The patient came to the clinic 08-September-2002 complaining of LBP for 9 years with weakness left foot. Exacerbation of the condition with bilateral sciatica the last 2 years. The patient cannot walk more than 50 meters with intermittent claudication. A known case of diabetes for 9 years in treatment. He has IHD. MRI done 24-February-1999 showing severe lumbar canal stenosis L3-4, L4-5 with retrolisthesis L4-5.

On examination: The patient in in pain, limping with exaggerated scoliotic stance. SLRS 90 degrees both sides with pain. There is drop left foot with severe weak planterflexion both feet and dorsiflexion right foot 3/5. Hypalgesia both L5 and left S1 territories.

The patient sent for investigations: MRI lumbar spine showing severe lumbar canal stenosis L3-4, L4-5 with retrolisthesis L4-5. 

Decompressive laminectomy L4 lower third of L3 and upper third of L5. Bilateral L4 and L5 foraminotomy both sides. Inspection of the disc revealed extruded disc L4-5 from the left with bilateral intradiscal cleaning L4-5. There was a tiny dural defect at the upper area of the field, which was repaired using nylon 6 zero. The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak. Routine closure of the wound.

Smooth postoperative recovery. The power of the right foot improved, but the drop left foot still the same. He was sent to the ward.

The patient came to the clinic 26-September-2002 with clean wound and still having slight weakness dorsiflexion right foot with the hypalgesia regressed to the L5 territories with still drop left foot. SLRS was 90 degrees without pain both sides.

The sooner the surgical decompression in progressive LCS, the better the outcome.

Drop left foot with this age and long unknown duration and diabetes, make expectation for recovery nearly zero.