The patient came to the clinic 13-December-2005 complaining of migraine and thyroid mass and rheumatoid arthritis and was treated accordingly. Then she came 08-April-2009 complaining of LBP for 7 months with intermittent claudication with bilateral sciatica and inability to walk more than 100 meters. On examination at that time, she was limping with exaggerated scoliotic stance. SLRS was 30 degrees with pain both sides. Weak dorsiflexion left foot -3/5 and right 3/4 and planterflexion both feet 4/5. There was hypalgesia both L5 and S1 both feet. MRI lumbar spine done 10-April-2009 showed severe lumbar canal stenosis L3-4 and L4-5 with mild spondylolisthesis L4-5. She was advised to undergo surgery, but she escaped.

The patient son then came 05-January-2013 telling that she was treated for Ca breast by chemotherapy with new MRI performed 05-January-2013 showing the same picture as before with cardiomegaly. The patient then was seen by cardiologist and oncologist, who they reported that, she is fit for surgery. The patient now cannot walk more than 10-20 meters.

Decompressive laminectomy L4 and upper third of L5 and lower2/3 of L3. The dura was lacking the epidural fat due to severe compression. Foraminotomy of L4, L5 roots both sides. During surgery at all stages check for instability or overmobility was negative, for what fusion was not needed.

Routine closure of the wound. Smooth postoperative recovery. The power of the feet became better.

The patient has severe lumbar canal stenosis with spondylolisthesis of L4-5. At all stages of surgery check for instability or overmobility was done to rule out the possible negative effect of this stable spondylolisthesis after surgery.