The patient came to the clinic 18-October-2015 complaining of LBP for 35 years with exacerbation the last 2 months  with left sciatica down to all toes left foot . The patient is a known hypertensive for 6 years in Warfarin 5 mg daily, Concor 5 mg, Exforge HCT  once and Dilatrend 25 once daily. She is allergic to Aspirin. MRI done 10-October-2015 showing spondylolisthesis L4-5 with severe stenosis. Dynamic studies confirm the above mentioned data.

On examination: the patient is limping with exaggerated scoliotic stance. SLRS was 50 degrees both sides with pain. There is weak dorsiflexion right foot 4/5, left foot 3/5. She had severe pain when trying to set or turning position.

The patient was sent for cardio evaluation and atrial fibrillation was established and it was advised to stop Warfarin and put the patient in Clexane 6 hours after surgery.

Skeletonization of L4-5 was performed. Using XIA 3, 4 monoaxial screws 6.5x50 mm were inserted to L4 and L5 pedicles with bended rods and MAC  42 mm, reduction and fixation of L4-5 was achieved. Decompressive laminectomy L4 and L5 was performed and foraminotomy both L5 roots. Using MultiGen, a bipolar pulsed mode RF with 42 Celsius, 240 sec, 2 Hz and 20 msec duration to both L5 roots was achieved using 4 bended catheters 10 mm exposed length. The harvested bone was milled and applied lateral to the rods. 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 still has an estimated postoperative recurrence around 7%, because the disc space still not completely shallow.

This is the 32nd case using the BPRF mode with MultiGen. This procedure regained routine acceptance  it will be a usual part of the spine surgery. Click here for reference.