The patient started to complain of right sciatica with LBP for three months with weak dorsiflexion and planterflexion all toes right foot with hypalgesia of the right foreleg and foot. The patient during examination had pronounced scoliotic stance with agonizing pain. The patient was operated 10 years ago for left sided sciatica at the same level. MRI showed recurrence of the disc at the right side with upward migration. Using part of the old incision, right L4-5 hemiflavotomy was done. Foraminotomy of the right L5 root was done. The root was swollen. It was noticed that the root was severely compressed by the extrusion, which was lift to the last moment to avoid surgical trauma to the root.  After that, the extrusion was removed and the swelling of the nerve decreased and the nerve became relaxed.