The patient came to the clinic 24-April-2016 complaining of LBP with right sciatica with numbness big toe right foot for 45 days. MRI performed 23-April-2016 showing huge extruded disk L5-S1 with right downward migration.

On examination: the patient is now not limping with mild scoliotic stance. SLRS was 70 degrees in the right with pain and 80 degrees left side without pain. There is weak dorsiflexion right foot -4/5 and weak planterflexion same foot -5/5 with hypalgesia of the right S1 territory.

Using the C-arm, the L5-S1 level was identified and foraminotomy right S1 root was achieved. The extruded disk was removed from the right side and right sided cleaning of L5-S1 was performed. Using MultiGen, stimulation of right S1 nerve was achieved with 1.7 V. A bipolar pulsed mode RF with 42 Celsius, 240 sec, 2 Hz and 20 msec duration to the right S1 root was achieved using 2 bended catheters 10 mm exposed length. Further motor stimulation done to the same root and the same response was noted at 1.4 V. Routine closure of the wound.

Smooth postoperative recovery. The patient is sciatica free. The power of the right foot normalized and he was sent to the ward.

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

This is the 61st 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.

It seems that the root becoming more responsive to lower volt threshold after the application. This could be to facilitation or improvement of the nerve function.