The patient came to the clinic 16-October-2008 complaining of LBP with bilateral sciatica for 10 years with exacerbation the last 2 years. He has intermittent claudication and can walk less than 100 meters.

On examination: the patient  has weak dorsiflexion both feet 4/5. He has scoliotic stance with SLRS 70 degrees both sides with pain.

The patient is a known diabetic for 19 years under treatment.

MRI of the lumbar spine with MRMyelography was performed 16-October-2008 showing lumbar canal stenosis L4-5 and lesser degree at L3-4.

Decompressive laminectomy of L4 and partial of L3 and L5 was performed. The epidural fat was missing at all levels. Foraminotomy of L5 roots was performed both sides. Inspection of the L4-5 annulus fibrosis was negative and it was decided not to violate the disc space. Routine closure of the wound.

Smooth postoperative recovery and the power of both feet normalized.

Recovery of the compressed root depends upon 2 major factors: 1. the degree of compression with the subsequent damage of the fibers before surgery, 2. the length of time of damage, before surgery.

Lumbar canal stenosis is a progressive disease and the sooner the better to perform surgery before permanent dame take place to the compressed root.

So as to prevent estimated progression of the stenosis at L3-4 in the near future, it was decided to decompress it as well.