{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:35:30Z","timestamp":1753893330464,"version":"3.41.2"},"reference-count":21,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T00:00:00Z","timestamp":1742342400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Gas-containing pseudocyst is an uncommon cause of lumbar radiculopathy and most lumbar gas-containing pseudocysts locate in the spinal canal. While, extraforaminal gas-containing pseudocysts are very rare. Here, we reported a case of extraforaminal gas-containing pseudocyst, which compressed L4 exiting nerve root and caused lumbar radiculopathy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 62-year-old female presented with low back pain and radiation to anteromedial aspect of right thigh and anterior aspect of right calf. Computed tomography and magnetic resonance imaging of lumbar spine showed a gas-containing pseudocyst compressing in L4 exiting nerve root right extraforaminal area at L4\u20135 level. L4 exiting nerve root blocking was performed to confirm the responsible level. Then we performed BESS through a paraspinal approach to remove the gas-containing pseudocyst and release L4 exiting nerve root. Postoperatively, the patient achieved a good outcome and the pain was relieved.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Lumbar gas-containing pseudocyst in extraforaminal area is rare and can cause lumbar radiculopathy. Paraspinal approach BESS is an alternative method to treat extraforaminal gas-containing pseudocyst and can provide good outcome.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2025.1521271","type":"journal-article","created":{"date-parts":[[2025,3,19]],"date-time":"2025-03-19T07:10:48Z","timestamp":1742368248000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Symptomatic extraforaminal gas-containing pseudocyst treated with unilateral biportal endoscopic spinal surgery: a case report and literature review"],"prefix":"10.3389","volume":"12","author":[{"given":"Ya-wen","family":"Zhang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bin","family":"Xu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xu-ke","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ao-te","family":"Zheng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2025,3,19]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"396","DOI":"10.1055\/s-0042-1750809","article-title":"Epidural gas pseudocyst: an uncommon cause of sciatica","volume":"17","author":"Krishnan","year":"2022","journal-title":"Asian J Neurosurg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"384","DOI":"10.3340\/jkns.2011.49.6.384","article-title":"Sudden foot drop caused by foraminal gas pseudocyst","volume":"49","author":"Kim","year":"2011","journal-title":"J Korean Neurosurg Soc"},{"key":"B3","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1007\/s00776-012-0313-x","article-title":"Severe radiating pain caused by extraforaminal gas-containing pseudocyst","volume":"19","author":"Seo","year":"2014","journal-title":"J Orthop Sci"},{"key":"B4","doi-asserted-by":"publisher","first-page":"89","DOI":"10.1007\/s11420-010-9168-x","article-title":"Percutaneous intradiscal aspiration of a lumbar vacuum disc herniation: a case report","volume":"7","author":"Pak","year":"2011","journal-title":"HSS J"},{"key":"B5","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1016\/j.wneu.2018.12.186","article-title":"Surgical treatment of extra-foraminal gas containing pseudocyst compressing L5 nerve root by using unilateral biportal endosopy: a case report","volume":"124","author":"An","year":"2019","journal-title":"World Neurosurg"},{"key":"B6","doi-asserted-by":"publisher","first-page":"e05061","DOI":"10.1002\/ccr3.5061","article-title":"Radiculopathies caused by spontaneous pneumorrachis: two case reports and review of literature","volume":"9","author":"Lassoued Ferjani","year":"2021","journal-title":"Clin Case Rep"},{"key":"B7","first-page":"E445","article-title":"Transforaminal endoscopic decompression for a giant epidural gas-containing pseudocyst: a case report and literature review","volume":"20","author":"Zhu","year":"2017","journal-title":"Pain Physician"},{"key":"B8","doi-asserted-by":"publisher","first-page":"379","DOI":"10.4097\/kjae.2012.62.4.379","article-title":"Symptomatic epidural gas cyst treated with epidural block and percutaneous needle aspiration-a case report","volume":"62","author":"Kang","year":"2012","journal-title":"Korean J Anesthesiol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"398","DOI":"10.1016\/j.jbspin.2010.10.006","article-title":"Lumbar epidural gas-containing pseudocysts as a cause of severe radicular pain","volume":"78","author":"Kuh","year":"2011","journal-title":"Joint Bone Spine Rev Rhumatisme"},{"key":"B10","doi-asserted-by":"publisher","first-page":"162","DOI":"10.11604\/pamj.2014.18.162.1354","article-title":"Sciatica caused by lumbar epidural gas","volume":"18","author":"Belfquih","year":"2014","journal-title":"Pan African Medical Journal"},{"key":"B11","doi-asserted-by":"publisher","first-page":"552","DOI":"10.1007\/bf00340142","article-title":"L5 radicular pain related to lumbar extradural gas-containing pseudocyst. 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