The patient came to the clinic 04-September-2004 complaining of LBP for 25 years with numbness both lower limbs, more the right the last 10 days. The condition is deteriorating with difficult walking with intermittent claudication.

On examination: The patient using crutches for 4 months, is limping with exaggerated scoliotic stance. SLRS was 90 degrees both sides without pain. There is bilateral drop feet with weak planterflexion both feet 3/5. There is hypalgesia 10 cm below both knees, more pronounced at both L5 roots territories. There is positive Hoffman sign left side.

The patient was sent for investigations and MRI of the brain done 06-September-2004 showing scattered infarctions, more at the left left semiovale. Lumbar spine showed lumbar canal stenosis L3-4, 4-5 and L5-S1.

Decompressive laminectomy L4, L5 and upper edge of the sacrum and lower half of L3 with foraminotomy both L4, both L5 and S1 roots was done. The disci of L3-4, L4-5 and L5-S1 were inspected and not removed because they were hard, immobile. Check for instability was negative. The subcutaneous fat was harvested with pedicle and transferred to the dura to decrease the postoperative scar formation.

Routine closure of the wound. Smooth postoperative recovery. The power of the right foot improved.

The patient came to the clinic 18-September-2004 with the wound having collection and 15 cc serous fluid evacuated and further improvement of the power of both feet. SLRS was 80 degrees both sides without pain.

The patient then came 22-September-2004  with regression of the hypalgesia to the dorsum of the left foot.

The lumbar canal stenosis when not progressing and the patient in good shape, we put him under observation, since progress and deterioration happens, surgery is mandatory.