The patient was operated by me for PLD L5-S1 for left sciatica 08-February-2001 and she was OK. Then she came 28-May-2013 complaining of left sciatica down to left L5 root territory for 2 months with feeling of coldness of the foot. The patient was operated for Crohn's disease 5 years ago.

On examination: The patient is limping with exaggerated scoliotic stance. SLRS was 85 degrees without pain in both sides. There is weak dorsi and planterflexion left foot -4/5. The left AJ is absent. The patient cannot set in the chair due to severe sciatica.

The patient was sent for investigations and MRI lumbar done 28-May-2013 showing extruded disc L4-5 with left downward migration. There is no recurrence at L5-S1 level. Vit D was very low with ESR 63 mm/h and CRP 7.25 mg/L.

Laminectomy L4 and the residual of L5. Foraminotomy L5 roots both sides. The left root was severely involved with compression. The extruded disc L4-5 was attacked from the left and the extrusion removed. Inspection of the right axilla showed compression, for what right sided cleaning was also done. The epidural fat was missing all over.

Routine closure of the wound. Smooth postoperative recovery. The power of left foot became normal.

The patient has lumbar canal stenosis with bilateral extrusion. All components must be corrected.

The patient still have a 7% postoperative recurrence rate because the disc space is still not shallow even if bilateral cleaning was achieved.