The patient came to the clinic 28-October-2002 complaining of LBP with left sciatica for 30 years with exacerbation last 15 years. The last month exacerbation of LBP with right sciatica down to right L5 territory with inability to walk more than 10 meters. Irritable colon.

On examination: The patient is limping, has LBP with exaggerated scoliotic stance. There is almost drop right foot and planterflexion right foot 4/5, hypalgesia right S1 territory and SLRS was 30 degrees with pain right side. The left AJ is absent.

The patient was sent for investigation and MRI lumbar spine showing huge extruded disc L4-5 more to the right.

Right L5 foraminotomy with removal of the extrusion lateral to the axilla and drilling of the osteophytes with right sided intradiscal cleaning of L4-5 disc space. The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak. Routine closure of the wound.  Routine closure of the wound.

Smooth postoperative recovery. The power of the right foot normalized. She was sent to the ward.

The patient came to the clinic 11-November-2002 with clean wound and normal power and sensation right foot. SLRS became 80 degrees without pain in the right.

The patient then came several times with left sciatica and the last one 09-August-2020. MRI lumbar spine performed 05-August-2020 ruled out recurrence. MRI pelvis showed edema around the left gluteal muscle tendon. She was given medications and sent for investigations, but disappeared.

The estimated postoperative recurrence is around 7% because the disc space is still not shallow.