The patient came to the clinic 29-September-2013 complaining of LBP for 10 days with right sciatica for 2 months down to the little toe right foot. Exacerbation of LBP with right sciatica last month. The patient was operated at KHMC for extruded disc L5-S1 13 years ago.

MRI lumbar spine done 29-July-2013 showing recurrent extruded disc L5-S1 with right foraminal occlusion. MRI lumbar spine repeated 02-September-2013 showing further enlargement of the extrusion.

On examination: the patient is limping with scoliotic stance. SLRS was 70 degrees with pain in the right. He has weak dorsiflexion right foot -4/5 and planterflexion right foot 4/5. He has hypalgesia right S1 territory. The patient has burn of the right foot 1x2 cm at the dorsal aspect of the right foot due to local treatment by a herb known by Arabic Qabbar. He suffered also form II degree of burn at the previous surgery site.

Foraminotomy of the right S1 root with removal of the scars. The extruded disc was removed lateral to the axilla. Right sided cleaning L5-S1 disc space.

Smooth postoperative recovery. The power of right foot became normal.

The patient still have an estimated postoperative recurrence around 5%, because the disc space height is still not shallow even bilateral cleaning performed.