The patient was operated by me 17-September-2013 for first recurrence of L4-5 with right upward migration. The patient was doing well, until 45 days after surgery got agonizing right sciatica with LBP.

MRI lumbar spine done 17-November-2013 showing huge recurrence of L4-5 right side with bulge L5-S1.

On examination is limping without scoliotic stance. SLRS was 45 degrees right side with agonizing pain. There is weak dorsiflexion right foot -3/5.

C-arm was used to identify the level. The upper right bony corner of L4-5 was refreshed. There is massive scar. The extruded disc of L4-5 was removed in several pieces. Right sided cleaning L4-5 disc space. Routine closure of the wound. 

Smooth postoperative recovery. The power of the right foot became better.

The patient still has an estimated postoperative recurrence around 7%, because the disc space is still not shallow.

It was discussed with the patient to perform fusion of L4-5 and he preferred to undergo simple discectomy for the recurrence.