The patient came to the clinic 19-December-2011 complaining of left hip for 3 months down to the left knee. The patient is a known diabetic for 5 years with arterial hypertension for the same period.

On examination, the patient is limping with exaggerated scoliotic stance. There is weak dorsi and planterflexion left foot 3/5 with weak dorsiflexion right foot 4/5 with hypalgesia left foreleg below knee. SLRS was 90 degrees in the right without pain and 40 degrees in the left with pain.

The patient was sent for MRI of the lumbar spine, which were done 21-December-2011 showing severe stenosis at L4-5 with left foraminal extrusion of L4-5 disc and spondylolisthesis L4-5  I degrees by Myerding and mild spondylolisthesis L5-S1.

Decompressive laminectomy L4 and partial of L3 and L5. The left far-lateral extrusion was removed and left sided cleaning of the disc space was achieved. At all stages of surgery, check for instability was performed and the L4-5 and L5-S1 were stable. There was slight overmobility of L3-4, but considering its non-relevance, it was omitted from calculations.

Routine closure of the wounds. Smooth postoperative recovery with improvement of the power of the left foot.

The patient had spondylolisthesis, for what transpedicular fixation was considered before surgery. Intraoperative findings ruled out the necessity for stabilizing procedures.