The patient came to the clinic 12-December-1998 complaining of LBP for 15 years with left sciatica for 3 months with numbness of left L5 territory and pain left knee. At that time she was neurologically free and treated conservatively. MRI lumbar spine done 28-December-1998 showed lumbar canal stenosis L1-2, 3-4, 4-5 and L5-S1, but she can walk freely more than 1 Km. The patient came several times and MRI was repeated and treated conservatively. The she came 05-July-2004 complaining of LBP with left sciatica for the last 5 days.

On examination: The patient is limping with exaggerated scoliotic stance. SLRS was 75 degrees left side with pain. There is drop both feet and weak planterflexion left foot 3/5.

The patient was sent for investigations and MRI lumbar spine done 06-July-2004 showing severe stenosis L3-4 and L4-5.

Decompressive laminectomy L4 and upper half of L5 and lower half of L3 with foraminotomy both L4 and both L5 roots was done. The disci of L3-4 and L4-5 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 both feet became normal.

The patient came to the clinic 24-July-2004 with clean wound and no motor deficit. SLRS was 90 degrees both sides without pain. There is hypalgesia right L5 root territory.

The patient came 15-September-2004 complaining of  right sciatica with SLRS was 80 degrees with pain. She has osteoporosis. She was neurologically free , but has OA right knee and treated conservatively.

The patient then came 13-March-2008  complaining of numbness both hands and feet for 5 months with morning stiffness with rheumatoid hands. There was neck pain and weak muscles upper limbs with hypalgesia both median territories. She was sent for thorough investigations and given medications, but she did not appear after that.

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

With age different pathologies arise and must be dealt accordingly.