The patient came to the clinic 06-April-2016 complaining of LBP with left sciatica for 6 years with intermittent course. Exacerbation of the LBP with left sciatica the last 3 weeks with further deterioration the last three days with numbness of all toes left foot. MRI lumbar spine performed 05-April-2016 showing very huge extruded disc L4-5 with left downward migration.

On examination: the patient using crutches and walking with help of 2 person and unable to estimate the limping nor scoliotic stance. SLRS was 30 degrees with pain in the right and 3 degrees with more pain in the left. The left AJ is absent in the left. There is drop left foot with weak planterflexion left foot 2/5. Hypalgesia both left L5, S1 roots.

The level of L4-5 was identified and partial decompressive laminectomy of L4 and upper left half of L5 was achieved from. Left L5 foraminotomy. The extruded disc of L4-5 was removed subaxillary in 2 huge pieces with left sided cleaning of the disc space. Using MultiGen, a bipolar pulsed mode RF with 42 Celsius, 240 sec, 2 Hz and 20 msec duration to left L5 root was achieved using 2 bended catheters 10 mm exposed length. Stimulation of the root with 1.2 V showed slight response, but with 2 V brisk response. Routine closure of the wound.

Smooth postoperative recovery. The planterflexion power of left foot became normal and the patient could dorsiflex the big toe with slight weakness. The patient is sciatica free. He was sent to the ward.

The patient still having an estimated postoperative recurrence around 7%, because the disc space is still not shallow.

This is the 48th case using the BPRF mode with MultiGen. This procedure regained routine acceptance  it became a usual part of the spine surgery. Click here for reference.

Before application of BPRF stimulation was applied to the root and got response with 1.2 V which indicate that the nerve have good chance for postoperative recovery. This means, that if the patient has a drop foot with agonizing pain with minimal period of time with good response to stimulation, the expected postoperative recovery will be considerable.