The patient came to the clinic 15-January-2003 complaining of LBP with left sciatica for 3 years with numbness left L5 territory. Exacerbation last 3 days. He is hypertensive for 16 years. MRI lumbar spine done 06-December-2001 showing LCS L4-5 with extruded disc L5-S1 with left foraminal occlusion.

On examination: the patient in agonizing pain, limping with exaggerated scoliotic stance. SLRS was 85 degrees with pain in the left. There is weak dorsi and planterflexion left foot 3/5, weak dorsiflexion right foot 4/5 with hypalgesia left L5 and S1 roots territories.

The patient sent for investigation and MRI lumbar spine showing the same previous data.

Decompressive laminectomy of L5, lower third of L4 and upper edge of the sacrum with bilateral L5 and S1 foraminotomies. The extruded disci were removed with bilateral intradiscal cleaning of L4-5 and L5-S1 disc spaces.  The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak. Routine closure of the wound

Smooth postoperative recovery. The radicular pain decreased and the power of left foot normalized. She was sent to the ward.

The patient came to the clinic 30-January-2003 with clean wound with SLRS 80 degrees with pain with no sensory, nor motor deficit.

The patient then came 27-April-2003 with no scoliosis with SLRS 90 degrees with pain left side and numbness left S1 territory. He was treated conservatively.

The recurrence rate in this case still ranking over 14% because the disci spaces are not completely collapsed.

The stenosis must be corrected, because it will escalate over the long run.