The patient came to the clinic 08-June-2014 complaining of LBP with left sciatica for 5 years with exacerbation last three months with numbness all toes left foot. MRI lumbar spine done 03-May-2014 showing extruded disc L5-S1 with left foraminal occlusion.

On examination; The patient is limping with exaggerated scoliotic stance. SLRS was 80 degrees left side with pain. The left AJ is absent. There is weak dorsi and planterflexion left foot -3/5.

Left S1 foraminotomy. The extruded disc was removed lateral to the axilla. Left sided cleaning L5-S1 disc space. Routine closure of the wound.

Smooth postoperative recovery. The power of the left foot became normal.

The patient came 12-July-2014 telling that the last 2 days got exacerbation of the left sciatica. On examination, she was limping with SLRS 80 degrees with pain left side and weak dorsiflexion left foot 4/5. The patient was sent for new MRS which was done the same day, showing recurrence of the extrusion with soft material. The patient was advised to wait for 30-45 days until the extrusion shrink by itself, or undergo surgery to ease the pain. They agreed to wait this period of time.

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

When recurrence take place, if it is medium size and soft in consistency, then with time 80% of cases improving without undergoing second surgery, due to shrinkage of the soft extrusion.