The patient came to the clinic 18-January-2016 complaining of LBP with right sciatica with numbness all toes right foot more the big toe. She was operated elsewhere for extruded disc L5-S1 in January-2015 for right sciatica without improvement.

On examination: the patient is limping with exaggerated scoliotic stance. SLRS was 30 degrees with pain in the right and 50 degrees with pain in the left. There is weak dorsiflexion both feet 4/5 more the right, weak planterflexion right foot 4/5 and hypalgesia right L5 and S1 territories.

The patient was sent for MRI lumbar spine. They were preformed the same day showing still having right foraminal occlusion L5-S1. Dynamic studies could not rule out overmobility.

The patient refused preoperative meeting to be recorded.  Foraminotomy both S1 roots. There was severe compression at the left S1 root from the lateral mass, pinching the root. The root became lax and free. Inspection of the annulus fibrosis showed that there is no need to violate the disc space. Using MultiGen, a bipolar pulsed mode RF with 42 Celsius, 240 sec, 2 Hz and 20 msec duration to both S1 roots was achieved using 4 bended catheters 10 mm exposed length. Routine closure of the wound.

Smooth postoperative recovery. The power of both feet became normal. The patient is sciatica free. She was sent to the ward.

The patient has still persisting source of pain with this foraminal compression. Good decompression and selective denervation of the C fibers is the best solution.

This is the 37th 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.