远端综合征（Far-out综合征，FOS）是一种罕见的脊柱疾病，主要由于L5神经根在L5横突与骶骨翼之间受到压迫而引起，导致患者出现严重的腰腿痛和功能障碍。其病因包括骨赘形成、假关节、增厚的腰骶韧带、黄韧带肥厚、椎间盘退变及移行椎等解剖变异。FOS的诊断具有挑战性，需结合影像学检查（如MRI、CT）和神经电生理检查。治疗方面，对于轻中度症状患者，非手术治疗如药物和物理治疗可能有效，而对于严重症状或非手术治疗无效的患者，单侧双通道内镜下神经根管减压术（UBE）等微创手术为优选方案。本文综述了FOS的病因、发病机制、诊断和治疗进展，并通过1例成功接受UBE手术的67岁女性患者的个案报道，展示了该技术的应用效果及治疗潜力。
Far-out syndrome (FOS) is a rare spinal disorder primarily caused by the compression of the L5 nerve root between the L5 transverse process and the sacral ala, leading to severe lower back pain, leg pain, and functional impairment. The underlying causes include osteophyte formation, pseudarthrosis, thickened lumbosacral ligaments, ligamentum flavum hypertrophy, intervertebral disc degeneration, and anatomical variations such as transitional vertebrae. Diagnosing FOS is challenging and requires a combination of imaging techniques (such as MRI and CT) and neurophysiological testing. For patients with mild to moderate symptoms, non-surgical treatments, including medications and physical therapy, may be effective. However, for those with severe symptoms or cases unresponsive to conservative treatment, minimally invasive surgery, such as unilateral biportal endoscopic decompression (UBE), is the preferred option. This article reviews the etiology, pathogenesis, diagnosis, and treatment of FOS and presents a case report of a 67-year-old female patient who successfully underwent UBE surgery, demonstrating the efficacy and potential of this technique.
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