{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,3]],"date-time":"2026-02-03T10:46:18Z","timestamp":1770115578139,"version":"3.49.0"},"reference-count":36,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"6","license":[{"start":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T00:00:00Z","timestamp":1739145600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2025,2,10]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Diagnosing cervical radiculopathy with root anomalies is difficult, as cervical nerve root anomalies are rare. Here, the authors report the rare case of a conjoined nerve root variant confirmed using full endoscopic cervical foraminotomy (FECF).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 40-year-old female presented with painful numbness and paresis in the right upper limb. Physical examination revealed multiple radiculopathies in the C6 and C7 nerve roots. However, magnetic resonance imaging and computed tomography did not reveal any lesions explaining the right C7 radiculopathy. Furthermore, the right C6 root block injection had no effect, whereas the right C7 root block injection was extremely effective. FECF revealed a conjoined nerve root variant in the right C6\u20137 intervertebral foramen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>The study revealed that single nerve root block injections can be useful for pain relief as well as diagnosis of the affected level. Although the current case is rare, the report revealed that a lesion at a single intervertebral foramen can cause multiple radiculopathies. The study also highlighted the importance of careful examination of the clinical symptoms and the limitations of imaging tools.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE24752\">https:\/\/thejns.org\/doi\/10.3171\/CASE24752<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case24752","type":"journal-article","created":{"date-parts":[[2025,2,10]],"date-time":"2025-02-10T01:50:13Z","timestamp":1739152213000},"source":"Crossref","is-referenced-by-count":0,"title":["Rare variant of cervical conjoined nerve root confirmed during full endoscopic cervical foraminotomy: illustrative case"],"prefix":"10.3171","volume":"9","author":[{"given":"Tatsuya","family":"Maegawa","sequence":"first","affiliation":[{"name":"Department of Spinal Surgery, Kameda Medical Center, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kotaro","family":"Kohara","sequence":"additional","affiliation":[{"name":"Department of Spinal Surgery, Kameda Medical Center, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eitaro","family":"Okumura","sequence":"additional","affiliation":[{"name":"Department of Spinal Surgery, Kameda Medical Center, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ryo","family":"Hashimoto","sequence":"additional","affiliation":[{"name":"Department of Spinal Surgery, Kameda Medical Center, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Motoo","family":"Kubota","sequence":"additional","affiliation":[{"name":"Department of Spinal Surgery, Kameda Medical Center, Chiba, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"5","key":"bib1","series-title":"J Orthop Sci","first-page":"842","article-title":"Cervical nerve root anomaly: report of a case and review of the literature","volume":"23","author":"Takahata","year":"2018","unstructured":"Takahata MIwasaki N.Cervical nerve root anomaly: report of a case and review of the literature. J Orthop Sci. 2018;23(5):842-844."},{"issue":"10","key":"bib2","series-title":"J Clin Neurosci","first-page":"1146","article-title":"A rare anatomical variation of the C7 pedicle and intraspinal course of the C7 nerve root","volume":"15","author":"Kern","year":"2008","unstructured":"Kern MLee GY.A rare anatomical variation of the C7 pedicle and intraspinal course of the C7 nerve root. J Clin Neurosci. 2008;15(10):1146-1148."},{"issue":"6","key":"bib3","series-title":"Neurosurgery","first-page":"740","article-title":"Anomalous exit of the C-6 nerve root via the C-6, C-7 foramen","volume":"14","author":"Rosner","year":"1984","unstructured":"Rosner MJWhaley R.Anomalous exit of the C-6 nerve root via the C-6, C-7 foramen. Neurosurgery. 