The patient came to the clinic 13-January-2007 complaining of LBP with shooting right sciatica and inability to walk the last week. Mild LBP had for 2 months. MRI performed 10-January-2007 showing LCS L3-4 and L4-5.

On examination: the patient was unable to stand to see his scoliotic stance. SLRS was 70 degrees both sides. Sensation was intact, but he had drop both feet with planterflexion right foot 2/5 and 3/5 of the left foot. Both knee abduction was 2/5 with adduction 3/5 and quadriceps femores 4/5 both sides. He had normal micturition and defecation.The patient is a known diabetic and hypertensive with bronchial asthma, for what cardio consultation was asked before the operation.

Decompressive laminectomy of L3, L4 and partial of L5 was done. The epidural fat was absent all over and the hypertrophied ligamentum flavum was inflamed in the left side and adherent to the dura. Using sharp dissection, these parts were removed. Foraminotomy of right L4,5 and left L4 was achieved and the the foramina were checked for their patency. Inspection of L3-4 and L4-5 disci confirmed their good alignment. They were kept intact. Routine closure with smooth postoperative recovery with normalization of the power except the power of the right foot dorsiflexion.

The patient showed an abnormal course of lumbar canal stenosis: short duration and right sciatica. The weakness is more profound, than to be explained by the morphologic data. These hold the suspicion, that another provocative factor playing a role. The presence of ligamentitis of granulomatous behavior hold suspicion about sarcoidosis or other granulomatous disease.The patient was complaining more from the right side and the pathological findings were in the left. This could be explained by the tiny structures of the nerve roots and severity of the compression. It is hard to tell, why such discrepancies taking place.

The patient showed an abnormal course of lumbar canal stenosis: short duration and right sciatica. The weakness is more profound, than to be explained by the morphologic data. These hold the suspicion, that another provocative factor playing a role. The presence of ligamentitis of granulomatous behavior hold suspicion about sarcoidosis or other granulomatous disease.

The patient was complaining more from the right side and the pathological findings were in the left. This could be explained by the tiny structures of the nerve roots and severity of the compression. It is hard to tell, why such discrepancies taking place.