The patient came to the clinic 05-April-2001 telling that he was operated elsewhere for PLD L4-5 and L5-S1 03-Sptemebr-2003 without improvement. He was limping when walking with SLRS 45 degrees with pain right side with weak dorsiflexion right foot 4/5 and hypalgesia right S1 territory. He was sent for investigation at that time and MRI of the lumbar spine performed 23-August-2003 before surgery showing extruded disc L5-S1 left side. MRI lumbar spine performed 16-February-2004  showing the same extrusion.

On examination: The patient is limping with exaggerated scoliotic stance. SLRS was 30 degrees in the left with pain. There is weak dorsi and planterflexion left foot 3/5 with hypalgesia left L5 and S1 territories.

Left S1 neurolysis and foraminotomy after scarolysis with removal of the extrusion lateral to the axilla and subaxillary. After that, the root became lax and left sided intradiscal cleaning L5-S1 disc space was done. The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak. A free fat was harvested from the subcutaneous layer and covered the exposed parts of the root. to minimize postoperative scarring. Routine closure of the wound. Smooth postoperative recovery. The power of the left foot became normal. He was sent to the ward.

The patient came to the clinic 17-April-2004 with clean wound and SLRS 80 degrees both sides without pain and no motor, nor sensory deficit. There is tingling sensation left gastrocnemius muscle area.

The patient came 24-September-2007 telling that he was exposed to RTA with fracture right knee and was operated for that. Neurologically he was free except for SLRS was 75 degrees right side with pain. He was sent for investigations, but he did not return.

The estimated postoperative re-recurrence is still ranking around 7%, because the disc space is still relatively not shallow.