The patient came to the clinic 08-September-2007 complaining of LBP for 2 months with left sciatica. Exacerbation the last month of the left sciatica.

MRI lumbar spine performed 10-September-2007 showed a small extrusion of L2-3 with bulge at the below levels and was treated conservatively.

The son then cam 21-September-2008 telling that his mother is now complaining of LBP with right sciatica for two months. MRI lumbar spine done 16-September-2008 showing PLD L5-S1 with right foraminal occlusion.

On examination before surgery: the patient in agonizing pain. Limping with scoliotic stance  with pain right side. She had almost drop right foot and weak planterflexion left foot 3/5.

Right hemiflavotomy of L5-S1 was done and foraminotomy of right S1 root was achieved.  The main compression was from the deformed right facet joint with calcified ganglion arising from it, obliterating the foramen. Disecectomy of L5-S1 was done with cleaning of the disc space from the right.

The defect of the annulus fibrosis was medium in size and disc space was shallow.

Routine closure of the wound and smooth postoperative recovery.

The patient had shallow disc space, for what the estimated recurrence rate could be below 7%.

Lateral recess syndrome could be due to calcified ganglion arising from the deformed facet joint. This finding still cannot be estimated in the MRI. More accurate tools must be installed in radiologic armamentarium to make this finding more easier before surgery.