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12-APRIL-2009  RASMIYEH ATIYEH HIJAZY  68 YEARS  LCS L3-4, L4-5 AND L5-S1 WITH SPONDYLOLISTHESIS L4-5 AND BILATERAL RECESS SYNDROME L4-5.

Anamnesis:

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The patient came to the clinic 09-April-2009 complaining of LBP for three years with exacerbation the last year and bilateral sciatica and inability to walk more than 150 meter with intermittent claudication. The patient has frozen left shoulder for more than 10 years.

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MRI lumbar spine performed 07-February-2009 showing spondylolisthesis L4-5 with elements of severe stenosis.

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On examination: there is weak dorsiflexion both feet 3/5 more the right and planterflexion right foot 4/5 and hypalgesia right L5 territory.

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The patient was sent for MRI lumbar spine with MR Myelography which was performed 10-April-2009 showing the same findings including LCS L5-S1 and L3-4 with bilateral recess syndrome at L4-5. Bone density scan was normal for the spine and osteoporotic for the hips.

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Decompressive laminectomy of L3-4-5 was performed and check for instability was performed at all steps of the operation. It was negative. Foraminotomy of both L5 roots was performed. The roots hanging free. Routine closure of the wound.

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Smooth postoperative recovery with prompt recovery of the power of both feet.

Comments

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During surgical intervention transpedicular screws were included in the plan for possible fixation, in case that instability having place.

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At all stages of the surgery, check for instability was performed and plan to use transpedicular screws was abandoned at the end of the procedure.

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