1984;14(6):740-743."},{"issue":"3","key":"bib4","series-title":"J Neurosurg","first-page":"548","article-title":"Cervical conjoined nerve root variant: preoperative imaging and surgical conformation. Case report","volume":"80","author":"Chu","year":"1994","unstructured":"Chu CRChesnut RM.Cervical conjoined nerve root variant: preoperative imaging and surgical conformation. Case report. J Neurosurg. 1994;80(3):548-551."},{"issue":"6","key":"bib5","series-title":"Br J Neurosurg","first-page":"624","article-title":"Unusual cervical nerve root arrangement exposed during surgery: case report and review of the literature","volume":"18","author":"Zrinzo","year":"2004","unstructured":"Zrinzo LAshkan KJohnston F.Unusual cervical nerve root arrangement exposed during surgery: case report and review of the literature. Br J Neurosurg. 2004;18(6):624-626."},{"issue":"4","key":"bib6","series-title":"Br J Neurosurg","first-page":"608","article-title":"Cervical nerve root variant: report of two cases under the cervical endoscopy and review of clinical literature","volume":"37","author":"Sun","year":"2023","unstructured":"Sun BShi CWu HCervical nerve root variant: report of two cases under the cervical endoscopy and review of clinical literature. Br J Neurosurg. 2023;37(4):608-611."},{"key":"bib7","series-title":"World Neurosurg","article-title":"Cervical conjoined nerve root during posterior percutaneous endoscopic cervical diskectomy","volume":"181","author":"Hsiao","year":"2024","unstructured":"Hsiao MCChung KCTsou HKChang YHKao THChang CP.Cervical conjoined nerve root during posterior percutaneous endoscopic cervical diskectomy. World Neurosurg. 2024;181:5."},{"issue":"1","key":"bib8","series-title":"Oper Orthop Traumatol","first-page":"13","article-title":"Full-endoscopic posterior foraminotomy surgery for cervical disc herniations","volume":"30","author":"Komp","year":"2018","unstructured":"Komp MOezdemir SHahn PRuetten S.Full-endoscopic posterior foraminotomy surgery for cervical disc herniations. Oper Orthop Traumatol. 2018;30(1):13-24."},{"issue":"3","key":"bib9","series-title":"Neurospine","first-page":"603","article-title":"Comparative analysis with modified inclined technique for posterior endoscopic cervical foraminotomy in treating cervical osseous foraminal stenosis: radiological and midterm clinical outcomes","volume":"19","author":"Kim","year":"2022","unstructured":"Kim JYHeo DHLee DCKim THPark CK.Comparative analysis with modified inclined technique for posterior endoscopic cervical foraminotomy in treating cervical osseous foraminal stenosis: radiological and midterm clinical outcomes. Neurospine. 2022;19(3):603-615."},{"issue":"1","key":"bib10","series-title":"Asian Spine J","first-page":"32","article-title":"Surgical outcomes of full endoscopic posterior cervical foraminotomy for proximal cervical spondylotic amyotrophy","volume":"18","author":"Lee","year":"2024","unstructured":"Lee DOhmori KYoneyama REndo TEndo Y.Surgical outcomes of full endoscopic posterior cervical foraminotomy for proximal cervical spondylotic amyotrophy. Asian Spine J. 2024;18(1):32-41."},{"issue":"4","key":"bib11","series-title":"Minim Invasive Neurosurg","first-page":"219","article-title":"A new full-endoscopic technique for cervical posterior foraminotomy in the treatment of lateral disc herniations using 6.9-mm endoscopes: prospective 2-year results of 87 patients","volume":"50","author":"Ruetten","year":"2007","unstructured":"Ruetten SKomp MMerk HGodolias G.A new full-endoscopic technique for cervical posterior foraminotomy in the treatment of lateral disc herniations using 6.9-mm endoscopes: prospective 2-year results of 87 patients. Minim Invasive Neurosurg. 2007;50(4):219-226."},{"issue":"2","key":"bib12","series-title":"J Spine Surg","first-page":"366","article-title":"Degree of satisfaction following full-endoscopic cervical foraminotomy","volume":"6","author":"Tonosu","year":"2020","unstructured":"Tonosu JOshima YTakano YInanami HIwai HKoga H.Degree of satisfaction following full-endoscopic cervical foraminotomy. J Spine Surg. 2020;6(2):366-371."