Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator .
07-APRIL-2016 HUSAM HASAN TAHA 49
YEARS HUGE EXTRUDED DISC L4-5 WITH LEFT DOWNWARD MIGRATION AND
DROP LEFT FOOT.
Anamnesis
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.
MultiGen
Comments
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.
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