The patient came to the clinic 28-February-2004 complaining of intermittent claudication for 8 months  with inability to walk more than 70 meters with numbness both feet, more the left. Diabetic for 30 years in medication. CABAG done 1993 with arterial hypertension in treatment.

On examination: the patient is limping with exaggerated scoliotic stance. SLRS was 80 degrees both sides without pain. There is almost drop left foot weak dorsi and planterflexion both feet 3/5 with diabetic neuropathy above the ankle level.

The patient was sent for investigations and MRI lumbar spine performed 01-March-2004 showed huge extruded disc L3-4.

Decompressive laminectomy L3-4 with bilateral foraminotomy L4 roots with bilateral removal of the extrusion lateral to the axilla. After that, the roots became lax and bilateral intradiscal cleaning L3-4 disc space was done. The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak. A free fat was harvested from the subcutaneous layer and covered the exposed parts of the root, to minimize postoperative scarring. Routine closure of the wound. Smooth postoperative recovery. The power of the right foot normalized, but the left improved to 4/5.

The patient came to the clinic 14-March-2004 with clean wound and SLRS 80 degrees both sides without pain and normal power right foot and weak dorsiflexion left foot 4/5 and hypalgesia the same.

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