The patient came to the clinic 17-July-2013 complaining of LBP with right sciatica 45 days ago after suffering direct trauma to the back during work. He was admitted to Islamic hospital for 2 days and MRI lumbar spine performed 09-June-2013 showed extruded disc L2-3 with right downward migration with bulge other disci in the lumbar area. Deterioration the last 2 days with numbness of the right leg.

On examination: the patient is limping with exaggerated scoliotic stance. SLRS was 10 degrees in the right with pain and 30 degrees in the left with less pain. AJ was absent both sides and preserved AJ in the left side. There is weak dorsiflexion both feet 3/5 and planterflexion right foot -4/5 and the quadriceps muscle right leg -4/5. There was hypalgesia above the right knee down to include L3,4,5 and right S1 roots territories.

Another MRI of the lumbar spine done 17-July-2013 showing the extrusion of L2-3 with right downward migration causing severe segmental stenosis with the same bulges mentioned above.

Partial laminectomy to include lower 4/5 of L2 and upper third of L3 with foraminotomy both L3 roots. There was a severe segmental stenosis at this level. The isthmi are narrow, but intact. There are elements of retrolisthesis with no gross overmobility. The extruded disc was removed from both sides and bilateral intradiscal cleaning of L2-3 disc space was achieved.

Routine closure of the wound. Smooth postoperative recovery. The power of the right foot became normal with regression of the sciatica.

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

The importance of the retrolisthesis is clinically hard to estimate. In case of troubleshooting in the future, transpedicular fixation could be needed.