The patient an old man with
gradual deterioration of his gait with bilateral sciatica and
intermittent claudication and inability to walk for more than 10-15
meters. The condition is progressing and he had severe weak dorsi
and planterflexion of his feet with hypalgesia of both feet . He has
no diabetes mellitus, nor arterial hypertension. MRI performed
showing severe stenosis of L3-4.
The patient underwent surgery and
all the compressive elements were eliminated and bilateral
foraminotomy of both L4 roots was performed. It was noticeable, that
there was mild instability of the L3-4 facet, but check for major
instability of flail parts was negative. Inspection of the roots
during that was evaluated and it was decided to leave the structures
without any violation.
Prompt immediate postoperative
improvement of power of the feet in the recovery room.