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27-JUNE-2009  LAFI MUSA SALEH  70 YEARS  LUMBAR CANAL STENOSIS L2-3, L3-4 AND L4-5 WITH DROP FEET

Anamnesis:

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The patient came to the clinic 25-April-2009 complaining of difficult walking due to severe weak distal muscles lower limbs. He is a known diabetic, insulin-dependant for 10 years and he performed decompressive laminectomy cervical region three years ago after what the power of the upper limbs improved.

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On examination: the patient was limping , using crutches with drop both feet and severe weak planterflexion both feet 2/5 more the right side. He has analgesia below the knee level both sides.

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MRI lumbar spine performed 26-April-2009 showing severe lumbar canal stenosis L2-3, L3-4 and L4-5 with foraminal stenosis.

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Decompressive laminectomy of L2-5 was performed. Bilateral foraminotomy of L2,3,4 and L5 roots was achieved both sides. The epidural fat was absent at all levels and the dura was transparent, that the running roots were seen pulsating inside it. Routine closure of the wound

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Smooth postoperative recovery with the same neurological picture.

Comments

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The patient has diabetic neuropathy which is mostly not related with the stenosis. It will not improve after surgery.

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The patient came with neglected neurological deficit, which will need a long time to recover partially.

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The aim of surgery is to prevent further deterioration of his neurological losses.

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