The patient came to the clinic 29-September-2010 complaining of agonizing right sciatica for 5 days with inability to walk. He had left sciatica 1 year ago.

On examination: The patient was unable to put him in the examination bed for evaluation; but the SLRS was 80 degrees in the right with pain. Dorsiflexion of the right foot was 3/5 and planterflexion 4/5.

MRI of the lumbar spine done 30-September-2010 showing huge old extruded disc in the left side with downward migration and fresh disc in the right side.

Bilateral flavotomy L4-5 with foraminotomy of L5 roots was performed. The right side, where compression was less severe in compression was attacked and it contained huge extrusion, which was removed in several pieces. The left L5 root was severely compressed for what further foraminotomy was achieved and the compressed root was delicately shifted to expose the old extrusion, which was also removed in several pieces. Meticulous cleaning of L4-5 was done from both sides.

Routine closure of the wound and smooth postoperative recovery and the power of the right foot became normal.

The patient was afraid of surgery and his agonizing pain brought him to surgery. The old bigger extrusion was in the left and the patient was complaining of right sciatica.

The MRI data definitely differ when performed in the supine and standing position. This case could have these data supporting that the right L5 root was more compressed when the patient take a standing position.