The patient came to the clinic 14-April-2009 complaining of neck and LBP for 6 years. He was limping  with no scoliotic stance with SLRS 30 degrees both sides. There was weak dorsiflexion both feet 4/5.

MRI performed 13-May-2009 showing extruded disc L5-S1 central more to the right. The patient was advised to try conservative treatment  and disappeared.

The patient then came 07-February-2010 complaining of bilateral sciatica more to the left for 2 weeks with numbness left foot. The patient was limping with exaggerated scoliotic stance with SLRS 20 degrees in the right and 5 degrees in the left side. He had drop left foot with left foot planterflexion 2/5 and dorsiflexion right foot -4/5 and planterflexion right foot 4/5. He had hypalgesia left L5 and S1 territories.

MRI lumbar spine requested and done showing the old extrusion of L5-S1 and fresh extrusion in the left side.

Bilateral flavotomy of L5-S1 and bilateral foraminotomy of S1 roots was achieved. The extruded disc was removed from both sides and meticulous cleaning of the disc space was achieved from both sides.

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 both feet.

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 even both sides, 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.