The Hong Kong Minimally Invasive Brain & Spine Neurosurgery Centre

Lumbar disease case

Grade 1 L4/5 Lumbar Spondylolisthesis and Spinal Stenosis causing severe compression to cauda equina nerves

Age: 87 years old lady


  1. Back pain
  2. Severe pain, numbness at legs during daytime and during sleep.
  1. Legs weakness at both sides, episodes of fell at home and at streets.
  2. Frequency in urination & constipation.
  1. Symptoms lead to disturbed emotion, bad morale.
  1. Home bounded, loss of opportunity of walking out home and loss of social activities.

4 hours of Minimally Invasive Spine Neurosurgery:

L4/5 Transforaminal Lumbar Interbody Fusion (TLIF) + Decompressive Laminectomy:
Continuous Intraoperative Nerves Monitoring, so as to sure the safety & the effectiveness of surgery

Objectives of surgeries:

  1. Fusion surgery to revert the spine slipping and to stabilize the spine in order to alleviate her back pain.
  2. Nerves decompressive surgery to free the cauda equina nerves so as to eliminate the numbness & pain at legs, and to improve the strength at legs, also to improve the urinary and bowel habit.

Surgery results:

  1. The old lady immediate felt no more pain & numbness at legs. Legs were strong in power. She could walk in a more erect normal posture and in a steady gait.
  1. There was no more urinary frequency & no more constipation.
  2. She showed improved morale & mood with smiling faces upon hospital discharge and clinic follow up.
  1. 3 mini-wounds healed well. Follow-up X ray, CT scan and MRI revealed that the spondylolithesis of spine
    was being corrected, all implants are in ideal positions, the compressed cauda equina nerves were all freed.
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