Lumbar canal stenosis when progressive, it must be treated by surgical decompression. The sooner the decompression the better the outcome.

The estimated postoperative recurrence is around 7%, because the disc space is still not completely shallow.

The patient came to the clinic 14-May-2003 complaining of LBP for 30 years with left sciatica. CT-scan lumbar spine done 1995 showing stenosis at L5-S1. Thyroidectomy 1977, in L-thyroxin 100 microgram daily.

On examination: the patient is in agonizing pain, limping with exaggerated scoliotic stance with SLRS 90 degrees right side without pain and 90 degrees left side with pain. She has weak dorsiflexion both feet 4/5 more pronounced in the left. There is hypalgesia left  L5.S1 roots.

The patient was sent for investigation and MRI lumbar spine done 12-May-2003 showing severe lumbar canal stenosis L2-3, 3-4, 4-5 with lateral recess syndrome.

Decompressive laminectomy L3,4, upper third of L5 and lower third of L2 with foraminotomy both L3, 4 and L5 roots. The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak. Routine closure of the wound

Smooth postoperative recovery. She was sent to the ward.

The patient came to the clinic 02-June-2003 with clean wound and full power and hypalgesia left L5 root.

The patient then came 15-September-2012 complaining of decreased vision with fainting attacks with neck pain and weak grip and extension right hand with right triceps muscle. The patient was sent for investigations, but she did not show up.