The patient came to the clinic 30-March-2009 complaining of right sciatica for one month with LBP for 5 years. She was limping with exaggerated scoliotic stance.

The patient has mitral valve prolapse.

On examination: SLRS was almost zero in the right  with weak dorsiflexion right foot 3/5 and planterflexion 4/5 with analgesia right S1 territory.

The patient was sent for MRI lumbar spine which was performed 31-March-2009 showing extruded disc L5-S1 with right downward migration.

Right S1 foraminotomy was performed and the extruded disc was removed from under the axilla. It was pushing the root lateral and the right S2 medially. All the extrusion was removed and meticulous cleaning of L5-S1 space was performed. Routine closure of the wound.

Smooth postoperative recovery with prompt recovery of the power and disappearance of the sciatica.

The disc space still not shallow and the defect in the annulus fibrosis was large. These factors make the estimated recurrence in the case above 7%, despite the fact that meticulous cleaning was achieved.