The patient came to the clinic 22-December-2010 complaining of LBP for 4 years with left sciatica for 4 months with numbness. Neck pain for one year with right upper limb weakness for 2 months.

MRI of the brain performed 20-December-2010 was normal, but MRI cervical spine showed very huge extruded disc C4-5 with severe compression of the spinal cord more to the right.

On examination: The patient  is limping with exaggerated scoliotic stance. SLRS was 85 degrees both sides without pain. There is pain in the neck when looking up and down and bending the head to the left shoulder. There is hypalgesia of the entire right upper limb and hypalgesia below the left nipple. The power of the right hand grip was -3/5 and the extensors /35 and the right triceps 4/5.

Anterior approach with discectomy of C4-5 was performed. All the extruded disc was removed in several pieces. The dura was seen in the entire plane of the posterior longitudinal ligament.

Routine closure of the wound. Smooth postoperative recovery with normalization of the power of the right upper limb.

The patient has very huge extruded disc C4-5 with elements of Brown-Sequard syndrome, affecting more the sensory compartment. The radicular manifestations prevailing.

The defect in the annulus fibrosis was huge, that during intradiscal decompression and traction, the extruded disc returned to the intradiscal space and small amount was needed to remove after that.

The recurrence rate after cervical discectomy is zero.