The patient came to the clinic 11-February-2007 complaining of right sciatica for 5 months with numbness of the right S1 root territory.

MRI lumbar spine done 08-February-2007 showed prolapsed lumbar disc L4-5 with left midio-lateral extension as manifestations of slipped epiphysis.

On examination: the patient had exaggerated scoliotic stance and limping during walk. SLRS was 15 degrees in the left with pain and 45 degrees in the left with shooting pain to the right leg. Weak dorsiflexion all toes left foot 3/5 and planterflexion 4/5.

Bilateral foraminotomy of both L5 roots was performed and the right root was pushed and compressed lateral and the slipped epiphysis was attacked from under the axilla. The extruded slipped epiphysis was removed from both sides trying to leave the posterior longitudinal ligament intact. The foramina were checked for patency. Meticulous cleaning of the disc space was achieved from both sides, because the defect of the destroyed annulus fibrosis was very wide.
Epidural fat transfer to the roots and routine closure.

Smooth postoperative recovery.

In patients under the age of 18 years the pathologic process of disc extrusion take a different etiological character. It is usually the result of slipped epiphysis. The slipping was so severe that, the right L5 root was entirely compressed and the slipping was huge, for what surgery was necessary.

The most youngest in this series of patients was 12 years age year age boy.

It is more appropriately to name this kind of operation, not discectomy, but epiphysectomy and usually it needs bilateral intervention to entirely remove the whole slipped epiphysis.