AGE
68
CONDITION
Lumbar spinal stenosis
TREATMENT
Two-level decompression
WALKING BEFORE
~200 yards
WALKING AFTER
4 miles at 3 months
Presentation
Over about two years, the patient noticed his legs growing heavy and crampy after only a short walk. Rest relieved it, but the distance he could manage kept shrinking, until reaching the local shops felt impossible. This pattern, eased by rest and by leaning forward, is classic neurogenic claudication.
Investigation
An unhurried consultation and a focused examination pointed to the lower lumbar spine. An MRI confirmed significant stenosis at the L3/4 and L4/5 levels , reviewed with the patient on screen so he could see the cause of his symptoms.
Shared decision
Non-surgical measures had already been tried. With the cause clear and his walking badly affected, decompression was discussed openly, including the option of continuing without surgery, so the decision was genuinely his.
Treatment
A muscle-sparing decompression was carried out at both the L3/4 and L4/5 levels under general anaesthetic. The patient mobilised soon after surgery and went home with a clear recovery plan.
Outcome
Three months following surgery, the patient was walking four miles without any leg pain.
