The patient is the aneasthiologist of most of my surgeries for more than 30 years came to the clinic 01-February-2016 complaining of LBP with right sciatica for 10 months with exacerbation last 2 months with dyseasthesia right foot. He is diabetic for 5 years, hypertensive for 20 years and in L-thyroxin 100 microgram daily for 4 years.

On examination: the patient is not limping with exaggerated scoliotic stance. SLRS was 80 degrees without pain both sides. There is weak dorsiflexion right foot 4/5 and hypalgesia right S1 territory.

The patient was sent for MRI lumbar spine. It was preformed the same day showing second degree spondylolisthesis L4-5 with dynamic studies confirming this. He was advised conservative treatment, but this did not succeed. He was sent for cardio consultation and stopped Baby aspirin for 5 days.

Skeletonization of L4 5 and part of L3. The interosseus ligament between L4-5 was absent.  Using XIA 3 system 4 transpedicular monoaxial screws 6.5x45 mm  inserted to L4 and L5 bodies. Foraminotomy both L5 roots was achieved. Cross connector MAC 42 mm applied with the harvested bone milled and applied lateral to the rods. 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. Routine closure of the wound.

Smooth postoperative recovery. The power of right foot became normal. The patient is sciatica free. He was sent to the ward.

The patient has progressing spondylolisthesis with overmobility. that surgical stabilization left to be the only solution.

This is the 39th 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.