The patient came from Saudi Arabia to the clinic 08-March-2016 and was examined in the ambulance due to the agonizing pain complaining of LBP for 1 year with intermittent course. Right agonizing sciatica for 2 weeks with inability to walk or sleep. The patient is hypothyroid under treatment.

On examination: the patient is sleeping in the ambulance with inability to evaluate the walking or stance nor SLRS. There is weak dorsi and planterflexion right foot -4/5 with hypalgesia right S1 territory. There is burned point of the right foot lateral aspect performed 3 days ago with some inflammatory process.

The patient was admitted to the hospital and MRI lumbar spine, dynamic studies and Lab investigations performed. MRI lumbar spine showing extruded disc L5-S1 with right S1 root compression. The extrusion piercing the nerve. Dynamic studies ruled out overmobility. ESR was 95 mm/h and CRP 45 mg/L. Antibiotic treatment started immediately after admission.

The level of L5-S1 was identified and right foraminotomy of S1 root was achieved. The extruded disc was removed and right sided intradiscal cleaning of L5-S1 was performed. The right S1 root was swollen. Using MultiGen, a bipolar pulsed mode RF with 42 Celsius, 240 sec, 2 Hz and 20 msec duration to the right S1 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 normal. The patient is sciatica free. She was sent to the ward.

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

This is the 43rd 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.