The patient was operated by me 27-December-2010 for huge extruded disc L5-S1 and was doing fine. The patient then came 13-January-2014 complaining of decreased vision right eye with scatoma right eye for 2 months with occasional feeling of tinnitus and fullness left side. Fundus photography done 05-January-2014 showed huge papilloedema right optic nerve.

On examination; the patient was neurologically free except the ophthalmologic findings  and absent left AJ which had place before the first surgery. The patient had elements of left hemifacial spasm due to stress.

The patient was sent for MRI of the brain and both orbits, which confirmed the presence of angry optic nerves both sides more the right. The brain otherwise was normal.

Using C-arm, the L3-4 level was identified. The Touhy needle was inserted and the distal part of the lumbo-peritoneal shunt inserted about 40 cm upward. It was necessary to make 3 mm incision to insert the anchor and insert the passer to the anterior upper quadrant of the abdomen. Through 2 cm length incision, the passer was reached and the distal end of the LPS was reached. The distal end was inserted intraperitoneally with anchor abutting the sheet, which was tightly closed and another anchor to the subcutaneous layer. Routine closure of the wounds.

Smooth postoperative recovery. 

The patient has severe papilloedema of the right optic nerve. Surgery can prevent possible visual function deterioration.