The patient was operated by me 08-August-2002 for LCS L3-4, L4-5 with left sciatica, then came to me 23-November-2011 10 days after suffering RTA and wedge fracture of D12 was diagnosed and treated conservatively. The patient then came 11-February-2016 with LBP and right sciatica down to the right knee for 12 days. The patient in Omnic for 4 years for hypertrophic prostate.

On examination: the patient is using crutches, limping walking bended with exaggerated scoliotic stance. He has essential tremor left hand. SLRS was 40 degrees with pain in the right. There is weak dorsi and planterflexion right foot 3/5 and 4/5 left foot.

The patient was sent for MRI lumbar spine and pelvis. It was preformed 14-February-2016 showing extruded disc L3-4 with right foraminal compression with severe stenosis at L1-2, 2-3 and L3-4. Dynamic studies ruled out overmobility and showing the old wedged fracture D12. The patient was sent for cardio consultation and stop anticoagulants for at least 5 days.

The level of L3-4 was identified and decompressive laminectomy of L2, L3 and lower half of L1 was achieved.  Bilateral L4 foraminotomy. The extruded disc of L3-4 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 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 around 7%, because the disc space still not completely collapsed.

This is the 44th 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.