The patient came to the clinic 02-August-2009 complaining of LBP with left sciatica for 2 weeks. MRI lumbar spine performed 30-July-2009 showing old bulge disc at L2-3, 3-4 and L4-5 with left downward migration. The patient had no limping, with mild scoliotic stance with weak dorsiflexion left foot 4/5. He was advised to continue in conservative treatment and he improved over the next several days.

The patient then came to the clinic 06-December-2009 complaining of exacerbation of LBP  with increased left sciatica the last 2 weeks with the weakness of the left foot dorsiflexion -4/5 and right foot 4/5.

Repeat MRI of the lumbar spine performed 09-December-2009 showing increase of the extrusion of L4-5 with foraminal occlusion.

Left L5 foraminotomy with partial hemiflavotomy L4-5 was performed from the left side. The extruded disc of L4-5 was removed after what the root became lax and free of compression. Further cleaning of the disc space was performed lateral to the axilla.

Routine closure of the wound. The power of the both feet normalized.

The patient is a young chap with still having a high disc space with wide defect in the annulus fibrosis. Logically the estimated recurrence rate is ranking around 15%. It was suggested to the patient to include PEEK Satellite sphere in his surgery, but he refused.