The patient was operated by me 16-January-2014 for huge chronic subdural hematoma left convexity. The patient then came 20-August-2014 complaining of edema of the entire left upper limb. The patient was treated conservatively. The patient then came 31-March-2016 complaining of LBP with bilateral sciatica for the last 40 days with difficult micturition. Seen by urologist and treated for prostatitis.

On examination: the patient is limping with no scoliotic stance. SLRS was 80 degrees with pain in the left. There is weak dorsiflexion both feet 4/5.

The patient was sent for MRI lumbar spine and neuro MRI of the pelvis. It was preformed the same day showing extruded disc L4-5 with left foraminal compression with severe stenosis at L2-3, L3-4 and L4-5. Dynamic studies ruled out overmobility. MRA of the pelvic showed ectatic dilation of the branches of the left internal iliac artery with signs of prostatitis. PSA Free and total were within normal range.

The level of L4-5 was identified and decompressive laminectomy of L3 and L4 with upper half of L5 was achieved.  Bilateral L5 foraminotomy. The extruded disc of L4-5 was removed lateral to the axilla with left sided cleaning of the disc space. Using MultiGen, a bipolar pulsed mode RF with 42 Celsius, 240 sec, 2 Hz and 20 msec duration to both L4,5 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. He was sent to the ward.

The patient having an estimated postoperative recurrence below 7%, because the disc space is shallow.

This is the 46th 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.