The patient came to the clinic 23-April-2016 complaining of bilateral sciatica the last 5 months migrating from the right to the left and inability to walk more than 50 meters. MRI lumbar spine performed 09-December-2015 showed severe lumbar canal stenosis with possible spondylolisthesis.

On examination: the patient is limping with exaggerated scoliotic stance. She is using crutches for 2 months. SLRS was 90 degrees both sides without pain. There is weak dorsiflexion both feet 3/5, and planterflexion right foot -4/5.

The patient was sent for investigations and MRI lumbar spine performed 23-April-2016 showing severe lumbar canal stenosis L4-5 with huge extruded disk occluding the canal. Dynamic studies could not rule out overmobility, nor confirming it. Uric acid was 7.1 mg/L, CRP was 46 mg/L, ESR was 70 mm/h.

Decompressive laminectomy of L4 and upper half of L5 was achieved. Foraminotomy both L5 roots was done. The disc space was inspected and overmobility was negative. The extruded disc was removed from both sides and bilateral cleaning of L4-5 was achieved. Using MultiGen, a bipolar pulsed mode RF with 42 Celsius, 240 sec, 2 Hz and 20 msec duration to both L5 root was achieved using 4 bended catheters 10 mm exposed length. Stimulation of the nerves with 2 volts revealed brisk response from both roots. Routine closure of the wound.

Smooth postoperative recovery. The patient is sciatica free. The power of both limbs normalized and she 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 52nd 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.