NEWS

The patient came to the clinic 20-August-2007 complaining of LBP  and bilateral sciatica for 2 months more to the right. He came with crutches.

On examination SLRS was 10 degrees in the right side with weak dorsi and planterflexion all toes right foot and scoliotic stance

The patient sent for MRI and it was performed 20-August-2007 showing LCS L3-4 and L4-5 with lateral recess syndrome and mild degree of spondylolisthesis L4-5 without isthmolysis.

Skeletonization of L3-4 and L5 laminae was performed with preservation of the intraspinous ligament. Check for instability and isthmolysis was negative.

Decompressive laminectomy of L4 with partial of L3 and L5 was done with foraminotomy of L4 and L5 roots both sides was performed.

Inspection of the L4-5 disc showed no extrusion and the annulus fibrosis was glistening, for what it was decided not to violate the intradiscal space.

Using the high-speed drill and small size Smith-Kerrison a special tunnel was created for the right L5 root.

There was no epidural fat in the entire field and the dura was very tiny, that the roots could be seen through the dura.

Check for instability or loose parts of the remaining bony alignment was negative for presence of iatrogenic complications. The isthmi were wide in both sides exceeding 10 mm.

Routine closure and smooth postoperative recovery and normalization of the power of the right lower limb.

The patient has the same diagnosis as the operation performed yesterday, but the surgery was different. This difference coming out from the sense of the surgeon, that he managed all the compressive elements.

The lateral recess syndrome share in the compressing process, which must be corrected during surgery.

Mild degree of spondylolisthesis with no evidence of overmobility did not interfere with corresponding management and no need for transpedicular fixation was required.