The patient came to the clinic 24-April-2008 complaining of LBP for 45 days with right sciatica. Three days later progressed minimal left sciatica.

The patient is a known diabetic for 12 years and hypertensive for 9 years and he underwent discectomy of L5-S1 1989 for right sciatica.

MRI performed 20-April-2008 showed huge recurrent disc L5-S1 with right downward migration.

On examination: the patient is limping with scoliotic stance. SLRS was 40 degrees in the right and 60 degrees in the left with pain. He had weak dorsi and planterflexion right foot  4/5 with hypalgesia right L5 and S1 territories.

Right S1 foraminotomy and scarolysis at the previous surgery was performed. The extruded disc was removed lateral to the axilla in several pieces. Cleaning of the disc space was done from the right side.

Routine closure of the wound with smooth postoperative recovery.

Considerable improvement of the power of the right foot.

In diabetic patients we try to avoid using the electrocautery  to minimize the rate of postoperative infection.

The recurrence happened 19 years after the first surgery in the same side.

The expected recurrence is low because the disc space is almost empty and the disc space height is minimal.