Full-endoscopic Spine Surgery for the Treatment of Far-out Syndrome: A Case Series

Far-out syndrome is a pathological condition characterized by entrapment of the L5 nerve root by the L5 transverse process, sacral ala, vertebral body, and adjacent soft tissue. Although many cases of far-out syndrome have been reported, a standardized surgical approach has not yet been fully established. As older adults are often affected by this condition, full-endoscopic spine surgery may be a preferable option due to its minimally invasive nature.This case series included six far-out syndrome cases treated with full-endoscopic spine surgery at our hospital. Patient background and operative data were collected from medical records. The numerical rating scale scores for pain and numbness, and the modified MacNab criteria, were recorded for 1 year postoperatively.The mean age was 73.5 years, and the mean duration of symptoms was 46.5 months. The mean operative time was 62.7 min without complications. In five of six cases, the amount of intraoperative bleeding was lower than the measuring limit in our hospital. The numerical rating scale score for pain improved at 1 year after surgery in all cases except case 6, who sustained a vertebral compression fracture 11 months after full-endoscopic spine surgery. According to the modified MacNab criteria, excellent or good outcomes were observed in five cases (83%) except for case 6.Full-endoscopic spine surgery for far-out syndrome appears to offer not only minimal invasiveness but also satisfactory surgical outcomes.