The patient came to the clinic 23-January-2016 complaining of acute LBP for 2 days radiating to the left thigh. The patient is diabetic for 2 months and hypertensive for 10 years.

On examination: the patient is in agonizing pain, limping with scoliotic stance. SLRS was 55 degrees in the right with pain  and 60 degrees with pain in the left. There is weak left quadriceps and abduction of the left knee 4/5. Weak dorsiflexion right foot 4/5.

The patient was sent for investigations and MRI done the same day showing a huge extruded disc L3-4 and bulge L4-5 with segmental stenosis. The patient was sent for cardio consultation. Dynamic studies were holding suspicion of overmobility.

Partial laminectomy of lower 3/4th of L3 and upper 1/4th of L4 with foraminotomy both L4 roots. The extruded disc was removed lateral to the left axilla and left sided intradiscal cleaning of L3-4 was achieved.  Check for overmobility was negative. Using MultiGen, a bipolar pulsed mode RF with 42 Celsius, 240 sec, 2 Hz and 20 msec duration to both L4 roots was achieved using 4 bended catheters 10 mm exposed length. 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 31st 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.