The patient came to the clinic 16-January-2016 complaining of LBP with bilateral sciatica, more the left with numbness left foot for 3 months. MRI lumbar spine done 03-October-2015 showing bulge disc L4-5 central with severe stenosis (The MRI bad quality).

On examination: the patient is limping with exaggerated scoliotic stance. SLRS was 10 degrees with pain in the left. There is weak dorsiflexion left foot -4/5 and 4/5 right foot. The left AJ is absent.

The patient was sent for new investigations and MRI lumbar spine performed 16-January-2016 showing huge central extruded disc L4-5 more to the left with total segmental stenosis. Dynamic studies ruled out the presence of overmobility.

Decompressive laminectomy L4 and upper third of L5 with bilateral foraminotomy both L5 roots. The extruded disc was removed lateral to the axilla and left sided  intradiscal cleaning of L4-5 was achieved.  Inspection of the right side was uneventful. Using MultiGen, a bipolar pulsed mode RF with 42 Celsius, 240 sec, 2 Hz and 20 msec duration to the left L5 root was achieved using 2 catheters 5 mm exposed length. Routine closure of the wound.

Smooth postoperative recovery. The power of both feet became normal. The patient is sciatica free. He was sent to the ward for observation.

The patient still has an estimated postoperative recurrence around 7%, because the disc space still not completely shallow.

This is the 26th case using the BPRF mode with MultiGen and the third with double BPRF. This procedure regained routine acceptance  it will be a usual part of the spine surgery. Click here for reference.