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29-JANUARY-2005 THURAYA DAWOOD ABDALLAH
AL-SALLAL 58 YEARS LUMBAR CANAL STENOSIS L4-5 WITH LEFT LATERAL
RECESS SYNDROME.
Anamnesis:
The patient came to the
clinic 12-January-2005 with
LBP and left sciatica L5 territory with
intermittent claudication for several months.
The patient is a known
diabetic for 6 years and hypertensive for 10
years.
MRI of the lumbar spine done
28-December-2004 showed bulge l%-s1 and L4-5
with segmental severe stenosis at L4-5 with
foraminal stenosis more the left.
On examination: the patient
has scoliotic stance, SLRS was 70 degrees in the
left with pain with almost drop left foot. She
had also O.A. both knees.
Decompressive laminectomy of
L4 and partial of L5 was performed and all the
compressive elements were eliminated. Bilateral
foraminotomy of both L5 roots was achieved,
using drilling to avoid surgical trauma to the
roots. The epidural fat was missing at the most
compressed levels.
Inspection of the L4-5
annulus fibrosis showed no extrusion.
Smooth postoperative recovery
and the power of feet improved dramatically, and
she was seen at the clinic 14-February-2005 with
mild left sciatica and mild weak dorsiflexion
left foot.
Follow Up
The patient came to the clinic 09-February-2005
with normalization of the power of the left
foot and decrease hypalgesia of the left L5,S1
territory. SLRS was 75 degrees both sides
without pain.
Comments
Lumbar canal stenosis is a
progressive disease and surgical intervention,
prevent further deterioration from the
progressive compression over the time.
Foraminotomies must be done
in most cases of LCS, because of frequent
association of lateral recess syndrome.
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