The patient came to the clinic 22-May-2002 complaining of LBP and right sciatica for 2 months, down to the calf right leg with numbness. MRI performed 17-April-2002 showing extruded disc L4-5 with right foraminal occlusion.

On examination: The patient is in agonizing pain, limping with exaggerated scoliotic stance with right sciatica. SLRS was 45 degrees with pain in the right. There is weak dorsiflexion right foot -4/5 with hypalgesia right L5 territory.

Decompressive laminectomy L4-5 with right extended L5 foraminotomy with removal of the extrusion lateral to the axilla and bilateral cleaning L4-5 disc space. 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 the right foot improved. She was sent to the ward.

The patient came to the clinic 05-June-2002 with clean wound and sciatica free and normal power right foot. SLRS was 60 degrees in the right without pain and there is still having hypalgesia and numbness right L5 territory.

The patient then came 16-March-2003 complaining of LBP more to the left, but neurologically she was free. Treated conservatively.

The patient then came 27-July-2008 with swollen four limbs. After examining her sarcoidosis was suspected and sent for pulmonologist.

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

In retrospective analysis, it was unnecessary to perform bilateral cleaning. (14-April-2021).