The patient came to the clinic 13-February-1999 telling that she was operated for disc surgery 13 months ago for lumbar disc with bilateral sciatica more the right. MRI lumbar spine done 15-Novemeber-1997 showed extruded disc L4-5. She is complaining of LBP with left sciatica with neck and right upper limb pain. She was sent for investigations including the whole spine. The patient came 31-May-1999 with LBP and agonizing left sciatica with MRI lumbar spine showing huge recurrence of L4-5 with left downward migration.

On examination, the patient is in agonizing pain, limping with exaggerated scoliotic stance. There is hypalgesia left L5 and S1 roots with almost drop left foot with weak dorsi and planterflexion left foot3/5. SLRS was 30 degrees with pain right side and 10 degrees left side with more pain.

The part of the old incision refreshed and scarolysis of the dura and extended foraminotomy both L5 roots was performed. Removal of the extrusion started from the left, then bilateral cleaning of the disc space of L4-5 was achieved. 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 power of left foot normalized. She was sent to the ward.

The patient came to the clinic 02-August- 2003 with clean wound  with hypalgesia left L5 root with weak dorsiflexion big toe both feet more the left. SLRS was 45 degrees right side and 30 degrees left with pain.

The patient then came 20-March-2004 telling that the last 8 months still complaining of LBP with both hips pain. SLRS was 80 degrees with minimal pain, hypalgesia left S1 root with no motor deficit. The patient was sent for investigations, but she did not perform them.

The patient then came 06-September-2004 complaining of tonsilopharyngitis with pain left side of the face and neck. She was sent for investigations but disappeared.

The estimated recurrence rate still ranking around 7%, because the disc space still not shallow.