The patient came to the clinic 07-August-2010 complaining of LBP for 17 years with right sciatica. The patient has lymphoedma of the left lower limb for 18 years. MRI performed 05-August-2010 showing extruded disc L5-S1 with right downward migration with bulge L4-5. In comparison to the MRI performed 10-May-2005 the extruded disc became bigger in size.

On examination: the patient is limping with exaggerated scoliotic stance . SLRS was70 degrees in the right with pain with almost drop right foot 3/5  and weak planterflexion 4/5.

Right sided L5-S1 hemiflavotomy with foraminotomy of right S1 root. The root was severely compressed laterally. The extruded disc was bony hard and it was necessary to drill it from under the axilla. After removing the subaxillary part and cleaning of the L5-S1 disc space, it became possible to retract the root medially and drilling of the lateral part of the extrusion was performed. Further cleaning of the intradiscal space was achieved. The root became relax and free of any compression. 

Routine closure of the wound and smooth postoperative recovery with improvement of the power of the right foot and disappearance of right sciatica.

The estimated postoperative recurrence rate in this case is minimal because the disc space height is very shallow.

The extruded disc was bony hard and neglected for long time and it was bony hard. It was necessary to remove it using high-speed drill.