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Case III
•66 yr old female housewife with progressive increasing NIC, pain and weakness of legs on walking and is relieved by bending forward and flexion of her spine
•More than 1 year of conservative treatment gave no relief
•Husband is an orthopedic surgeon
•Unwilling to under go open invasive spinal surgery
•L4-5 X-stop interspinous process decompression implant, and evacuation of synovial cyst gave relief
Severe L4-L5 spinal stenosis
MRI Axial view
L4-5 Interspinous process decompression
L4-L5 Sagital T2 MRI view
with stenosis and
synovial cyst
Single
level lumbar stenosis (central and lateral)
associated with a synovial cyst
L4-5 Interspinous process decompression