Patient Name : Mr. Dalvi
Age : 67 years
Introduction
Chronic back pain and leg weakness can severely limit mobility, especially in seniors. This case study details the journey of a 67-year-old patient who suffered from severe Lumbar Canal Stenosis and Spondylolisthesis. Under the care of Dr. Sangram Rajale, a leading Spine Surgeon in Pune, the patient underwent advanced spinal surgery and achieved a complete recovery, restoring his ability to walk without pain.
Patient History & Presentation
Mr. Dalvi, a 67-year-old male, visited The Spine Doctor clinic in Bavdhan with a two-year history of debilitating low back pain. His condition had deteriorated to the point where he experienced:
- Instability Pain: Aggravated by turning in bed, sitting down, or getting up.
- Neurogenic Claudication: He could not stand for more than 5 minutes or walk for more than 2 minutes without severe leg pain.
- Radiculopathy: Tingling and numbness in both legs, significantly worse on the left side.
- Motor Weakness: Examination revealed a “List” to the right and an inability to heel walk on the left side due to muscle weakness (Grade 4/5 power).
Diagnosis & Radiology Findings
Advanced imaging (MRI and X-Ray) confirmed a complex spinal condition often seen in degenerative lumbar spine disease.
- Spondylolisthesis: Grade I Anterolisthesis of L4 over L5 (slipped vertebra) and Retrolisthesis of L2 over L3.
- Lumbar Canal Stenosis: Severe narrowing of the spinal canal at L4-L5 with a thecal sac area of only 60mm.
- Nerve Compression: Circumferential disc bulges were compressing the exiting nerve roots, causing the left-sided weakness.
- Modic Changes: Type II changes indicated chronic degeneration of the vertebral endplates.
Surgical Procedure: Spinal Decompression with Fixation
To address both the nerve compression (stenosis) and the spinal instability (listhesis), Dr. Sangram Rajale performed a Spinal Ostectomy Multilevel with Fixation.
The Procedure Included:
- Decompression: Removing the thickened ligamentum flavum and bony overgrowth to free the compressed nerve roots.
- Stabilization (Fixation): Using high-quality GESCO implants (screws and rods) to realign the slipped vertebrae and fuse the unstable segments.
- Endoscopic Assistance: Utilizing Endoscopic Spine Surgery techniques to minimize tissue damage and speed up recovery.
People Also Ask:
- Is spine surgery safe for seniors? Yes, with modern Minimally Invasive Spine Surgery Pune techniques, safety profiles are excellent.
- Can endoscopic spine surgery treat stenosis? Absolutely, it effectively decompresses nerves with smaller incisions.
Post-Operative Recovery
The patient’s recovery was monitored closely at our Spine Clinic Bavdhan.
- Day 1: Patient was stable and afebrile.
- Day 2: Pain significantly reduced; mobilization started.
- Discharge (Day 5): The patient was walking independently and climbingstairs.
- Neurological Outcome: Most importantly, the power in his left foot (EHL and Dorsiflexion) improved from 4/5 to 5/5 (Normal Strength). The sensation in L4, L5, and S1 dermatomes was intact.
Long-Term Outcome
Following this Lumbar stenosis treatment Pune, the patient has returned to a normal lifestyle.
- 100% Pain Relief from sciatica.
- Improved Walking Tolerance: No longer limited to 2 minutes.
Stable Spine: No risk of further slippage due to the fixation.
Why Surgery Was Necessary
Conservative treatments had failed to stop the progression of the disease. The presence of a “foot drop” (weakness in heel walking) indicated that the nerves were under critical pressure. Delaying surgery could have led to permanent paralysis of the foot. As the Best Spine Surgeon Pune, Dr. Rajale recommended surgery to preserve neurological function.
About Dr. Sangram Rajale
Dr. Sangram Rajale is a highly experienced Spine Surgeon in Pune, specializing in Endoscopic Spine Surgery Pune and minimally invasive techniques. With a focus on patient safety and rapid recovery, he runs The Spine Doctor clinic in Bavdhan, providing world-class care for sciatica, slip disc, and spinal stenosis.
FAQs
Symptoms include pain in the lower back, cramping in the legs while walking (claudication), and tingling or numbness that improves when sitting or bending forward.
Most patients, like Mr. Dalvi, walk within 24 hours. Stair climbing is possible within 4-5 days. Complete bony fusion takes a few months, but normal activities can resume much sooner.
Yes, Endoscopic Spine Surgery Puneinvolves smaller cuts, less blood loss, and faster recovery compared to open surgery.
If you have weakness in your limbs (like difficulty lifting your toe), loss of bowel/bladder control, or pain that persists despite 6 weeks of medication and therapy, surgery is recommended.