Patient Name : Mrs. Babar
Age : 61 years
Introduction
This case highlights a 61-year-old woman suffering from severe lumbar canal stenosis from L2–S1 with L3–L5 listhesis, resulting in chronic low back pain, radiculopathy, and neurogenic claudication.
After a comprehensive evaluation at The Spine Doctor – Bavdhan, Pune, she underwent Spinal Osteotomy with Posterior Spinal Fixation and TLIF.
The outcome was exceptional — complete symptom relief, restored mobility, and high patient satisfaction.
Patient History & Presentation
The patient reported:
- Low back pain for 5 years
- Progressive worsening over the past 6 months
- Neurogenic claudication: Walking tolerance ~2 minutes
- Right leg radiculopathy
- Pain worsening with bending, sitting, coughing, sneezing
- Sleep disturbance
Clinical examination revealed:
- Flexion: Full
- Extension: Painful with catch
- Listhesis clinically evident
- Slouch test positive bilaterally
- EHL & EDL weakness (4/5 bilaterally)
These findings suggested multi-level nerve compression, degenerative spine disease, and dynamic instability.
Diagnosis & Radiology
X-ray LS Spine
- Grade I listhesis at L3–L4 and L4–L5
- Degenerative lumbar changes
MRI LS Spine
- Degenerative lumbar spine changes
- Grade I anterolisthesis L3–L4 & L4–L5
- Partial sacralization of L5
- Severe stenosis at L3–L4 and L4–L5 due to:
- Disc bulge
- Right paracentral protrusion
- Ligamentum flavum thickening
- Facetal arthropathy
- Bilateral lateral recess stenosis
- Nerve root compression (right > left)
This confirmed multi-level lumbar canal stenosis with two-level listhesis causing advanced neurogenic claudication.
Surgical Procedure – Spinal Osteotomy + Fixation + TLIF
To correct deformity, decompress nerves, and stabilize the spine, the following were performed:
- Spinal Osteotomy
- Corrected alignment
- Opened compressed canal space
- L3–S1 Posterior Spinal Fixation
Using Jesco implants:- Poly screws 6.5 mm (lengths 40 & 45 mm)
- Pre-cut rods
- Titanium cages
- TLIF at L3–L4 and L4–L5
- Disc removal
- Cage placement for fusion
- Bilateral decompression of nerve roots
People Also Ask:
Is spine surgery safe for elderly patients?
Yes — MIS techniques and proper planning make it safe and effective.
Does TLIF help in severe stenosis?
TLIF stabilizes the spine and decompresses nerves, offering excellent relief.
What is recovery time after spinal fixation?
Patients walk day 1 and improve significantly within weeks.
Post-Operative Recovery
Day 1
- Walking full weight-bearing
- Significant radicular pain relief
Day 2
- Stair climbing
- Improved posture and mobility
Neurological Recovery
- All movements 5/5 bilaterally
- Sensation intact
- Reflexes normal
Long-Term Outcome (5 Months)
The patient reported:
- Complete (100%) symptom relief
- No back or leg pain
- No numbness or tingling
- Able to walk long distances confidently
- Sleep restored
- No functional limitations
- High emotional satisfaction after overcoming fear of surgery
This demonstrates successful lumbar stenosis treatment Pune, and excellent fusion outcomes.
Why Surgery Was Necessary
- Multi-level severe lumbar canal stenosis
- Progressive radiculopathy
- Neurogenic claudication
- Two-level listhesis
- Poor quality of life
- Failed conservative treatment
Surgery was the only option to prevent further neurological deterioration.
About Dr. Sangram Rajale
Dr. Sangram Rajale is a leading Spine Surgeon in Pune, specialising in:
- Minimally Invasive Spine Surgery
- Endoscopic Spine Surgery
- Deformity correction & osteotomies
- Lumbar fusion (TLIF/PLIF/OLIF)
- Sciatica & stenosis treatment
He practices at The Spine Doctor – Bavdhan, offering evidence-based and ethical spine care.
FAQs
Degeneration, disc bulges, ligament thickening, and facet changes.
Yes — instability narrows spinal spaces and compresses nerves.
Most walk on the same day or next day.
Yes, when performed by a trained spine surgeon.
When walking tolerance reduces, weakness appears, or pain persists despite treatment.
Highly effective for decompression + stabilization.