The patient came to the clinic 12-October-2010 complaining of LBP for one month and right sciatica down to L5 territory with numbness.

On examination: The patient is limping with exaggerated scoliotic stance, walking bended  with SLRS 70 degrees in the left with pain. There is weak dorsiflexion right foot -4/5 with no sensory deficit.

MRI lumbar spine performed 24-October-2010 showing severe lumbar canal stenosis L4-5.

Decompressive laminectomy of L5 with partial of L5 and foraminotomy both L5 roots and bilateral flavotomy L3-4 was achieved. There was no epidural fat and the dura was transparent, that the roots could be seen through it.

No CSF leak and no tears  and inspection of the annulus fibrosis revealed no disc extrusion.

Routine closure of the wound. Smooth postoperative recovery and normalization of the power of the right foot.

The patient has lumbar canal stenosis with root compression from behind. Since the stenosis is a progressive disease, surgery is the only solution.

Decompression must include the ongoing stenosis at L3-4, so as to avoid further surgery in the near future.