Caso clínico estenosis de dos niveles: L4L5 listesis, L5S1 quiste

Clinical case

Two-level stenosis: L4L5 listhesis, L5S1 cyst

Today we are faced with a 67-year-old patient who comes to us with pain in her left leg that greatly compresses her L4, L5 and L5S1 roots. His pain is so strong that it radiates through his left leg and reaches approximately his calves, and on some occasions to the sole of his foot.


After knowing this information, we were now able to know the territory where we had to go to look for the pathology. As we have done in similar clinical cases, we performed an MRI and found that the L5S1 root had a synovial cyst that compressed said root.

Furthermore, the L4 and L5 roots had a slight listhesis. This means that the fourth vertebra, with respect to the fifth vertebra, is slightly displaced and causes a small hernia in the patient that compresses the L4 root and probably also affects L5.


For everything mentioned above, the treatment we had to give the patient was more than clear. We propose a complete endoscopic surgery column in which we perform a 3mm incision.

With this operation, what we intended to achieve was to address the canal, remove the synovial cyst in the cyst between the fifth root and S1, and remove the hernia in the fourth root and free the roots.

Estenosis de dos niveles operacion
Estenosis de dos niveles radiografias


What this operation allowed us to do was check all of the patient's nerves, check everything that would be the sac and see that there were no types of compressions. During the operation we removed the hernias and saw what condition the rest of the canal was in.

This technique is very safe and the surgery only lasts 1 hour – 1:15 hours.

The patient was able to go home calmly during the day of the same operation and was able to recover her daily life in just a few days.