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

The patient came to the hospital 29-March-2003 complaining of LBP with left sciatica for 1 year with exacerbation last 20 days with agonizing pain and positive cough sign.

On examination: the patient in agonizing pain, limping with exaggerated scoliotic stance. SLRS was 75 degrees with pain left side. There is almost drop left foot with weak planterflexion left foot with hypalgesia left L5 and S1 territories.

The patient was sent for investigations and MRI lumbar spine performed 01-April-2003 showing huge extruded disc L3-4 left side and stenosis L4-5 with extrusion left side.

Decompressive laminectomy L4 with lower half of L3 and upper half of L5 with extended foraminotomy both L4 and 5 roots both sides. The extruded disc of L3-4 and L4-5 were attacked from the left axilla and bilateral cleaning of L3-4 and left sided cleaning of L4-5 was achieved until the roots became lax. 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 disappeared and the power of left foot improved. He was sent to the ward.

The patient came to the clinic 03-May-2003 with clean wound with no sensory or motor deficit. SLRS was 80 degrees with minimal pain left side.

The patient then came 02-June-2003 with further improvement, but complaining of numbness II-IV toes left foot.