The patient came to the clinic 11-June-2006 complaining of LBP with inability to walk for 1 year. She was complaining of LBP with bilateral sciatica more the left for 2 years.

MRI lumbar spine done 14-June-2006 showed severe lumbar canal stenosis L3-4 and L4-5.

On examination: the patient was in agonizing pain with scoliotic stance with SLRS 5 degrees right side and 20 degrees left side. There was weak planterflexion and dorsiflexion both feet and hypalgesia right L5 root and analgesia left S1 root territories.

The patient came to the clinic another time 03-February-2007 with repeat MRI showing further escalation of her lumbar canal stenosis with clinical deterioration with bone scan demonstrating osteoporosis.

Decompressive laminectomy of L4 and L5 with partial laminectomy of the 2/3 of the lower part of L3 lamina was achieved. Check for instability was performed and no overmobility was noted especially at the L4-5 level. The epidural fat was absent and the dura was very thin and transparent, that the running roots were under vision.
Foraminotomy of L4, L5 roots was performed from both sides.

Routine closure and smooth postoperative recovery and improvement of the power of the feet.

Lumbar canal stenosis is a progressive disease, which require surgery sooner or later.
The sooner the intervention the better the outcome.
Osteoporosis contribute in the escalation of the pathologic process but it's treatment cannot arrest the progression of the disease. The patient must receive osteoporosis treatment for long period of time.