IH/II RFA

[specepic]

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I have a pt who did well with pulsed RFA of the ilioing/iliohypogastric. Wore off in about 3 months. Who has done these with standard RfA and are there are decent articles you would rec'd?

Thx

 

[clubdeac]

Do you use US specepic? What was ur technique regardless?

 

[specepic]

Yea, sorry, left that out -- I used US and typical approach. This pt is tough b/c she had an attempted surgery in the past to cut these nerves which was not successful so her tissue planes are a bit jacked up. I used sensory stim + US and eventually found the pain generator. She had the 'best 3 months' of her life, and now I'm thinking standard rather than pulsed RFA

 

[lobelsteve]

How about repeat prf or botox. Stim for possible long term relief.

 

[drf]

What are your pRF settings? I use voltage constant mode and pulse 480 pulses x2. When it works it tends to last for 6-12 months.

 

[clubdeac]

What are your pRF settings? I use voltage constant mode and pulse 480 pulses x2. When it works it tends to last for 6-12 months.

drf, remind me what that mode is called on the neurotherm machine. Is it called pulsed mode?

 

[drf]

drf, remind me what that mode is called on the neurotherm machine. Is it called pulsed mode?

Push pulse RF once
It enters pulsed RF mode. This is time constant
Push pulse RF again
It enters pulsed Dose mode. This is voltage constant

 

[specepic]

So the reason I asked is when I was doing the pulsed the rep says to me, "hey, you could just

 

[specepic]

I appreciate the discussion, however, my original question is this: Are any of you doing standard radiofrequency of these nerves, and is there any reason this would be a bad idea versus pulsed? Anyone?

 

[clubdeac]

I've done it on a guy with post herniorrhaphy pain. Did it blind so the results were so so. He got better relief from the L2/3 DRG PRFA I also did