The patient came to the clinic 27-April-2005 complaining of pain left wrist with hypalgesia of the thumb and index left hand and weak grip left hand and left triceps muscle. She had also weak dorsiflexion right foot with hypalgesia right L5 territory. The patient was sent for investigations and given medications and disappeared.

The patient then came 30-March-2013 complaining of LBP for 45 days with left sciatica down to the big toe left foot.

MRI lumbar spine done 27-February-2013 showing huge extruded disc L5-S1 with left downward migration. The patient telling that her condition further deteriorated the last 2 days.

On examination: The patient is in agonizing pain, limping with exaggerated scoliotic stance. SLRS was 75 degrees in the right with pain shooting to the left leg and 40 degrees in the left with more pain. There is weak dorsi and planterflexion left foot 2/5 with hypalgesia left S1 root. The left KJ is less than the right.

The patient was sent for further investigations, which confirmed the presence of huge extrusion L5-S1 with left foraminal occlusion with left downward migration.

The level of L5-S1 was identified. Left partial L5-S1 flavotomy and foraminotomy left S1 root was done. The extruded extrusion was removed from under the axilla in one piece. Left sided intradiscal cleaning L5-S1 disc space.

Routine closure of the wound. Smooth postoperative recovery. The power of the left foot became normal.

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