The patient came to the clinic 05-January-1999 complaining of LBP for three years with left ankle pain for 1 week. On examination at that time, she was neurologically free with polyarthralgia and she had non-steroidal with anti-osteoporosis treatment.

The patient came 04-December-2001 with neck and right shoulder pain with numbness of the ulnar distribution both upper limbs. MRI of the cervical spine showed degenerative changes with mild cervical canal stenosis. She was treated conservatively.

The patient then came 13-November-2007 with exacerbation of the LBP for one month and bilateral sciatica more the left with difficult walking. She could walk only 5-7 meters. The pain increase during night and walk with bending foreword. MRI lumbar spine performed 09-November-2007 showing severe lumbar canal stenosis L2-3, L3-4 and L4-5 with left lateral recess syndrome. MRI cervical spine showing mild cervical canal stenosis.

On examination: The patient has scoliotic stance with SLRS 70 degrees in the left, hypalgesia left L5 territory with weak dorsiflexion both feet 4/5 right and 3/5 left.

Decompressive laminectomy of L3-4 and partial of L2 and L5 with foraminotomy of both L4,5 roots was performed. The dura was lacking the epidural fat and its wall was very transparent.
Routine closure of the wound.

Smooth postoperative recovery with normalization of the power of both feet.

Lumbar canal stenosis is a progressive disease and if it is showing deteriorating course, surgery is mandatory to prevent further damage to the neural tissues.