The patient came to the clinic 06-July-2013 complaining of left sciatica sciatica for 20 days after lifting heavy object in Dubai. The patient was operated 2007 for PLD L5-S1 for right sciatica elsewhere. He is diabetic for 2 years with arterial hypertension for 3 years.

MRI lumbar done 08-February-2011 showed small extruded disc L5-S1 left side.

On examination: the patient is limping cannot be evaluated  for scoliotic stance due to agonizing pain, with SLRS 90 degrees with pain in the left. The left AJ was absent. Weak dorsiflexion left foot -4/5 and planterflexion same foot 4/5. There is hypalgesia left left L4 root.

MRI repeated 07-July-2013 showing huge recurrence at L5-S1 with left foraminal occlusion.

The upper left bony defect of L5-S1 was refreshed. There is a lot of scan and foraminotomy of left S1 root was done. The extruded disc of L5-S1 was removed in several pieces and part of it was intradural, due to what CSF came when this part was removed. The scarred dural defect was repaired by one stitch of 4 zero nylon. Check for CSF leak was negative. Left sided intradiscal cleaning of L5-S1 disc space.

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

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