The patient came to the clinic 22-August-2010 complaining of LBP and right sciatica for 5 days down to the right L5 territory with numbness . On examination at that time, he was limping with exaggerated scoliotic stance with weak dorsiflexion right foot 4/5.  MRI lumbar spine done 26-August-2010 showed bulge L3-4, L4-5 and L5-S1 and the patient improved with pain-killers. The patient then came several times and the last visit was 28-September-2015 telling that he got exacerbation of his LBP with right sciatica the last 5 days. MRI lumbar spine performed 27-September-2015 showing recent extruded disc L4-5 with right foraminal occlusion. He was limping with exaggerated scoliotic stance with SLRS 80 degrees with pain in the right with weak dorsiflexion right foot -3/5.

Right L5 root foraminotomy with removal of the extrusion, which was penetrating the posterior longitudinal ligament compressing the root,  lateral to the root which was shifted medially. Right sided intradiscal cleaning L4-5 disc space. Subaxillary inspection for extrusion remnants. The root is lax and free. Using MultiGen a pulsed mode RF with 42 degrees Celsius, 240 sec, 2 Hz and 20 millisecond pulse width the right L5 root was manipulated using 2 curved catheters above and below the axilla. Routine closure of the wound.

Smooth postoperative recovery. The power of the right foot became normal. No sciatica. The patient was sent to the ward.

The patient still has an estimated postoperative recurrence around 7%.

This is the 9th case during which PRF was used. It seems that the sciatica disappearing better in comparison with patients not exposed to such manipulation.