report of four cases. Spine. 2002;27 (6):E169-73. doi: 10.1097\/00007632-200203150-00020","DOI":"10.1097\/00007632-200203150-00020"},{"key":"17","doi-asserted-by":"publisher","unstructured":"17) Ando M, Tamaki T, Kawakami M, et al. Electrophysiological diagnosis using sensory nerve action potential for the intraforaminal and extraforaminal L5 nerve root entrapment. Eur Spine J. 2013;22 (4):833-9. doi: 10.1007\/s00586-012-2592-5","DOI":"10.1007\/s00586-012-2592-5"},{"key":"18","doi-asserted-by":"publisher","unstructured":"18) Yeo J. Failed back surgery syndrome-terminology, etiology, prevention, evaluation, and management: a narrative review. J Yeungnam Med Sci. 2024;41 (3):166-78. doi: 10.12701\/jyms.2024.00339","DOI":"10.12701\/jyms.2024.00339"},{"key":"19","doi-asserted-by":"publisher","unstructured":"19) Iwasaki M, Akiyama M, Koyanagi I, et al. Double crush of L5 spinal nerve root due to L4\/5 lateral recess stenosis and bony spur formation of lumbosacral transitional vertebra pseudoarticulation: a case report and review. NMC Case Rep J. 2017;4 (4):121-5. doi: 10.2176\/nmccrj.cr.2016-0308","DOI":"10.2176\/nmccrj.cr.2016-0308"},{"key":"20","doi-asserted-by":"publisher","unstructured":"20) Maki Y, Fukaya K. Efficacy of oblique lateral interbody fusion at L5\/S1 for lumbosacral transitional vertebrae-related far-out syndrome: a report of two cases. Cureus. 2025;17 (2):e79431. doi: 10.7759\/cureus.79431","DOI":"10.7759\/cureus.79431"},{"key":"21","doi-asserted-by":"publisher","unstructured":"21) Ise S, Abe K, Orita S, et al. Surgical treatment for far-out syndrome associated with abnormal fusion of the L5 vertebral corpus and L4 hemivertebra: a case report. BMC Res Notes. 2016;9:329. doi: 10.1186\/s13104-016-2123-2","DOI":"10.1186\/s13104-016-2123-2"},{"key":"22","doi-asserted-by":"publisher","unstructured":"22) Iwai H, Inanami H, Koga H. Comparative study between full-endoscopic laminectomy and microendoscopic laminectomy for the treatment of lumbar spinal canal stenosis. J Spine Surg. 2020;6 (2):E3-11. doi: 10.21037\/jss-20-620","DOI":"10.21037\/jss-20-620"},{"key":"23","doi-asserted-by":"publisher","unstructured":"23) Chang CW, Tominaga R, Oshima Y, et al. Full-endoscopic spine surgery for the treatment of lumbar ligamentous flavum hematoma. Neurol Med Chir (Tokyo). 2024;64 (11):401-8. doi: 10.2176\/jns-nmc.2024-0086","DOI":"10.2176\/jns-nmc.2024-0086"},{"key":"24","doi-asserted-by":"publisher","unstructured":"24) Mizutani T, Takebayashi K, Oshima Y, et al. Full-endoscopic discectomy for the treatment of thoracic myelopathy caused by upward-migrating thoracic disc herniation. NMC Case Rep J. 2025;12:147-52. doi: 10.2176\/jns-nmc.2024-0285","DOI":"10.2176\/jns-nmc.2024-0285"},{"key":"25","doi-asserted-by":"publisher","unstructured":"25) Gideon B, Takebayashi K, Inui T, et al. Comparison of the Outcomes of Microendoscopic Cervical foraminotomy versus Full-endoscopic Cervical foraminotomy for the Treatment of Cervical radiculopathy. Neurol Med Chir (Tokyo). 2023;63 (9):426-31. doi: 10.2176\/jns-nmc.2023-0073","DOI":"10.2176\/jns-nmc.2023-0073"},{"key":"26","doi-asserted-by":"publisher","unstructured":"26) L\u00fcbbers T, Abuamona R, Elsharkawy AE. Percutaneous endoscopic treatment of foraminal and extraforaminal disc herniation at the L5-S1 level. Acta Neurochir (Wien). 