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The patient came to the clinic
29-June-2006 complaining inability to fell the legs after
parathyroidectomy 5 years ago. The condition continued to
deteriorate the last year with inability to walk with intermittent
claudication. She is using crutches the last 4 months. MRI of the
spine done 29-May-2006 showing severe LCS L4-5 with lesser degree at
L3-4 with mild right CTS. She is a known parkinsonian. She has
micturition problems for the last 4 months. On examination: SLRS
was 45 degrees with pain in the right side with almost drop both
feet with weak planterflexion both feet and abduction and
adduction of the knees and hypalgesia both feet above the ankle.
Decompressive laminectomy of L4 and partial of L3 and L5 was
performed and foraminotomy of L4 and L5 was done both sides.
The power of both legs improved immediately after the operation
and the sensation still the same.
Comments: 1. LCS when
progressing, surgery give better results when the patient still not
suffering from irreversible damage to the neural structures. 2.
Parathyroidectomy provoked the
sensory deficit as the patient mentioning, but it is unclear how the
LCS playing role in this situation. |
