The patient came to the clinic 02-November-2013 complaining of LBP with right sciatica for 15 years. Exacerbation of LBP and right sciatica the last 3 months with electric-like pain down to the right L5 territory.

MRI of the lumbar spine done 20-February-2013 showed extruded disc L5-S1 right side (bad quality).

On examination: the patient is limping with exaggerated scoliotic stance. There is pain with fainting when bending the neck toward the chest. Weak extension both hands 4/5 with hypalgesia median distribution right hand. SLRS was 20 degrees with pain in the right. Weak dorsiflexion right foot 3/4, planterflexion same foot 4/5 with hypalgesia right L5 and S1 territories.

MRI of the cervical and lumbar spine done 02-November-2013 showing extruded disc L3-4 with severe segmental stenosis. Extruded disc C6-7 with right foraminal occlusion. EMG confirmed the presence of severe CT syndrome both hands more the right.

Using C-arm, the L3-4 level was identified. Laminectomy of L3 and upper third of L4. Foraminotomy both L4 roots. The medial parts of the kissing facets were drilled out. There is no epidural fat due to severe compression. The extruded disc L3-4 was removed and right sided intradiscal cleaning was achieved.

Smooth postoperative recovery. The power of the right foot became normal.

The patient has 2 major problems in cervical and lumbar spine. The patient is severely affected by the lumbar problem, for what surgery is directed to the lumbar spine.

The estimated postoperative recurrence is 7% because the disc space is still not shallow.