The patient was operated by me 09-November-2007 for extruded disc L4-5 with right foraminal occlusion. Then she came 25-March-2011 complaining of LBP with left sciatica for 1 month with MRI performed 18-March-2011 showing small extruded disc L5-S1 with no recurrence at L4-5. On examination at that time, she was limping with exaggerated scoliotic stance with SLRS 50 degrees both sides with pain in the left side. There was weak dorsi and planterflexion left foot -4/5. The patient was treated conservatively.

The patient then came 04-June-2013 complaining of right sciatica for 3 months with exaggerated scoliotic stance. Weak dorsiflexion right foot +3/5 with weak planterflexion right foot 4/5. SLRS was 30 degrees in the right with pain and 35 degrees in the left with pain shooting to the right leg.

MRI lumbar done 10-June-2013 showing medium sized extrusion L5-S1 with right foraminal compromise. The patient was advised to try conservative treatment and in case not improving to undergo surgery.

The patient then came 13-July-2013 reporting that the right sciatica became more agonizing with SLRS 5 degrees in the right with more weak dorsi and planterflexion right foot 3/5 and hypalgesia right S1 root territory. The scoliotic stance became inverted and she cannot stand right and walking bended anterior and rotated to the left side.

Another MRI of the lumbar spine done 16-July-2013 showing the extrusion of L5-S1 with right foraminal occlusion.

Right S1 foraminotomy. The right S1 root was severely compressed by the extrusion. The extruded disc was removed lateral to the axilla. Right sided intradiscal cleaning of the L5-S1 disc space.

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.