The patient came to the clinic 30-October-2005 complaining of LBP with left sciatica for 1 week with numbness of the left foot. The patient is a known hypertensive and in L-thyroxin for 30 years after thyroidectomy.

MRI lumbar spine done 21-April-2005 showed lumbar canal stenosis L3-4 and L4-5.

On examination: the patient could not walk than 5 meters and was limping with exaggerated scoliotic stance. She had weak dorsiflexion both feet more in the left.

The patient was sent for another MRI of the lumbar spine and she disappeared.

The patient came 01-February-2007 with continuous numbness both feet and bilateral sciatica. The scoliotic stance was inverted with weak dorsi and planterflexion both feet.

The patient sent for MRI with MR Myelography, which confirmed the presence of more severe degree of lumbar canal stenosis at the above mentioned levels.

Decompressive laminectomy of L4 and 2/3 of L3 and 1/3 of L5 was performed with foraminotomy of L4 and L5 roots both sides. There was no epidural fat and in some places the ligamentum flavum was adherent to the dura, which was transparent and very thin, that, it was possible to see the running roots inside the dura.

Routine closure and smooth postoperative recovery and improvement of the power of both feet.
 

Lumbar canal stenosis is a progressive disease. When there are clinical manifestations , related to the pathologic process, the sooner to operate, the better the prognosis for recovery of the neural structures.

Inspection of the foramina is important, so as to decompress the neural structures at the root level. For that a special probe must be applied to check the patency of the foramen.