The patient came to the clinic 25-August-2009 complaining of LBP for 10 years with bilateral sciatica. MRI lumbar spine performed 21-February-2008 showing extruded disc L5-S1. The patient was operated elsewhere and intraspinous fixating device was inserted without any improvement. MRI repeated 20-April-2009 showing the same extrusion and added compression from behind by the fixating device.

The patient was limping and walking with aid and exaggerated scoliotic stance with shooting bilateral sciatica. SLRS was 70 degrees in both sides with pain. The patient had weak dorsiflexion both feet and planterflexion left foot 3/5 and planterflexion right foot 4/5. There is numbness both feet.

New MRI and dynamic studies of the lumbar spine were performed and done 07-September-2009 showing the device and the extruded disc of L5-S1 compressing both the dural sac from both sides.

The lower half of the incision was refreshed and the flail intraspinous fixating device was removed. There was no trade mark in the device and only 7 mm was found as the device measurement. Left hemiflavotomy was performed and the left S1 root was exposed. Meticulous cleaning of the extruded disc and the intradiscal space of L5-S1 was achieved. The left S1 root became free from any compression.

Routine closure of the wound and smooth postoperative recovery and the patient sent to the ward.

This case is a demonstration that all the devices starting with Nelson spinous fixating devices all finish with failure since 1980. The spinous processii are not so heavy bone constructs, that can hold the spine, not mentioning that it is far from the central axis of load.

The patient had only extruded disc which required its removal and there was no instability to perform such erroneous procedures.