The patient came to the clinic 17-March-2014 complaining of LBP for 17 days with heaviness both lower limbs, more the left. The patient was operated at the University hospital in July-2013 for extruded disc L5-S1 with left sciatica. MRI lumbar spine done 09-March-2014 showing recurrence of L5-S1 central with downward migration more to the left.

On examination; the patient is limping with exaggerated scoliotic stance. Walking bended anterior. SLRS was 20 degrees right side with pain and 10 degrees with more pain in the left. The left AJ is absent. There is weak dorsi and planterflexion both feet -3/5.

Using C-arm, the L5-S1 level was identified. It was far up from the previous incision. Bilateral foraminotomy both S1 roots. There was a little scar at the left lower corner of the exposed field. The disc was initially attacked lateral to the left axilla. The extruded disc was removed in several pieces. There is no scar at the working area for removal and cleaning of the intradiscal material. Right sided further cleaning of the disc space was done. Both roots hanging free. All stages of surgery were checked with the C-arm. Routine closure of the wound.

Smooth postoperative recovery. The power of the feet became better.

The patient  still has an estimated postoperative recurrence rate around 7%, because the disc space height still not shallow.

It is impossible to perform intradiscal cleaning from the previous incision.

Bilateral cleaning was done to ensure that all the causative factors of bilateral practical drop feet, be eliminated.