The patient was admitted urgently to Shmaisani hospital 30-November-2009 complaining of LBP with right sciatica for 5 days with agonizing pain depriving him sleep.

The patient was unable to walk with exaggerated scoliotic stance. SLRS 5 degrees in the right and 60 degrees in the left. He had weak dorsiflexion right foot 4/4 and planterflexion 3/5 with hypalgesia right S1 root.

MRI lumbar spine performed 30-November-2009 showing extruded disc L5-S1 with right downward migration.

Right L5-S1 hemiflavotomy with exposure of the compressed right S1 root.  There was no epidural fat due to severe compression. Using image-intensifier during all steps of surgery the level of L5-S1 was confirmed and the extruded disc was removed lateral to the axilla of right S1 root. Meticulous cleaning of the disc space of L5-S1 was achieved from the right.

PEEK Satellite nucleus replacement sphere No 11 was inserted and check in AP and lateral views was done confirming acceptable position of the device. The sphere all the time trying to shift to the left, in spite, that, three attempts to bring it back to the center.

Routine closure of the wound and smooth postoperative recovery and improvement of the power of left foot.

Recurrence of disc prolapse is around 15% in this case because the disc space is still high and the defect of the annulus fibrosis is wide.

To minimize the estimated recurrence to 2%, PEEK Satellite nucleus replacement sphere was applied.