The patient came to the clinic 21-December-2005 with complains for 4 weeks with exacerbation the last 4 days an agonizing pain in the back and left sciatica with drop left foot and weak planterflexion. She had also anesthesia of both left L5 and S1 roots. She was unable to stand to evaluate her scoliosis. MRI performed showing huge extrusion of L5-S1 disc with down and left far-lateral migration.

On examination: She is limping with exaggerated scoliotic stance. SLRS was 50 degrees left side with pain. There was weak dorsiflexion left foot 3/5.

The patient was sent for investigation and MRI lumbar spine performed showing severe lumbar canal stenosis L4-5 with left lateral recess syndrome. The patient was sent for cardio evaluation and Lab tests and cath done 10-November-2004 was normal.

The patient was slim and through 15 mm skin incision, it was possible to perform left L5-S1 hemiflavotomy and left S1 foraminotomy with removal of the extrusion lateral to the axilla. Minimal cleaning of the disc space was performed.

Smooth postoperative recovery. The power of left foot became normal. She was sciatica free. She was sent to the ward.

The patient came to the clinic 03-January-2006 with no sciatica and no senso-motor deficit.

The patient then came 10-July-2019 telling that she has LBP with right sciatica for 1 week. She was not limping with SLRS 90 degrees both sides. There was weak dorsiflexion right foot 4/5. MRI done 11-July-2019 showing small recurrence L5-S1 left side. She was treated conservatively.

The patient then came 11-January-2020 complaining of LBP with left sciatica for 45 days. MRI lumbar spine done 12-January-2020 showing further extrusion L5-S1 with left upward migration. The patient was advised conservative treatment and in case of not improving then surgical treatment.

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