History :
A 58-year-old woman presented to Spine Surgery Specialist in Pune Dr. Sangram Rajale with a 10-year history of low back pain and bilateral lower limb radiculopathy, more pronounced on the left side. Her radicular pain was more severe than the low back pain and had progressively worsened over the past six years, particularly when bending forward and sitting for extended periods. She also reported neurogenic claudication, with walking limited to 5 minutes and standing for only 2 minutes. Additionally, her low back pain intensified during movements such as sitting, standing, and bending forward. She experienced leg swelling and had completely stopped walking due to the pain. Her sleep was disrupted, and she was unable to sit for long durations, eat comfortably, or find relief despite seeking treatment at multiple hospitals.
Examination of Lumbar Spine:
- Listing: Towards the right side
- Midline tenderness: Present
- Lumbosacral spine extension: Painful
- Lumbosacral spine flexion: Possible
Muscle Strength:
- EHL (Extensor Hallucis Longus): Right: 5/5, Left: 4/5
- EDL (Extensor Digitorum Longus): Right: 5/5, Left: 4/5
Sensory Loss: Present over the L5 region on the left side
Slouch test: Positive on the left side
Radiological Investigations:
- X-ray Lumbosacral Spine AP/LAT (08/05/2024): L5-S1 grade 1 listhesis with reduced disc space
- MRI Lumbosacral Spine: L4-S1 lumbar canal stenosis
Operation :
L4-S1 posterior spinal fixation was performed under general anesthesia on 11/06/2024 by Dr. Sangram Rajale, the Top Spine Specialist in Pune.
Operating Surgeon: Dr. Sangram Rajale, known as the Best Spine Surgeon in Pune.
Implants Used: GESCO
Post-Operative Neurological Examination:
Muscle Strength:
- EHL (Extensor Hallucis Longus): 5/5 bilaterally
- EDL (Extensor Digitorum Longus): 5/5 bilaterally
Condition On Discharge :
After surgery, the patient experienced significant pain relief within eight days. She gradually regained the ability to walk and is now fully capable of performing her daily activities, including sitting for extended periods without discomfort. She reports to Spine Specialist Doctor in Pune Dr. Sangram Rajale of feeling completely normal, as she did before her symptoms began. Currently, she can walk 4 to 5 kilometers without stopping and is entirely pain-free. She can even cook for at least 10 people and is fully satisfied with the surgical outcome, thanks to Spine Surgery Specialist in Pune, Dr. Sangram Rajale, one of the Best Orthopedic Spine Doctors in Pune.