The patient came to the clinic 06-February-2010 complaining of LBP since 1995. 3 weeks ago got severe LBP with agonizing left sciatica. Three days ago the pain suddenly disappeared but drop left foot took place with numbness of the left L5 territory.

MRI performed 28-January-2010 showing extruded disc L4-5 with far downward migration to the foramen of the left L5 root.

On examination: the patient is limping with mild scoliotic stance. He had drop left foot with diabetic neuropathy above the ankles both feet. The patient is a known diabetic with hypertension and hyperlipidemia. He performed cath 3 times with normal results.

Using the image-intensifier the L4-5 level was identified and left hemiflavotomy L4-5 with foraminotomy of the left L5 root was performed. The extruded disc was removed from under the axilla and left sided cleaning of L4-5 was done from the left.

Using PEEK Satellite spinal system, was not necessary because the disc space was shallow.

Routine closure of the wound.

Smooth postoperative recovery, with improvement of the power of left foot.

The surgeon think that he performed meticulous cleaning of the disc space, but it is not true. It is impossible to clean the disc space from one side using the available standards.

The shallow disc space means minimal disc recurrence, for what the idea of nucleus replacement device was abandoned in this case.

The explanation of sudden disappearance of sciatica, that the extruded disc slipped down to the canal for more than 8 mm below the disc space level.