Cervical RFA with cervical SCS leads

[RoloTomassi]

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What's the correct way to proceed? Bipolar vs mono with grounding pad right up against needles?

 

[lobelsteve]

What's the correct way to proceed? Bipolar vs mono with grounding pad right up against needles?

Meh, turn off device, put ground pad adjacent to needle placement.
But how much bang for the buck you getting out of this patient?

 

[RoloTomassi]

Meh, turn off device, put ground pad adjacent to needle placement.
But how much bang for the buck you getting out of this patient?

Thanks. I've RF'd him before, pre SCS with decent results. Young guy with mostly axial pain and cervicogenic headaches above ACDF. SCS done by someone else for residual arm pain, helps moderately for that.

 

[clubdeac]

I fried a stim once doing RF on a patient.

 

[bedrock]

I fried a stim once doing RF on a patient.

Details please ..

 

[clubdeac]

Details please ..

Early in my career. Did lumbar RFA on a guy with a standard SCS. I’m pretty sure we had him turn it off but honestly don’t remember. All I know is that when he came for f/u he said his stim had quit working. Had the rep come interrogate and they said the battery had died. I think he had it put it in 5 yrs prior. I attributed it to my RFA but who knows

 

[Ducttape]

Nah. That's because he forgot all about the stim, hadn't recharged it in 5 years and wanted to blame you for it not working....


Not due to your RFA.

 

[drmamba]

Turn off device, grounding pad away from device, monopolar unless you're particularly motivated to use bipolar.

 

[callmeanesthesia]

I do bipolar if near the leads.

 

[Orin]

I've done bipolar for this when someone forgot to bring their remote and it was a PITA
Worst case scenario, you'll have to replace the SCS which is a billable procedure.

It's not an AICD so you won't levitate them with your RF

 

[mygalperin]

What's the correct way to proceed? Bipolar vs mono with grounding pad right up against needles?

No connection, the frequency of the RF in totally different, for you comfort you may turn the stim off