The patient came to the clinic 31-August-2003 telling that he was operated elsewhere 28-September-2002 for left sciatica with slight improvement with exacerbation of left sciatica the last 2 months. The patient is hypertensive for 3 years in medication. MRI done 26-July-2003 showing the extruded disc L4-5 the same as before the surgery.

On examination: the patient is in agonizing pain, limping with exaggerated scoliotic stance. SLRS was 80 degrees left side with pain. There is weak dorsiflexion both feet more the left.

The old incision refreshed. Decompressive laminectomy L4-5. There was massive scar in this area and scarolysis with foraminotomy both L5 roots were achieved. The extruded disc L4-5 was removed from the left side with bilateral intradiscal cleaning L4-5 was achieved. The lateral wall of the right L5 axilla was torn and stitched by 6 zero nylon. The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak. Routine closure of the wound. Smooth postoperative recovery. The power of the feet slightly improved.

The patient came to the clinic 20-September-2003 with clean wound and the power of the right foot was 4/5. The power of the left normalized. SLRS was 85 degrees left side without pain.

The patient then came 07-June-2004 telling that the is pain right leg, but there is weak dorsiflexion left foot 4/5. He was treated conservatively and sent for investigations, but did not return.

There is still an estimated postoperative re-recurrence around 7% because the disc space not completely shallow.