The patient came to the clinic 28-Sptember-2003 complaining of LBP for 3 months and right sciatica for 2 months with numbness of the right L5 and S1 territories. MRI lumbar spine performed 06-August-2003 showing bulge disc L4-5 right side and huge extruded disc L5-S1 more to the right.

On examination, the patient in agonizing pain, walking with difficulty, limping with exaggerated scoliotic stance with drop right foot and weak planterflexion same foot 3/5 and hypalgesia right L5 and S1 territories. SLRS was 20 degrees right side with pain.

Decompressive laminectomy L4-5 and L5-S1. Foraminotomy both L5 and S1 roots was achieved. The huge extruded disc L5-S1 was removed from the right, then bilateral intradiscal cleaning L5-S1 was performed. Inspection of L4-5 disc was performed and decided not to violate it, instead to perform extended foraminotomy right L5 root. 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 right foot slightly improved.

The patient came to the clinic 11-October-2003 with clean wound  complaining of left hip pain with numbness both feet with no sensory or motor deficit. SLRS was 45 degrees right side and 50 degrees left side without pain. MRI done during this period after surgery showing no recurrence.

The patient then came 06-January-2004 complaining of left hip pain with numbness both feet, more the right. MRI done 01-December-2003 ruling out recurrence at L5-S1.

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