The patient came to the clinic 18-November-2006 complaining of right sciatica for 1 year duration.

On examination: The patient has scoliotic stance with SLRS 80 degrees in the right, absent AJ both sides and hypalgesia right L5 and S1 territories with weak dorsiflexion both feet 3/5 right and 4/5 left and planterflexion right foot.

MRI lumbar spine performed 23-November-2006 showed severe lumbar canal stenosis L2-3, L3-4, L4-5 and L5-S1. The patient was advised to undergo surgery but she disappeared.

The patient came 10-November-2007 with deterioration of her condition and right sciatica and cramps both lower limbs with hypalgesia below L1 dermatome in the right and weak both feet and the right quadriceps femoris.

The patient was sent another time for MRI investigation, which confirmed the presence of the previous mentioned stenosis with right lateral recess syndrome.

Decompressive laminectomy of L2-3-4-5 and partial of L1 and upper sacrum with foraminotomy of both L3-4-5 and right S1 roots was performed. The dura was lacking the epidural fat and its wall was whitish with calcification, due to old compression. Routine closure of the wound.

Smooth postoperative recovery with normalization of the power of both legs.

Lumbar canal stenosis is a progressive disease and if it is showing deteriorating course surgery is mandatory to prevent further damage to the neural tissues.

There was a huge Tarlov cyst at S2 which was coincidental finding and have no clinical significance.