The patient came to the clinic 29-January-2008 with agonizing right sciatica and LBP for three months.

The patient was operated elsewhere June-2006 for the same sciatica and discectomy of L4-5 was performed. The patient noted slight improvement of her sciatica.

MRI performed 23-January-2008 showing huge recurrence at L4-5 with right downward migration.

On examination: the patient is limping and has scoliotic stance. SLRS was 45 degrees in the right and 75 degrees in the left with radiating pain to the right leg. The patient had almost drop right foot with weak dorsiflexion right foot 1/5. There was numbness at S1 root territory right side.

The old incision was completely above the projection of the problem, for what another incision was performed under the old incision.

Neurolysis of the right L5 root was achieved and the extruded disc was removed lateral to the axilla.

Meticulous cleaning of the disc space of L4-5 from the right. Inspection under the axilla for remnant of the extrusion was negative.

Routine closure of the wound and smooth postoperative recovery with normalization of the power of the right foot.

Foraminotomy of the involved root must be done in all disc surgeries to be sure that there is no remnant left under the axilla.

The skin incision must be adequate so as to ease the surgery. Working with inadequate skin incision, could mislead the surgeon and make the angle of vision more difficult.

The annulus fibrosis was widely violated from the first surgery, but the disc height was narrower, these controversies make the expected rate of re-recurrence around 5-7 %.