The patient came to the clinic 27-March-2013 complaining of LBP for 10 years with right sciatica for 5 years. Bilateral sciatica with intermittent claudication for for 7 months. She can walk only 200 meters. The last 3 months right shoulder pain with right upper limb pain and weakness and incontinent for 6 months.

On examination: The patient is not limping now. There is weak grip and extension right hand 4/5 and right triceps muscle 4/5. There is weak dorsiflexion both feet -4/5. Exaggerated scoliotic stance. OA right shoulder without frozen shoulder.

The patient was sent for MRI of the cervical and lumbar spine, which done 27-March-2013 showing extruded disc C5-6 with severe lumbar canal stenosis L2-3, L3-4 and L4-5. Dynamic studies ruled out spondylolisthesis. Gout was diagnosed and Zyloric started and Vit D3 deficiency was considered.

Decompressive laminectomy of L3,4,5 and lower half of L2. Foraminotomy L3,4,5 both sides and right S1 root. All the compressive elements were removed. The dura was transparent with no epidural fat.

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

The patient has has severe progressive lumbar canal stenosis. The earlier the surgical decompression the better the result.