},{"issue":"9","key":"bib13","series-title":"Spine (Phila Pa 1976)","first-page":"940","article-title":"Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study","volume":"33","author":"Ruetten","year":"2008","unstructured":"Ruetten SKomp MMerk HGodolias G.Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study. Spine (Phila Pa 1976). 2008;33(9):940-948."},{"key":"bib14","series-title":"Int J Gen Med","first-page":"6897","article-title":"Comparison of percutaneous endoscopic cervical keyhole foraminotomy versus microscopic anterior cervical discectomy and fusion for single level unilateral cervical radiculopathy","volume":"15","author":"Ma","year":"2022","unstructured":"Ma WPeng YZhang SComparison of percutaneous endoscopic cervical keyhole foraminotomy versus microscopic anterior cervical discectomy and fusion for single level unilateral cervical radiculopathy. Int J Gen Med. 2022;15:6897-6907."},{"issue":"2","key":"bib15","series-title":"Clin Spine Surg","first-page":"59","article-title":"Microscopic anterior cervical discectomy and fusion versus posterior percutaneous endoscopic cervical keyhole foraminotomy for single-level unilateral cervical radiculopathy: a systematic review and meta-analysis","volume":"36","author":"Guo","year":"2023","unstructured":"Guo LWang JZhao ZMicroscopic anterior cervical discectomy and fusion versus posterior percutaneous endoscopic cervical keyhole foraminotomy for single-level unilateral cervical radiculopathy: a systematic review and meta-analysis. Clin Spine Surg. 2023;36(2):59-69."},{"issue":"9","key":"bib16","series-title":"Neurol Med Chir (Tokyo)","first-page":"426","article-title":"Comparison of the outcomes of microendoscopic cervical foraminotomy versus full-endoscopic cervical foraminotomy for the treatment of cervical radiculopathy","volume":"63","author":"Gideon","year":"2023","unstructured":"Gideon BTakebayashi KInui TComparison 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):426-431."},{"issue":"5","key":"bib17","series-title":"J Bone Joint Surg Am","first-page":"1025","article-title":"Complications of fluoroscopically guided extraforaminal cervical nerve blocks. An analysis of 1036 injections","volume":"87","author":"Ma","year":"2005","unstructured":"Ma DJGilula LARiew KD.Complications of fluoroscopically guided extraforaminal cervical nerve blocks. An analysis of 1036 injections. J Bone Joint Surg Am. 2005;87(5):1025-1030."},{"issue":"1","key":"bib18","series-title":"Global Spine J","first-page":"7","article-title":"Fluoroscopically guided extraforaminal cervical nerve root blocks: analysis of epidural flow of the injectate with respect to needle tip position","volume":"4","author":"Shipley","year":"2014","unstructured":"Shipley KRiew KDGilula LA.Fluoroscopically guided extraforaminal cervical nerve root blocks: analysis of epidural flow of the injectate with respect to needle tip position. Global Spine J. 2014;4(1):7-12."},{"issue":"5","key":"bib1","series-title":"J Orthop Sci","first-page":"842","article-title":"Cervical nerve root anomaly: report of a case and review of the literature","volume":"23","author":"Takahata","year":"2018","unstructured":"Takahata MIwasaki N.Cervical nerve root anomaly: report of a case and review of the literature. J Orthop Sci. 2018;23(5):842-844."},{"issue":"10","key":"bib2","series-title":"J Clin Neurosci","first-page":"1146","article-title":"A rare anatomical variation of the C7 pedicle and intraspinal course of the C7 nerve root","volume":"15","author":"Kern","year":"2008","unstructured":"Kern MLee GY.A rare anatomical variation of the C7 pedicle and intraspinal course of the C7 nerve root. J Clin Neurosci. 2008;15(10):1146-1148."},{"issue":"6","key":"bib3","series-title":"Neurosurgery","first-page":"740","article-title":"Anomalous exit of the C-6 nerve root via the C-6, C-7 foramen","volume":"14","author":"Rosner","year":"1984","unstructured":"Rosner MJWhaley R.Anomalous exit of the C-6 nerve root via the C-6, C-7 foramen. Neurosurgery. 