Perineural (Tarlov) cysts are a common benign pathology in the lumbosacral area but are rarely symptomatic, even when compressing the spinal root. Despite the rarity of Tarlov cyst formation in the foramen of the spine, this type is more symptomatic than those in other sites due to the narrow space. We introduce a biportal endoscopic fenestration for symptomatic foraminal Tarlov cysts. We present the case of a 40-year-old woman experiencing radiating pain in her right lower leg for 4 years. On seeking treatment, her great toe and ankle plantar flexion power had decreased. Magnetic resonance imaging revealed a cystic mass located in the L5-S1 intervertebral foramen that compressed the lumbar nerve root. Partial laminotomy was performed using a percutaneous biportal endoscopic system with a far lateral approach. An oval cystic mass of 2.6×1.1 cm was identified on high-definition images. Partial bone and foraminal ligament removal and cystic membrane fenestration were performed for nerve decompression. After decompression, the patient's motor weakness and radiating pain improved. Due to high-definition images and the minimally invasive laminotomy procedures associated with percutaneous biportal endoscopic fenestration, a foraminal Tarlov cyst was fenestrated safely, and weakness arising from radiculopathy was resolved in the current case. [Orthopedics. 20XX;XX(X):xx–xx.]

神经周围 (Tarlov) 囊肿是腰骶部常见的良性病变，但很少出现症状，即使在压迫脊柱根部时也是如此。尽管 Tarlov 囊肿在脊柱孔中很少见，但由于空间狭窄，这种类型比其他部位的症状更明显。我们为有症状的椎间孔 Tarlov 囊肿引入双孔内窥镜开窗术。我们介绍了一名 40 岁女性的右小腿放射痛 4 年的病例。在寻求治疗时，她的大脚趾和脚踝跖屈力量有所下降。磁共振成像显示位于 L5-S1 椎间孔内的囊性肿块压迫腰神经根。使用经皮双孔内窥镜系统和远外侧入路进行部分椎板切开术。椭圆形囊性肿块，大小为 2.6×1。在高清图像上识别出 1 厘米。部分骨和椎间孔韧带切除和囊膜开窗术用于神经减压。减压后，患者的运动无力和放射痛得到改善。由于高清图像和与经皮双孔内窥镜开窗相关的微创椎板切开术，Tarlov 椎间孔囊肿被安全开窗，神经根病引起的虚弱在本例中得到解决。[ 由于高清图像和与经皮双孔内窥镜开窗相关的微创椎板切开术，Tarlov 椎间孔囊肿被安全开窗，神经根病引起的虚弱在本例中得到解决。[ 由于高清图像和与经皮双孔内窥镜开窗相关的微创椎板切开术，Tarlov 椎间孔囊肿被安全开窗，神经根病引起的虚弱在本例中得到解决。[骨科。20XX;XX(X):xx–xx.]