Narrowing of the lumbar canal due to bone regrowth after lumbar decompression surgery generally occurs at the facet joint; it is exceedingly rare for this phenomenon to occur at the laminar arch. Herein, we describe a case of restenosis caused by marked bone overgrowth at the facet joints and laminar arch after lumbar decompression surgery. A 64-year-old man underwent partial hemilaminectomy for lumbar canal stenosis at the L3/L4 level 12 years ago. His symptoms recurred 7 years after the first surgery. Overgrowth of the laminar arch and facet joints was observed at the decompression site. Thus, partial laminectomy of L3 and L4 was performed as a second surgery. Four years after the second surgery, a laminectomy of L3-L4 was performed for bone restenosis and disc herniation. The underlying mechanism of the remarkable overgrowth of the removed lamina remains unclear. Endochondral ossification signals and mechanosignals should be comprehensively examined.

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We report a rare case presenting radiculopathy caused by unilateral lumbosacral facet abnormality resembling facet interlocking. The patient was a 57-year-old man with no medical and traumatic history. He began to exhibit numbness below his left ankle followed by pain at the left buttock with no obvious causes. He visited our hospital approximately 1 year after the onset of his symptom. Preoperative images revealed a left lumbosacral facet abnormality resembling facet interlocking. His left S1 nerve root was compressed by the dislocated left L5 inferior articular process and bone fragment. His symptom was consistent with left S1 radiculopathy without an obvious stenosis of the left L5 intervertebral foramen; thus, we performed partial facetectomy of the left L5/S1, posterior decompression of the S1 nerve root tunnel, and removal of bone fragment. After the operation, his symptom completely disappeared with satisfactory result. There are several types of congenital facet anomalies in the lumbosacral facet joint; however, congenital unilateral lumbosacral facet abnormality resembling facet interlocking described in this paper has not been reported. His clinical symptom was completely recovered after simple decompression surgery. In this paper, we report the interesting and unique findings of facet abnormality resembling facet interlocking.

We report a case of sufficient improvement of postural and gait abnormalities by surgery and additional postoperative meticulous rehabilitation in the patient with juvenile lumbar disc herniation. The patient was a 17-year-old boy with lumbar disc herniation at L4/5 level．In spite of conservative treatment for nine months, he began to show remarkable postural and gait abnormalities, such as forward bending posture with shortening of the iliopsoas muscle and knee joint flexion contracture. Microsurgical lumbar discectomy partially improved his symptoms, the residual symptoms were sufficiently improved by additional postoperative rehabilitation. To identify the causative muscles for the knee joint contracture and iliopsoas muscles shortening, trigger muscle identification test was performed. After the identification, muscles stretching was meticulously performed with satisfactory results. The significance of postoperative rehabilitation for patients with residual symptoms was confirmed in the present case. Herein, the clinical manifestation and postoperative rehabilitation are described in detail.

A 76-year-old man who had undergone total bladder cancer resection one and a half year ago without recurrence or metastasis was presented. He started experiencing right lower limb pain two months prior accompanied by a right foot drop two weeks ago. On admission, severe right lower limb pain, weakness of the right anterior tibialis muscle, and toe dorsiflexion were noted. Routinely performed lumbar magnetic resonance imaging(MRI)revealed slight lumbar spinal stenosis at the L3/4 and L4/5 levels, which could not explain the exact mechanism of the patient's complaints and neurological deficits. Considering the severe leg pain and rapidly progressing foot drop, we suspected malignant lesions despite the former doctor's comments. Positron emission tomography scan was performed to rule out malignant disorders, which revealed a pelvic metastatic tumor in the right lumbosacral nerve trunk and plexus. The passage of the L5 and S1 nerves through the mass lesion at the lumbosacral plexus was clearly described by the MR neurography.In this report, the authors gained vast knowledge about medical history taking, and meticulously performed neurological and image examination depending on the targeted lesion. The authors discussed lumbosacral plexus lesion as a cause of foot drop.