The patient came to the clinic 22-October-2003 complaining of LBP for 13 years with left sciatica for 5 days. MRI done 21-October-2003 showing huge disc L4-5 with left downward migration.

On examination: the patient is in agonizing pain, limping with exaggerated scoliotic stance. SLRS was 45 degrees left side with pain. There is almost drop left foot and planterflexion left foot 3/5 with hypalgesia left L5 and S1 territories.

Decompressive laminectomy L4-5. Foraminotomy left L5 roots was achieved. The extruded disc material of L4-5 was removed from the left side of the axilla with left sided intradiscal cleaning L4-5 was achieved. A free fat tissue piece obtained from the subcutaneous layer obtained and transferred to the root area to minimize postoperative scarring. 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 power of the left foot normalized.

The patient came to the clinic 10-November-2003 with clean wound and weak dorsiflexion left foot 4/5 and numbness left L5 territory. SLRS was 85 degrees left side with no pain.

The patient then came 15-December-2003 complaining of numbness left L5 territory with mild weak dorsiflexion big toe left foot.

The patient then came 09-February2005 after falling down with LBP with right sciatica with weak dorsiflexion right foot 4/5.He was give medications and sent for investigations and MRI lumbar spine with contrast performed 21-June-2005 showing no recurrence.

There is still an estimated postoperative recurrence around 7% because the disc space not completely shallow.