The patient came to the clinic 02-July-2008 complaining of LBP for 6 years with right hip pain. Exacerbation of right sciatica the last 6 months.

MRI of the lumbar spine performed 19-June-2008 showed extruded disc L5-S1 with small, but severe compression of the right S1 root.

On examination: the patient is limping with scoliotic stance . SLRS was 80 degrees in the right with pain. There is weak dorsi and planterflexion right foot  4/5.

The patient was advised to try conservative treatment, because the extrusion was not large, but he insisted for surgery, because the pain during the lest 6 months making his life intolerable.

Right S1 foraminotomy with partial L5-S1 flavotomy was performed. The extruded sic was severely compressing the right S1 root. It was removed in two pieces. The disc space was cleaned meticulously from the right side.

Routine closure of the wound and smooth postoperative recovery with normalization of the power of the right foot.

The patient has relatively small extrusion, but with severe compression upon the right S1 root.  In these circumstances 2 out of 8 patients undergo surgery.

The estimated recurrence in this case is around the average, because the disc space height still not shallow, but the defect in the annulus fibrosis is tiny small.