The patient came to the clinic 15-October-2000 complaining of LBP for 20 years with left sciatica. The patient sent for MRI lumbar spine and came back 04-October-2001 with MRI performed 12-March-2001, showing huge extruded disc L4-5

On examination at that time he had scoliotic stance with bilateral sciatica with SLRS was 75 degrees in the right side and 85 degrees in the left with pain with weak dorsiflexion all toes right. He was advised for surgery, but disappeared.

The patient came 26-August-2007 after trying all available charlatans maneuvers, urging for surgery.

MRI performed 12-August-2007 showing huge central extruded disc L4-5 more to the right.

On examination: the patient had the same scoliotic stance with bilateral sciatica more the right with SLRS 45 degrees both sides and weak dorsiflexion all toes both feet.

Right 2/3 L4-5 flavotomy with foraminotomy of right L5 root was performed. The extruded disc was pushing the right L5 root laterally, for what it was attacked and removed from under the axilla. Meticulous cleaning of the extrusion and the disc space from the right side. Routine closure and smooth postoperative recovery and normalization of the power of both feet.

The patient tried all charlatans methods without effect. He performed the 2 parallel incisions at the dorsum of the right foot and all imaginable procedures without effect.

The expected recurrence rate in this case is low, because the disc space height is minimal. This factor considerably decrease the expected recurrence rate.