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15-JULY-2003 KUZAYDEH RUSHDI ABU-SOFEH 70
YEARS SEGMENTAL STENOSIS WITH BILATERAL DROP FEET.
Anamnesis
The patient came to the clinic 10-July-2003
complaining of inability to walk more than 10
meters due to bilateral sciatica more the left
for 5 years with intermittent
claudication. Micturition problems for more than
2 years. The patient has Parkinson disease under
treatment.
On examination, the patient has drop both feet
of unknown duration with weak planterflexion
both feet 3/5 with hypalgesia both L5 and S1
roots. SLRS was 70 degrees both sides without
pain.
The patient was sent for investigation and MRI
of the lumbar spine showed severe lumbar canal
stenosis L4-5 with collapsed disc space and
stable spondylolisthesis L4-5.
Decompressive laminectomy
L4-5 with bilateral foraminotomy both L5 roots.
Fat transfer was performed to minimize
postoperative adhesions. 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 both feet slightly improved. She was sent to the ward.
FOLLOW UP
The patient
came to the clinic 13-August- 2003 with clean wound.
Micturition control improved and the power of both
feet , but still having weak dorsiflexion left foot
4/5 and the sensation recovered.. The patient has
severe OA both knees and sent for orthopedic
consultation for total knee replacement.
Comments
It seems that drop feet was of
short duration and not complete, for what the
recovery took place after short postoperative
duration.
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Notice: Not all operative activities
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Notice: Head injuries and very urgent surgeries are also
escaped from the plan .
