The patient was operated by me 04-August-2002 for PLD L4-5 right side  and he made good recovery, until 10 days ago got agonizing right sciatica with inability to walk or set down. The patient was advised to perform repeat MRI lumbar spine, which was done 17-September-2006 and showed a huge recurrence at the same level and side.

On examination, he had almost drop right foot and severe right sciatica with hypalgesia right L5 root. The patient was advised to undergo surgery.

Through the same incision, right L5 foraminotomy was performed and the root was followed upward and the extruded disc was stuck with the root. Lateral to the axilla the sequestrated disc material was removed and further cleaning of the disc space was performed from the right side. The patient was put in Reverse Trendelenburg position with Valsalva maneuver and hyperventilation. No CSF leak. Routine closure of the wound.

Smooth postoperative recovery. The power of the right foot improved. He was sent to the ward.

The patient came to the clinic 30-Sptember-2006 with clean wound and full power of the right foot with hypalgesia both L5 and S1 territories as diabetic neuropathy type.

There is still an estimated postoperative re-recurrence around 7%.

Since the defect in the annulus fibrosis in the first surgery was wide, the possibility for recurrence was relatively higher than usual. There is a possibility that the intradiscal material with time can give growth and each time when performing meticulous cleaning, a large quantity of disc material come out, holding the possibility of such speculation.