Lumbar canal stenosis when progressive, it must be treated by surgical decompression. The sooner the decompression the better the outcome.

The estimated postoperative recurrence is around 7%, because the disc space is still not completely shallow.

The patient came to the clinic 26-April-2003 complaining of LBP for 12 years with exacerbation last 4 years with bilateral sciatica more to the left for 5 months. She cannot walk more than 50 meters. MRI lumbar spine performed 10-October-2002 showing bulge L3-4 and L5-S1 with extruded disc L4-5 left side. The patient is hypertensive for 18 months in medication.

On examination: the patient is in agonizing pain, limping with exaggerated scoliotic stance with SLRS 90 degrees right side without pain and 90 degrees left side with pain. She has weak dorsi and planterflexion both feet 4/5 more pronounced in the left. There is hypalgesia left  L5.S1 roots.

The patient was sent for investigation and MRI lumbar spine done 11-May-2003 showing extruded disc L4-5 more to the left, bigger than before.

Decompressive laminectomy L4, upper third of L5 and lower third of L3 with foraminotomy both L4 and L5 roots. Bilateral cleaning of L4-5 disc space with removal of the extrusion. The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak. Routine closure of the wound

Smooth postoperative recovery. She was sent to the ward.

The patient came to the clinic 26-May-2003 with clean wound and full power and no sensory deficit.

The patient then came 28-June-2003 complaining of LBP with left sciatica, but she can walk more than 100 meters. The patient was treated conservatively.