History :
A 53-year-old woman presented to Best Spine Specialist in Pune Dr. Sangram Rajale with complaints of low back pain for 5 years, along with tingling and numbness in her right lower limb and weakness in both legs. Despite not having radicular pain, her symptoms were severe. Local village doctors had told her there was no hope for recovery, which led her to believe she would never regain her strength. She had experienced these symptoms for six years but initially dismissed them, thinking they were related to her hysterectomy. However, as her leg pain worsened, she gradually lost the ability to walk.She also reported to Spine Pain Treatment in Pune Dr. Sangram Rajale about low back pain with instability, especially when getting up, sitting down, and turning in bed. Additionally, she noticed her right shoe often slipped off, indicating right foot weakness. There were no issues with sleep, bowel, or bladder functions, and she had no known comorbidities.
Examination of L-S Spine:
- Gait: Waddling gait with right foot drop
- Heel/Toe Walk: Not possible
Range of Motion (ROM): Flexion was terminally painful, but extension was full and free.
Radiological Investigations:
MRI Lumbar Spine
- Lumbar spondylosis changes
- Grade 1 spondylolisthesis of L5 over S1
Posterior disc bulges at L3-L4 and L4-L5, mildly encroaching on the neural foramina and abutting the bilateral exiting L4 and traversing L5 nerve roots.
Operation :
L3, L4, L5 Laminectomy
L4-L5, L5-S1 Transforaminal Interbody Fusion with Cage
L3-S1 Fixation
Operating Surgeon: Dr. Sangram Rajale, the Best Spine Specialist in Pune
Implants Used: PARSHWA
Condition On Discharge :
Right EHL (Big toe extension): Before surgery: 1/5 | After surgery: 4/5
Right EDL (Toe extension): Before surgery: 0/5 | After surgery: 1/5
Right FHL (Big toe flexion): Before surgery: 2/5 | After surgery: 4/5
Right Ankle Dorsiflexion (Upward movement): Before surgery: 1/5 | After surgery: 3/5
Right Ankle Plantarflexion (Downward movement): Before surgery: 0/5 | After surgery: 3/5
Right Knee Flexion/Extension: Before surgery: 2/5 | After surgery: 5/5
Day 2 Post-Surgery: The patient was able to walk.
Day 8 Post-Surgery: She had regained significant muscle power. She was advised not to bend forward for the first three months, after which she could resume her daily activities. Her relatives were amazed at her transformation from being disabled to fully functional.
She can now lift up to 25-30 kg and travel long distances.
The patient regained her confidence and feels like she has a new lease on life after the surgery. She is extremely happy and motivated.