patient on supine position, surgical markings done and the appopriate levels: S1-L1 defined. Local infiltration done with xylocaine with adrenaline. Sterile drapping done. askin incision and dura mata approached via sharp and diathermy disections. Thick and multiple calcified ligamentum flavum identified and removed with kerrison punch untill clear dura reached. Nerve roots freed and no disc identified.
Wound clean and drained inserted. Wound sutured in layers. 