2012;154 (10):1789-95. doi: 10.1007\/s00701-012-1432-z","DOI":"10.1007\/s00701-012-1432-z"},{"key":"27","doi-asserted-by":"publisher","unstructured":"27) Abe E, Sato K, Shimada Y, et al. Anterior decompression of foraminal stenosis below a lumbosacral transitional vertebra. A case report. Spine. 1997;22 (7):823-6. doi: 10.1097\/00007632-199704010-00023","DOI":"10.1097\/00007632-199704010-00023"},{"key":"28","doi-asserted-by":"publisher","unstructured":"28) Kikuchi K, Abe E, Miyakoshi N, et al. Anterior decompression for far-out syndrome below a transitional vertebra: a report of two cases. Spine J. 2013;13 (8):e21-5. doi: 10.1016\/j.spinee.2013.02.033","DOI":"10.1016\/j.spinee.2013.02.033"},{"key":"29","doi-asserted-by":"publisher","unstructured":"29) Castellvi AE, Goldstein LA, Chan DP. Lumbosacral transitional vertebrae and their relationship with lumbar extradural defects. Spine. 1984;9 (5):493-5. doi: 10.1097\/00007632-198407000-00014","DOI":"10.1097\/00007632-198407000-00014"},{"key":"30","doi-asserted-by":"publisher","unstructured":"30) Zhu W, Ding X, Zheng J, et al. A systematic review and bibliometric study of Bertolotti&apos;s syndrome: clinical characteristics and global trends. Int J Surg. 2023;109 (10):3159-68. doi: 10.1097\/JS9.0000000000000541","DOI":"10.1097\/JS9.0000000000000541"},{"key":"31","doi-asserted-by":"publisher","unstructured":"31) Stein E, Panjeton GD, Kumar S. Endoscopic resection of pseudoarticulation as a treatment for Bertolotti&apos;s syndrome. Cureus. 2023;15 (1):e33397. doi: 10.7759\/cureus.33397","DOI":"10.7759\/cureus.33397"},{"key":"32","doi-asserted-by":"publisher","unstructured":"32) Wu PH, Sebastian M, Kim HS, et al. How I do it? Uniportal full endoscopic pseudoarthrosis release of left L5\/S1 Bertolotti&apos;s syndrome under intraoperative computer tomographic guidance in an ambulatory setting. Acta Neurochir (Wien). 2021;163 (10):2789-95. doi: 10.1007\/s00701-021-04975-0","DOI":"10.1007\/s00701-021-04975-0"},{"key":"33","doi-asserted-by":"publisher","unstructured":"33) Paudel B, Kim HS, Jang JS, et al. Percutaneous full endoscopic treatment of Bertolotti syndrome: a report of three cases with technical note. J Neurol Surg A Cent Eur Neurosurg. 2017;78 (6):566-71. doi: 10.1055\/s-0037-1598173","DOI":"10.1055\/s-0037-1598173"},{"key":"34","doi-asserted-by":"publisher","unstructured":"34) Ju CI, Kim P, Seo JH. Full-endoscopic J-shaped transforaminal L5 nerve decompression in Bertolotti syndrome. Neurospine. 2024;21 (4):1131-6. doi: 10.14245\/ns.2449112.556","DOI":"10.14245\/ns.2449112.556"}],"container-title":["Neurologia medico-chirurgica"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/nmc\/65\/12\/65_2025-0168\/_pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,20]],"date-time":"2025-12-20T04:07:06Z","timestamp":1766203626000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.jstage.jst.go.jp\/article\/nmc\/65\/12\/65_2025-0168\/_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,15]]},"references-count":34,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025]]}},"URL":"https:\/\/doi.org\/10.2176\/jns-nmc.2025-0168","relation":{},"ISSN":["0470-8105","1349-8029"],"issn-type":[{"value":"0470-8105","type":"print"},{"value":"1349-8029","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,15]]},"article-number":"2025-0168"}}