The patient  came to the clinic 07-April-2012 complaining of LBP with bilateral sciatica down to the knees for 1 month with inability to walk. The patient underwent surgery to the spine for lumbar canal stenosis L3-4, but the LSS-X-ray showing transpedicular fixation of L4-5 and S1. The patient had CVA in November-2011. The patient is a known hypertensive for 5 years in treatment.

On examination, the patient is unable to stand for Romberg and scoliotic evaluation. There is weak grip left hand 3/5 and extension left hand and left biceps and triceps 4/5. SLRS was 50 degrees with tightness right side and with pain left side. There is weak dorsiflexion both feet +3/5 with analgesia right L5 root territory. The patient was sent for investigations and MRI lumbar spine performed 14-May-2012 showing severe lumbar canal stenosis L3-4 with the pedicle screws in the L4,5 and S1 bodies. There is also bulge L3-4.

Decompressive laminectomy L2,3 and L4 down until the scar covering the dura was noted. The epidural fat was missing all over the exposed area. Foraminotomy of L4,L5 both sides. All the compressing elements were eliminated. Check image-intensifier was applied to be sure that no missing compression was escaped.

Routine closure of the wound. Smooth postoperative recovery and the power of both legs normalized.

The patient has lumbar canal stenosis of L3-4 for which she must be operated in the first time, but due to scanty data, the transpedicular screws were inserted to L4,5 and S1 bodies.

The L4 lamina was left in place in the previous surgery. Laminectomy of this part was included.