The patient came to the clinic 04-November-2013 complaining of right sciatica for 4 weeks, then left sciatica for 6 days. He had minimal LBP for 8 months.

MRI of the lumbar spine done 03-November-2013 showing huge extruded disc L4-5 central more to the right and extruded huge disc L5-S1 with left downward migration.

On examination: the patient is limping with slight scoliotic stance. He is in agonizing pain, that his examination was interrupted several times due to pain. SLRS was 70 degrees in the right and 10 degrees in the left with pain. There is analgesia of the left S1 territory. The left AJ was absent in the left side. There is drop left foot and weak dorsiflexion right foot and planterflexion left foot 4/5.

Laminectomy L5 and lower third of L4 and upper part of the sacrum. Foraminotomy both L5 roots and left S1 root. The extruded disc of L4-5 was attacked from both sides and bilateral cleaning and removal of the extrusion of L4-5 disc space was achieved. The L5-S1 disc space was cleaning from the left side.

Smooth postoperative recovery. The power of the right foot became normal, but the drop foot still the same with normalization of the left foot planterflexion.

The patient has 2 major problems in both disc levels. Discectomy of both levels must be resolved.

The estimated postoperative recurrence is 7% for each level.