The patient came to the clinic 26-January-2016 complaining of LBP for 5 months with exacerbation of LBP with left sciatica the last month then the sciatica became to the right the last 2 weeks down to the right foot with numbness of the right foot. MRI lumbar spine done 19-September-2015 showing bulge L4-5 and L5-S1 with right foraminal occlusion of small size. The patient is diabetic for 8 years and hypertensive for 20 years. Cath with stenting done 2002.

On examination: the patient is in agonizing pain, limping with scoliotic stance. SLRS was 10 degrees with pain in the left shooting to the right and 45 degrees in the right with pain. There is weak dorsiflexion right foot 2/5 and planterflexion same foot 3/5. There is hypalgesia  right L5 and S1 roots territories. The patient repeated the MRI 27-January-2016 and a huge extruded disc L4-5 with right foraminal and downward migration was seen. The patient was sent for cardio consultation and Baby aspirin stopped for 5 days before surgery. 

Right L4-5 flavotomy with right foraminotomy L5 root. The extruded disc was removed subaxillary and right sided intradiscal 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 the right L5 root was achieved using 2 bended catheters 10 mm exposed length. Routine closure of the wound.

Smooth postoperative recovery. The power of right foot became better. 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 30th 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.