The patient came to the clinic 02-April-2013 complaining of LBP with bilateral sciatica more to the right with numbness of the right foot. The patient was operated elsewhere 26-August-2012 for extruded disc L4-5 after what he improved to start suffer of the same pain after 2 months with escalation of the bilateral sciatica the last 2 weeks.

MRI lumbar spine done 23-December-2012 showing huge recurrence of L4-5 more to the right. MRI repeated 24-March-2013 showing total collapse of the L4-5 disc space with bigger extrusion of the recurrence.

On examination: The patient is limping with exaggerated scoliotic stance. SLRS was 60 degrees in the right with pain and 80 degrees in the left without pain. There is weak dorsiflexion both feet -4/5  and planterflexion right foot 4/5.

The old wound refreshed and scarolysis of the right side with foraminotomy of the right L5 root. The root was followed up until the most right part of the extrusion was found. It was so huge that it was removed in several pieces intentionally, to prevent traction trauma to the already traumatized root, lateral to the axilla. The root and and dura became lax after this removal. The collapsed disc space was inspected and it was very shallow and no disc material inside.

Routine closure of the wound. Smooth postoperative recovery. The power of both feet became normal.

There is an estimated postoperative recurrence around 0%, because the disc space of L4-5 suffered total collapse.