1984;14(6):740-743."},{"issue":"3","key":"bib4","series-title":"J Neurosurg","first-page":"548","article-title":"Cervical conjoined nerve root variant: preoperative imaging and surgical conformation. Case report","volume":"80","author":"Chu","year":"1994","unstructured":"Chu CRChesnut RM.Cervical conjoined nerve root variant: preoperative imaging and surgical conformation. Case report. J Neurosurg. 1994;80(3):548-551."},{"issue":"6","key":"bib5","series-title":"Br J Neurosurg","first-page":"624","article-title":"Unusual cervical nerve root arrangement exposed during surgery: case report and review of the literature","volume":"18","author":"Zrinzo","year":"2004","unstructured":"Zrinzo LAshkan KJohnston F.Unusual cervical nerve root arrangement exposed during surgery: case report and review of the literature. Br J Neurosurg. 2004;18(6):624-626."},{"issue":"4","key":"bib6","series-title":"Br J Neurosurg","first-page":"608","article-title":"Cervical nerve root variant: report of two cases under the cervical endoscopy and review of clinical literature","volume":"37","author":"Sun","year":"2023","unstructured":"Sun BShi CWu HCervical nerve root variant: report of two cases under the cervical endoscopy and review of clinical literature. Br J Neurosurg. 2023;37(4):608-611."},{"key":"bib7","series-title":"World Neurosurg","article-title":"Cervical conjoined nerve root during posterior percutaneous endoscopic cervical diskectomy","volume":"181","author":"Hsiao","year":"2024","unstructured":"Hsiao MCChung KCTsou HKChang YHKao THChang CP.Cervical conjoined nerve root during posterior percutaneous endoscopic cervical diskectomy. World Neurosurg. 2024;181:5."},{"issue":"1","key":"bib8","series-title":"Oper Orthop Traumatol","first-page":"13","article-title":"Full-endoscopic posterior foraminotomy surgery for cervical disc herniations","volume":"30","author":"Komp","year":"2018","unstructured":"Komp MOezdemir SHahn PRuetten S.Full-endoscopic posterior foraminotomy surgery for cervical disc herniations. Oper Orthop Traumatol. 2018;30(1):13-24."},{"issue":"3","key":"bib9","series-title":"Neurospine","first-page":"603","article-title":"Comparative analysis with modified inclined technique for posterior endoscopic cervical foraminotomy in treating cervical osseous foraminal stenosis: radiological and midterm clinical outcomes","volume":"19","author":"Kim","year":"2022","unstructured":"Kim JYHeo DHLee DCKim THPark CK.Comparative analysis with modified inclined technique for posterior endoscopic cervical foraminotomy in treating cervical osseous foraminal stenosis: radiological and midterm clinical outcomes. Neurospine. 2022;19(3):603-615."},{"issue":"1","key":"bib10","series-title":"Asian Spine J","first-page":"32","article-title":"Surgical outcomes of full endoscopic posterior cervical foraminotomy for proximal cervical spondylotic amyotrophy","volume":"18","author":"Lee","year":"2024","unstructured":"Lee DOhmori KYoneyama REndo TEndo Y.Surgical outcomes of full endoscopic posterior cervical foraminotomy for proximal cervical spondylotic amyotrophy. Asian Spine J. 2024;18(1):32-41."},{"issue":"4","key":"bib11","series-title":"Minim Invasive Neurosurg","first-page":"219","article-title":"A new full-endoscopic technique for cervical posterior foraminotomy in the treatment of lateral disc herniations using 6.9-mm endoscopes: prospective 2-year results of 87 patients","volume":"50","author":"Ruetten","year":"2007","unstructured":"Ruetten SKomp MMerk HGodolias G.A new full-endoscopic technique for cervical posterior foraminotomy in the treatment of lateral disc herniations using 6.9-mm endoscopes: prospective 2-year results of 87 patients. Minim Invasive Neurosurg. 2007;50(4):219-226."},{"issue":"2","key":"bib12","series-title":"J Spine Surg","first-page":"366","article-title":"Degree of satisfaction following full-endoscopic cervical foraminotomy","volume":"6","author":"Tonosu","year":"2020","unstructured":"Tonosu JOshima YTakano YInanami HIwai HKoga H.Degree of satisfaction following full-endoscopic cervical foraminotomy. J Spine Surg. 2020;6(2):366-371."