The patient came to the clinic 11-December-2004 complaining of LBP  with right sciatica for 5 years with deterioration last 5 months  with inability to walk more than 50 meters due to intermittent claudication. MRI lumbar spine performed 30-November-2004 showing severe LCS L3-4 and L4-5 with mild spondylolisthesis L4-5 with no overmobility.

On examination: The patient is not limping with exaggerated scoliotic stance. She has urinary incontinence the last 2 months. There is weak dorsi and planterflexion both feet 4/5. SLRS was 80 degrees with without pain right side.

Decompressive laminectomy L3,4, lower half of L2 and upper half of L5 with foraminotomy both L4 and L5 roots both sides. Check for overmobility during skeletonization was negative for what transpedicular fixation was not performed. The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak. Routine closure of the wound.

Smooth postoperative recovery. The power of the feet improved. She was sent to the ward.

The patient came to the clinic 25-December-2004  with normal micturition and normal senso-motor  state. The patient then came 08-January-2005 with LBP  after falling down, but neurologically she was intact. The patient then came 25-June-2005 with numbness right foot. There is severe OA both knees with limitation of flexion right knee with signs of inflammatory process. She was sent for investigation, but she disappeared.

The sooner the surgical decompression the better the outcome during progressive lumbar canal stenosis.