The patient was operated by me 09-Sptember-2003 for extruded disci C4-5, 5-6 and C6-7 with anterior fusion of C4-5-6-7. The patient recovered his tetraparesis and disappeared. The patient then came 12-April-2015 complaining of right shoulder pain for 45 days. LBP for 6 days with right sciatica.

On examination; the patient is limping with exaggerated scoliotic stance. Neck and upper limbs were neurologically free. OA right shoulder. SLRS was 80 degrees with pain in the right. There is weak dorsi and planterflexion right foot.

The patient was sent for investigations and MRI lumbar spine performed 12-April-2015 showing severe lumbar canal stenosis L2-3, L3-4 and L4-5. Dynamic studies ruled out overmobility, instead there is fusion of the anterior annulus fibrosis of L2-3, 3-4 and L4-5. with massive ossification.

Using the C-arm, decompressive laminectomy of L3,4 and upper 2/3 of L5 and lower third of L2 was done. Foraminotomy right L4 and L5 roots. The dura was transparent due to severe compression. Routine closure of the wound.

Smooth postoperative recovery. The power of right foot became normal.

The patient came to the clinic 09-May-2015 with clean wound and the power of the feet normalized with hypalgesia right L5 root. SLRS was 80 degrees both sides without pain.

The patient then came 06-March-2017 with left sciatica for 10 days down to all toes left foot with SLRS 60 degrees left side with pain. No motor deficit. The patient was sent for investigations and MRI of the lumbar spine done the same day showing extruded disc L4-5 with left foraminal occlusion. The patient was given medication and given admission, but he disappeared.

The stenosis when progressive, the sooner the decompression the better the outcome.