The patient came to the clinic 16-February-2016 complaining of LBP with bilateral sciatica for 8 months with numbness below the knees more the left side. LSS-X-ray done 16-February-2016 showing grade II spondylolisthesis L4-5. MRI lumbar spine done 02-February-2016 showing extruded disc L4-5 central with severe segmental stenosis L4-5 with spondylolisthesis L4-5. The patient is a known diabetic under treatment for 2 years.

On examination: the patient is limping with exaggerated scoliotic stance. SLRS was 85 degrees with pain both sides. There is weak dorsiflexion both feet 3/5. MRI lumbar spine performed the day before surgery to check if any changes happened before surgery.

The level of L4-5 was identified and transpedicular reduction and fixation of L4-5 was achieved using XIA 3 system with 4 monoaxial screws 6.5x45 mm with dross connector 42 and 2 bended rods. Decompressive laminectomy of L4 and upper 1/5th of L5 was achieved. Bilateral L5 foraminotomy. The extruded disc of L4-5 was removed lateral to the axilla with bilateral 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. She was sent to the ward.

The patient could have complications to the potential defects of the construct, beside the 5% postoperative infection.

This is the 47th 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.