Inomed Stockert Neuro N50. A versatile
RF lesion generator and stimulator for
countless applications and many uses
Multigen RF lesion generator .
15-FEBRUARY-2017 AMAL ABDALLA KHALEEL 52 YEARS
HUGE EXTRUDED DISC L4-5 WITH RIGHT DOWNWARD MIGRATION.
The patient came to the clinic
complaining of LBP for 2 months with right
sciatica down to the right ankle. MRI lumbar
spine performed 15-January-2017 showing bulge
L2-3, 3-4, L5-S1 with huge extruded disc L4-5
with right downward migration.
On examination, the patient is limping with exaggerated scoliotic stance. SLRS
was 90 degrees both sides without pain. There is weak
dorsiflexion right foot 3/5.
Foraminotomy right L5 root. The extruded disk was removed
lateral to the axilla of the right L5 root
Right sided cleaning of L4-5 was performed.
MultiGen, bipolar motor stimulation of the right L5
was achieved with 1.9 V. A
bipolar pulsed mode
RF with 42 Celsius, 240 sec, 2 Hz and 20 msec
duration to right L5 root was achieved using
2 bended catheters 10 mm exposed length. Further
bipolar motor stimulation of the right L5
was achieved with 1.7 V. Routine closure of the
Smooth postoperative recovery. The power of
right foot normalized and she was sciatica free.
She was sent to the ward.
The patient still having an estimated
postoperative recurrence around 7%, because the disc
space is still not shallow.
This is the 109th case using the BPRF mode
with MultiGen. This procedure regained routine acceptance.
It became a usual part of the spine and peripheral nerves
surgery. Click here for
It still unclear to evaluate the
differences of pre and post application motor responses. The
only sure thing that it tells that the electrodes did not
migrate during the procedure and the nerve is functioning
properly. Here there was slight improvement of the threshold of stimulation
power of motor stimulation of the right L5.
With accumulation of data, it became
clear that the irritated nerve with aberrant currents
running in the C fibers up, not only causing no change or elevation of
the required voltage to achieve motor response, but they could cause the preoperative
weakness. Ablation of such currents results in facilitation
of the motor response and improvement of function with
disappearance of pain.
It is unclear why the roots have several
motor response with different patients, despite the fact
that the neurological status is the same and the anaesthesia
protocol also the same.