The patient came to the clinic 10-November-2001 complaining of LBP with right leg analgesia below L2 with dysesthesia. Transpedicular screws were inserted 27-August-2000 at the level of L2,3,4 for unknown reason, because before the surgery, there was only small right extruded disc L3-4 and stenosis of L4-5. The patient was complaining of numbness right foot and lateral aspect of the thigh. MRI performed 14-November-2001 showing the screws at mentioned levels, with stenosis at L4-5. The patient then came 19-December-2001 with cervical pain with numbness of the fingers of the left hand. MRI cervical spine performed 24-December-20001 showing bulge C5-6 and extruded disc C6-7 with left foraminal compression. He was treated conservatively. The patient then came 20-August-2003 with agonizing pain  with MRI done the same day showing huge extruded disc L4-5.

On examination, the patient in agonizing pain, limping with exaggerated scoliotic stance with weak both lower limbs 3/5 and hypalgesia both L4 and S1 territories. SLRS was 20 degrees both sides with pain.

Decompressive laminectomy L4-5. Foraminotomy both L5 roots were achieved. The Bilateral intradiscal cleaning L4-5 was achieved. 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 left foot slightly improved.

The patient came to the clinic 27-September-2003 with clean wound and the power of both feet normalized with normal sensation. SLRS was 80 degrees right side with tightness.

The patient then came the last time 13-July-2005 complaining of both hips pain and neuralgia like pain both feet with urinary problems. He was sent to urology.

The indication for transpedicular screws is not clear. I cannot understand that.