The recurrence rate in this case still ranking around 7% because the disc space is not completely collapsed.

The patient came to the clinic 29-May-2002 complaining of LBP with right sciatica for 3 years with neck pain. MRI lumbar spine performed 21-May-2002 showing extruded disc L5-S1. The patient came several times and 21-December-2002 came with data confirming advanced CTS more the right for what right CT release was performed and came to the clinic 23-December-2002 with clean wound and numbness free of the right hand. The patient then came 16-April-2003 telling exacerbation of LBP with bilateral sciatica more the right the last 3 days.

On examination: the patient in pain, limping with exaggerated scoliotic stance. SLRS was 85 degrees with pain right side. There is weak dorsi and planterflexion right foot with hypalgesia left L5 and S1 territories.

The patient was sent for investigations and MRI lumbar spine performed 16-April-2003 showing huge extruded disc L5-S1 central more to the right. There is lumbarization of S1.

Decompressive laminectomy L5-S1 with extended foraminotomy both S1 roots. The extruded disc of L5-S1 was attacked from the right axilla and bilateral cleaning of L5-S1 was achieved until the roots became lax. The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak. Routine closure of the wound

Smooth postoperative recovery. The radicular pain disappeared and the power of the right foot normalized. He was sent to the ward.

The patient came to the clinic 03-May-2003 with clean wound with no motor deficit. There still hypalgesia both S1 roots. SLRS was 90 degrees with minimal pain right side.

The patient then came several times for other problems and the last visit was 15-December-2011 with MRI of the brain done the same day showing serous mastoiditis both sides  with bulge C4-5 and C5-6 and was treated conservatively.