The patient a known
diabetic, was operated for PLD? 1971. He was complaining of
inability to walk for several months and numbness of both feet. On
examination, there was severe weak dorsi and planterflexion both
feet more pronounced in the right side. Hypalgesia both feet 10 cm
above the right ankle and 20 cm above the left ankle resembling
diabetic neuropathy. MRI requested and and showed severe stenosis of
L3-4, L4-5 and L5-S1.
The patient was operated through his old big
incision. It was surprisingly, that a lot of adhesions were found
all over in both sides, except the perineural structures, mandating,
that the previous surgery was done by immature surgeon and nothing
Decompressive laminectomy L3-4-5 and the upper
sacrum was done using the high-speed drill. All the compressive
elements were eliminated and bilateral foraminotomy of L4, 5 and S1
was done. Routine closure.
Immediate postoperative improvement of the power
both legs noted in the recovery room.