The patient came to the clinic 08-June-2013 complaining of LBP with left sciatica for one year with numbness left foot the last 45 days. The patient is a known SLE patient for 23 years.

On examination: the patient is limping due to old injury to the right Achill's tendon 7 years ago, with exaggerated scoliotic stance. SLRS was 85 degrees both sides. AJ was absent both sides and preserved AJ in the left side. Weak dorsiflexion left foot -4/5.

The patient came 27-June-2013 with MRI lumbar spine bad quality done 18-May-2013 showing extruded disc L4-5 with left foraminal occlusion. The MRI was repeated 27-June-2013 showing extruded central disc L4-5 more to left in its upper part and down more to the right. The patient was advised to try conservative treatment, but she came 22-July-2013 in agonizing bilateral sciatica the last 2 days with inability to stand and walk. SLRS was 60 degrees in the right and 70 degrees in the left with pain. There is weak dorsiflexion right foot 4/5 and left foot -4/5. Hypalgesia left L5 and S1 territories.

Partial laminectomy L4 and L5. Bilateral foraminotomy both L5 roots. The extruded disc attacked from lateral to the left axilla. Bilateral intradiscal cleaning L4-5 disc space. The disc material was inflammatory and soft in consistency, friable. The was no epidural fat due to severe compression.

Routine closure of the wound. Smooth postoperative recovery. The power of both feet became normal with regression of the sciatica.

The patient still has an estimated postoperative recurrence around 7%, because the disc space is still not completely shallow.