The patient came to the emergency of Shmaisani hospital complaining of LBP with bilateral sciatica for 20 days with radiation down to the both L5 and S1 root territory. MRI done 01-October-2003 showing huge extruded disc L3-4 more to the right.

On examination: the patient is in agonizing pain, limping with exaggerated scoliotic stance. SLRS was 20 degrees both sides with pain. There is weak dorsi and planterflexion both feet with hypalgesia both L5 and S1 root territory.

Decompressive laminectomy L2-3 with foraminotomy L4 roots both sides .Right sided L3-4 discectomy lateral to the axilla and right sided intradiscal cleaning of L3-4 space was achieved. After that, bilateral cleaning was performed. The epidural fat was transferred around the L4 roots to minimize postoperative adhesions. 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 left foot normalized.

The patient came to the clinic 12-October-2003 with clean wound and the power of both feet became normal. SLRS was 80 degrees. There is numbness right L4 territory.

the patient then came several times for several reasons and the last one in 09-August-2006 complaining of neck pain . She was sent for investigations and no signs of recurrence and the MRI of the brain and MRA showed slight stenosis of ICA. MRI cervical showed bulge disci. She was treated conservatively.

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