The patient came to the clinic 01-September-2004 complaining of severe LBP with left sciatica for 3 months with exacerbation past week.

On examination: The patient is limping with exaggerated scoliotic stance. SLRS was 90 degrees in the right  and 80 degrees in the left with pain. There is weak dorsi and planterflexion left foot 3/5 with hypalgesia left L5 territory.

The patient was sent for investigations and MRI lumbar spine performed the same day showing extruded disc L4-5 with left downward migration.

Foraminotomy left L5 root with removal of the extrusion partially subaxillary and mostly lateral to the axilla from the left side. After that, the root became lax and left sided intradiscal cleaning L4-5 disc space was done. The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak. A fat in pedicle was transferred from the subcutaneous layer and covered the exposed parts of the dura and roots to minimize postoperative scarring. Routine closure of the wound. Smooth postoperative recovery. The power of the left foot became normal. She was sent to the ward.

The patient came to the clinic 29-Septmber-2004 with clean wound and SLRS 90 degrees left side without pain and normal power and sensation.

The patient came 12-July-2007 complaining of LBP for 2 weeks, but neurologically free. She was treated conservatively.

The last time she came 22-September-2008 complaining of neck pain with left radicular pain with weak grip and extension left hand. She was sent for investigations and she disappeared.

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