There is an estimated postoperative recurrence around 7%, because the disc space is not completely collapsed.

The patient came to the clinic 18-May-2003 complaining of LBP with bilateral sciatica for 4 weeks. CT-scan done 23-April-2003 showing bulge L3-4 and L4-5.

On examination: the patient in agonizing pain, limping with exaggerated scoliotic stance. SLRS was 45 degrees right side with pain and 30 degrees left side with more pain. There is hypalgesia both L5 roots with weak dorsiflexion both feet 3/5.

The patient was sent for investigation and MRI lumbar spine performed 24-May-2003 showing wide-based extruded disc L4-5 more to the right.

Bilateral L4-5 hemiflavotomy with extended both L5 foraminotomy. The extruded disc of L4-5 was removed from the left and left sided intradiscal cleaning of L4-5 disc space was achieved until the root was hanging free. After then right sided removal of the extrusion and left sided cleaning L4-5. The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak.  Routine closure of the wound

Smooth postoperative recovery. She was sent to the ward.

The patient came to the clinic 24-June-2003 with clean wound with sensori-motor normalization SLRS was 50 degrees both sides without pain.

The patient then came several times and MRI lumbar spine performed 29-July-2003 ruled out recurrence of the disc.

The last time she came 21-August-2005 after falling down 45 days ago with right sciatica. MRI lumbar spine performed 31-May-2005 was without recurrence and MRI cervical was normal.