Patient Name : Mrs. Shinde
Age : 56 years
Introduction
A 56-year-old woman presented with severe low back pain, bilateral leg pain, neurogenic claudication, and difficulty walking for more than 5 minutes. MRI confirmed L4–L5 foraminal stenosis with lumbar canal stenosis, a common degenerative lumbar spine condition causing nerve compression.
She underwent L4 laminectomy, bilateral L3 foraminotomy, and L4–L5 TLIF in Pune, followed by rapid postoperative recovery and complete symptom resolution.
Patient History & Presentation
This patient experienced:
- 2 years of continuous low back pain
- Bilateral lower limb radiculopathy
- Pain that increased during standing, walking, sitting-to-standing transitions, and floor sitting
- Night-time pain disturbing sleep
- Neurogenic claudication with walking limited to 5 minutes
- Frequent slipping of chappals due to subtle motor weakness
- Difficulty performing kitchen activities due to need for frequent rest
Clinical findings included:
- Bilateral positive Straight Leg Raise test
- Motor weakness: EHL 4/5, EDL 4/5
- Symptoms consistent with disc prolapse, degenerative lumbar spine disease, and bilateral radiculopathy
These signs suggested significant nerve compression requiring surgical intervention.
Diagnosis & Radiology Findings
MRI confirmed:
- L4–L5 lumbar canal stenosis
- Severe foraminal stenosis compressing exiting nerve roots
- Degenerative changes of the lumbar spine
- Features suggestive of neurogenic claudication and radiculopathy
Layman Explanation:
The nerves at the L4–L5 level were pinched due to narrowing of the spinal canal and foramina. This caused pain, numbness, weakness, and difficulty walking.
Surgical Procedure: L4 Laminectomy + Bilateral L3 Foraminotomy + L4–L5 TLIF
The surgery included:
- L4 laminectomy
- Bilateral L3 foraminotomy for nerve root decompression
- L4–L5 TLIF (Transforaminal Lumbar Interbody Fusion)
- Use of GESCO implants
- Complete decompression of neural structures
- Fusion to stabilize the degenerative segment
People Also Ask:
Is spine surgery safe?
Yes — with modern MIS and endoscopic methods, safety and outcomes have greatly improved.
What is the recovery time after TLIF?
Walking begins within 24 hours; full healing takes 3–6 months.
Can endoscopic spine surgery treat stenosis?
Yes, biportal and uniportal endoscopic methods are excellent for selected patients.
Post-Operative Recovery
Day 1
- Full weight-bearing walking
- Pain significantly reduced
Day 2
- Completed staircase climbing
- Stable vitals, healthy incision line
Discharge (Day 3)
- Ambulating comfortably
- No fever, wound clean and dry
3 Months & 6 Months
- 100% improvement
- No back or leg pain
- No numbness
- Standing and walking tolerance fully restored
- Completely normal daily activities
Long-Term Outcome
The patient now experiences:
- Complete pain relief
- No tingling or numbness
- Ability to walk long distances without rest
- Full independence in household and outdoor activities
- Restored sleep quality
- High satisfaction with the surgical result
Why Surgery Was Necessary
Surgery was chosen because:
- Symptoms persisted for 2 years
- Walking tolerance was severely reduced
- Sleep was affected
- Progressive neurological weakness
- MRI showed severe nerve compression
- Conservative treatment failed
Without surgery, nerve damage could have become permanent.
About Dr. Sangram Rajale
Dr. Sangram Rajale is a leading Spine Surgeon in Pune, specializing in:
- Minimally Invasive Spine Surgery (MIS)
- Endoscopic Spine Surgery
- Biportal Endoscopy
- TLIF/PLIF fusion surgeries
- Nerve decompression
- Complex lumbar stenosis treatment
He practices at The Spine Doctor – Bavdhan, delivering high success rates and evidence-based care.
FAQs
Back pain, leg pain, numbness, tingling, weakness, and difficulty walking.
Patients walk the next day; full recovery occurs in 3–6 months.
Yes — it’s minimally invasive with faster recovery.
If symptoms persist >6 weeks or if weakness/numbness progresses.
Yes, because compressed nerves control leg muscles.