Patient Name : Mr. Jadhav
Age : 66 years
Introduction
A 66-year-old patient with long-standing low back pain and progressive neurogenic claudication presented to our clinic. Imaging confirmed multi-level lumbar canal stenosis with degenerative disc disease, facet arthropathy and ligamentum flavum hypertrophy. After careful evaluation, we performed a L2–S1 laminectomy with posterolateral fusion fixation to decompress the neural elements and stabilise the spine. The patient experienced a rapid postoperative recovery and returned to normal activities by three months. This page explains the diagnosis, treatment and expected outcomes for lumbar stenosis treatment in Pune.
Patient History & Presentation
The patient had a decade of low back pain, worsening over two years, and notable functional decline in the last six months. Key clinical features included:
- Severe neurogenic claudication — walking tolerance ~5 minutes
- Progressive weakness of ankle and toe muscles (motor deficit)
- Forward stooped gait and inability to bend forward due to pain
- Symptoms exacerbated by standing, sitting, coughing and sneezing
On examination there was reduced ankle/toe power, inability to walk on heels/toes and a positive forward-stoop gait consistent with symptomatic lumbar canal stenosis and nerve root compression.
(Semantic terms: neurogenic claudication, radiculopathy, degenerative lumbar spine, nerve root compression, foraminal stenosis.)
Diagnosis & Radiology Findings
Imaging revealed:
- MRI: multi-level disc degeneration and bulges at L2–3, L3–4, L4–5 and L5–S1 with facet arthropathy and ligamentum flavum thickening producing severe canal stenosis, lateral recess narrowing and foraminal compromise.
- X-ray: Grade I anterolisthesis at L3–L4 (no pars defect).
Lay explanation: The spinal canal and nerve exits are narrowed due to age-related wear and tear (disc bulge, thickened ligaments and arthritic facet joints) which compress the nerves and cause pain, weakness and walking difficulty.
Surgical Procedure
L2–S1 laminectomy with posterolateral fusion fixation (decompression + stabilization)
Step-by-step:
- Preoperative planning with imaging and medical optimization.
- Midline exposure and removal of lamina (laminectomy) from L2 to S1 to decompress the spinal canal and lateral recesses.
- Direct decompression of nerve roots by trimming hypertrophied ligamentum flavum and facet overgrowth.
- Posterolateral fusion with pedicle screws and rods to stabilise degenerative segments and prevent further slippage.
- Bone grafting and hardware placement for fusion.
People Also Ask:
- Is spine surgery safe? When performed by an experienced spine surgeon with appropriate perioperative care, decompression and fusion are safe and effective for symptomatic lumbar stenosis.
- What is the recovery time after laminectomy + fusion? Most patients begin walking within 24–48 hours and show marked improvement over 4–12 weeks; fusion consolidation continues over months.
- Can stenosis be treated without fusion? In selected cases decompression alone may be sufficient; however, when instability or listhesis is present, fusion is recommended.
Post-Operative Recovery
Milestone-based recovery:
- Day 0–1: Hemodynamically stable; sitting in bed day 1; pain controlled.
- Day 2: Ambulation with support started; supervised physiotherapy.
- Day 3–7: Continued gait training; brace as required.
- 1 month: Many patients are brace-free, walking independently and doing ADLs.
- 3 months: Significant functional improvement such as stair climbing, bending and prolonged walking.
Monitoring includes wound care, neurological checks, mobilisation and progressive physiotherapy focusing on gait, core strengthening and posture.
Long-Term Outcome
With adequate decompression and stabilization, patients typically experience:
- Major reduction or resolution of leg pain and claudication
- Improved motor function and gait
- Restored walking distance and daily function
- High patient satisfaction and return to normal lifestyle
This case achieved full functional recovery by 3 months with restored mobility and improved sleep.
Why Surgery Was Necessary
Surgery was indicated due to:
- Severe multi-level lumbar canal stenosis causing motor deficits
- Progressive neurogenic claudication affecting quality of life
- Radiological instability (anterolisthesis) and multi-level foraminal compromise
- Failure of conservative measures and risk of further neurological deterioration
About Dr. Sangram Rajale
Dr. Sangram Rajale is a leading Spine Surgeon in Pune with expertise in degenerative spine disease, decompression, fusion techniques and minimally invasive spine approaches. At The Spine Doctor – Bavdhan, Dr. Rajale focuses on evidence-based treatment, careful patient selection and faster recovery protocols for lumbar stenosis treatment Pune and related conditions.
FAQs
A. Leg pain, numbness, weakness, forward-bent walking posture and limited walking distance (neurogenic claudication).
A. Early mobilization occurs within 24–48 hours; functional milestones are typically reached by 4–12 weeks; fusion matures over 6–12 months.
A. Fusion is recommended if instability (listhesis) or significant degenerative change is present; decompression alone may suffice in stable spines.
A. Pain, heaviness or cramping in the legs on walking due to nerve compression in the spine that improves on sitting or bending forward.