{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T05:12:26Z","timestamp":1754111546271,"version":"3.41.0"},"reference-count":3,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n<jats:title>Background: <\/jats:title>\n<jats:p>A patient presented with sciatica attributed to a conjoined lumbosacral nerve root, an extruded disc herniation, and epidural varicose veins.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st2\">\n<jats:title>Case Description: <\/jats:title>\n<jats:p>A 60-year-old male presented with 5 months of sciatica (4\/5 motor deficit). The lumbosacral magnetic resonance showed a right paracentral disc herniation causing thecal sac\/L5-S1 nerve root compression. Intraoperatively, the patient had an L5-S1 conjoined nerve root, an extruded disc herniation, and type C epidural varicose veins. A wide fenestration and foraminotomy were performed to facilitate the removal of the extruded disc and partial coagulation of the epidural varicose veins. Surgery resulted in complete symptom resolution within the 1<jats:sup>st<\/jats:sup> postoperative month.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"st3\">\n<jats:title>Conclusion: <\/jats:title>\n<jats:p>A patient with intractable right-sided sciatic was found at surgery to have an L5-S1 conjoined nerve root, a herniated disc, and marked epidural varicosities. Following a wide fenestration\/foraminal decompression, the patient\u2019s symptoms fully resolved within the 1<jats:sup>st<\/jats:sup> postoperative month.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni_371_2025","type":"journal-article","created":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T08:23:24Z","timestamp":1747988604000},"page":"200","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Conjoined nerve root, epidural varicose vein, and extruded lumbar disc: Triad of refractory sciatica"],"prefix":"10.25259","volume":"16","author":[{"given":"Nazmin","family":"Ahmed","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Ibrahim Cardiac Hospital and Research Institute (A Centre for Cardiovascular, Neuroscience and Organ Transplant Units), Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Nazrul","family":"Hossain","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ibrahim Cardiac Hospital and Research Institute (A Centre for Cardiovascular, Neuroscience and Organ Transplant Units), Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shahidul Islam","family":"Khan","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Bangladesh Medical University, Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raad","family":"Kazi","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Ibrahim Cardiac Hospital and Research Institute (A Centre for Cardiovascular, Neuroscience and Organ Transplant Units), Dhaka, Bangladesh"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2025,5,23]]},"reference":[{"key":"10.25259\/SNI_371_2025\/ref-1","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1007\/s00256-007-0421-4","article-title":"Conjoined lumbosacral nerve roots compromised by disk herniation: Sagittal shoulder sign for the preoperative diagnosis","volume":"37","author":"Kang","year":"2008","journal-title":"Skeletal Radiol"},{"key":"10.25259\/SNI_371_2025\/ref-2","doi-asserted-by":"crossref","first-page":"23","DOI":"10.15406\/jnsk.2021.11.00449","article-title":"Spinal epidural varicosity resembling prolapsed intervertebral disc on MRI: A diagnostic dilemma for lumbar canal stenosis","volume":"11","author":"Raut","year":"2021","journal-title":"J Neurol Stroke"},{"key":"10.25259\/SNI_371_2025\/ref-3","first-page":"CASE24301","article-title":"Contralateral discectomy as a novel approach for disc herniation compressing a conjoined nerve root: Illustrative case","volume":"8","author":"Trakolis","year":"2024","journal-title":"J Neurosurg Case Lessons"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/conjoined-nerve-root-epidural-varicose-vein-and-extruded-lumbar-disc-triad-of-refractory-sciatica\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/conjoined-nerve-root-epidural-varicose-vein-and-extruded-lumbar-disc-triad-of-refractory-sciatica\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,23]],"date-time":"2025-05-23T08:23:25Z","timestamp":1747988605000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/conjoined-nerve-root-epidural-varicose-vein-and-extruded-lumbar-disc-triad-of-refractory-sciatica\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,23]]},"references-count":3,"alternative-id":["10.25259\/SNI_371_2025"],"URL":"https:\/\/doi.org\/10.25259\/sni_371_2025","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2025,5,23]]},"article-number":"200"}}