The patient came to the clinic 24-February-2008 complaining of LBP for 1 month with exacerbation the last week with left sciatica and positive cough sign.

On examination: the patient is limping and has scoliotic stance. SLRS was 85 degrees in the right and 70 degrees in the left with radiating pain to the left leg. The patient had weak dorsiflexion left foot 4/5.

The patient was sent for MRI lumbar spine which was done 27-February-2008 showing huge PLD L5-S1 left side.

Foraminotomy of left S1 root was performed and partial flavotomy of L5-S1 was done. The extruded disc was removed lateral to the axilla in three successive pieces. Inspection of the disc space, confirmed that the disc space was practically obliterated, for what it was decided not to violate it.

Routine closure of the wound and smooth postoperative recovery with normalization of the power of the left foot.

Foraminotomy of the involved root must be done in all disc surgeries to be sure that there is no remnant left under the axilla.

The disc space was very shallow, for what the expected recurrence rate in this case is almost zero.