The patient came to the clinic 22-January-2007 complaining of LBP with left sciatica for three years. Exacerbation the last five months. MRI of lumbar spine done 23-December-2006 showed extruded disc L4-5 more to the left with segmental stenosis at the same level. The patient could walk more than 100 meters with SLRS 70 degrees both sides and weak dorsiflexion both feet 4/5. The patient was treated conservatively.

The patient then came 30-April-2008 with gross deterioration the last 2 weeks. SLRS was 60 degrees in the right and 40 degrees in the left with weak dorsiflexion right foot 4/5 and left foot 3/5 and inability to walk without aid and severe scoliotic stance.

MRI performed 02-May-2008 showed severe lumbar canal stenosis L4-5 with extruded disc L4-5 more to the left with total CSF occlusion in MRMyelography.

Decompressive laminectomy of L4 and foraminotomy of left L5 root was performed. Bilateral inspection of the disc of L4-5 was performed and the extruded disc L4-5 was removed from the left side lateral to the axilla and meticulous cleaning of the disc space was achieved.

Routine closure of the wound with smooth postoperative recovery.

Considerable improvement of the power of the left foot.

Lumbar canal stenosis is a progressive disease and surgery must be performed the sooner the better, if the clinical manifestations are escalating.

Lumbar canal stenosis is not a cause for radicular pan, and the cause must be found and resolve, as in this case the extruded disc material, which was compressing the left L5 root.