},{"issue":"9","key":"bib13","series-title":"Spine (Phila Pa 1976)","first-page":"940","article-title":"Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study","volume":"33","author":"Ruetten","year":"2008","unstructured":"Ruetten SKomp MMerk HGodolias G.Full-endoscopic cervical posterior foraminotomy for the operation of lateral disc herniations using 5.9-mm endoscopes: a prospective, randomized, controlled study. Spine (Phila Pa 1976). 2008;33(9):940-948."},{"key":"bib14","series-title":"Int J Gen Med","first-page":"6897","article-title":"Comparison of percutaneous endoscopic cervical keyhole foraminotomy versus microscopic anterior cervical discectomy and fusion for single level unilateral cervical radiculopathy","volume":"15","author":"Ma","year":"2022","unstructured":"Ma WPeng YZhang SComparison of percutaneous endoscopic cervical keyhole foraminotomy versus microscopic anterior cervical discectomy and fusion for single level unilateral cervical radiculopathy. Int J Gen Med. 2022;15:6897-6907."},{"issue":"2","key":"bib15","series-title":"Clin Spine Surg","first-page":"59","article-title":"Microscopic anterior cervical discectomy and fusion versus posterior percutaneous endoscopic cervical keyhole foraminotomy for single-level unilateral cervical radiculopathy: a systematic review and meta-analysis","volume":"36","author":"Guo","year":"2023","unstructured":"Guo LWang JZhao ZMicroscopic anterior cervical discectomy and fusion versus posterior percutaneous endoscopic cervical keyhole foraminotomy for single-level unilateral cervical radiculopathy: a systematic review and meta-analysis. Clin Spine Surg. 2023;36(2):59-69."},{"issue":"9","key":"bib16","series-title":"Neurol Med Chir (Tokyo)","first-page":"426","article-title":"Comparison of the outcomes of microendoscopic cervical foraminotomy versus full-endoscopic cervical foraminotomy for the treatment of cervical radiculopathy","volume":"63","author":"Gideon","year":"2023","unstructured":"Gideon BTakebayashi KInui TComparison 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):426-431."},{"issue":"5","key":"bib17","series-title":"J Bone Joint Surg Am","first-page":"1025","article-title":"Complications of fluoroscopically guided extraforaminal cervical nerve blocks. An analysis of 1036 injections","volume":"87","author":"Ma","year":"2005","unstructured":"Ma DJGilula LARiew KD.Complications of fluoroscopically guided extraforaminal cervical nerve blocks. An analysis of 1036 injections. J Bone Joint Surg Am. 2005;87(5):1025-1030."},{"issue":"1","key":"bib18","series-title":"Global Spine J","first-page":"7","article-title":"Fluoroscopically guided extraforaminal cervical nerve root blocks: analysis of epidural flow of the injectate with respect to needle tip position","volume":"4","author":"Shipley","year":"2014","unstructured":"Shipley KRiew KDGilula LA.Fluoroscopically guided extraforaminal cervical nerve root blocks: analysis of epidural flow of the injectate with respect to needle tip position. Global Spine J. 2014;4(1):7-12."}],"container-title":["Journal of Neurosurgery: Case Lessons"],"original-title":[],"link":[{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/9\/6\/article-CASE24752.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/9\/6\/article-CASE24752.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/thejns.org\/downloadpdf\/journals\/j-neurosurg-case-lessons\/9\/6\/article-CASE24752.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,2,2]],"date-time":"2026-02-02T23:36:38Z","timestamp":1770075398000},"score":1,"resource":{"primary":{"URL":"https:\/\/thejns.org\/view\/journals\/j-neurosurg-case-lessons\/9\/6\/article-CASE24752.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,10]]},"references-count":36,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.3171\/case24752","relation":{},"ISSN":["2694-1902"],"issn-type":[{"value":"2694-1902","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,10]]}}}