The patient came to the clinic 26-August-2012 complaining of LBP for 5 years with bilateral sciatica for one year in the left and 1 month in the right.

MRI lumbar spine performed 23-August-2012 showing bulge L2-3, 3-4, 4-5 with severe canal stenosis L4-5 and to lesser degree of the L2-3.

On examination, the patient is limping with exaggerated scoliotic stance, using crutches for one year. SLRS was 70 degrees with pain in the right. There is weak dorsiflexion both feet -4/5 and planterflexion right foot -4/5. Hypalgesia right L5 and S1 territories. There is OA both knees without local pain.

Laminectomy L4 and L5. There is severe stenosis mostly at L4-5 level. The ligamentum flavum and ligamentous structures of the lateral masses were severely adherent to the dura, for what sharp dissection was applied to avoid tear of the transparent dura. Foraminotomy of both L5 roots. Inspection of the annulus fibrosis of L4-5 revealed no extrusion, for what it was decided not to violate the disc structure.

Routine closure of the wound. Smooth postoperative recovery and the power of  both feet became normal.

The patient has severe lumbar canal stenosis. The sooner the surgical decompression the better the outcome.