The patient came to the clinic 14-March-2004 complaining of left sciatica with drop left foot for 4 years with numbness both feet. Using crutch for 1 month. MRI lumbar spine done 18-March-2001 showing lumbar canal stenosis L2-3, 3-4 and L4-5.

On examination: the patient is limping walking bended anterior with exaggerated scoliotic stance. SLRS was 80 degrees left side with pain. There is atrophy both forelegs with drop left foot and weak dorsi and planterflexion both feet 3/5 with hypalgesia below the left knee. Weak both quadriceps femoris 4/5 and abduction of both knees 3/5.

The patient was sent for investigations and MRI lumbar spine performed 14-March-2004 showed severe lumbar canal stenosis L1-2, 2-3, 3-4 and L4-5.

Decompressive laminectomy L2,3,4 upper half of L5 and lower half of L1 with foraminotomy L2,3,4,5 both sides. The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak. A free fat was harvested from the subcutaneous layer and covered the exposed parts of the root, to minimize postoperative scarring. Routine closure of the wound. Smooth postoperative recovery. The power of the left foot improved.

The patient came to the clinic 29-March-2004 with clean wound and SLRS 80 degrees both sides without pain and normal power of all muscles of the lower limbs, except the dorsiflexion left foot 3/5. The analgesia disappeared and dysesthesia at L4 dermatome appeared.

The patient then came 07-August-2005 complaining of cramps left lower limb. He was treated conservatively.

The patient then came 06-October-2009 with LBP for 1 month with left sciatica, walking bended with scoliotic stance  with weak dorsi and planterflexion left foot 2/5.He was sent for investigations and MRI lumbar spine done 10-October-2009 showing severe osteoporosis with fracture L3 and L4 with extruded disc L1-2. He was treated conservatively.

The progressing lumbar canal stenosis needs surgical intervention. The sooner the surgical intervention, the better the outcome.