Lumbar RFA Temperature

[jewwithguitar]

I just came across this article which suggests that RFA at 90°C provides longer duration relief than 80°C. I have been performing monopolar Lumbar RFA using 18G conventional needles with 10 mm active tip at 80°C for 120 seconds x 2 lesions (IPSIS technique). Based on this study, I am considering increasing temperature to 90°C for Lumbar RFA.

Have any of you been routinely performing Lumbar RFA at 90°C for 120 seconds? Anything to be concerned about or possible complications to watch out for as opposed to 80°C?

https://rapm.bmj.com/content/50/4/331

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[callmeanesthesia]

I’ve been doing 90/120 for lumbar and thoracic for about a year or so. Haven’t noticed any issues compared to 80 or 85.

 

[Ducttape]

It is a little more uncomfortable than 80 degrees. I use 80 for the cervical.

Otherwise, have been using 90 degrees in most lumbars for the past 15 years.

Literature does not seem to report any different complication rate between 80 and 90.

 

[Taus]

See the Cosman paper regarding lesion size. That is why I switched to 90 degrees about a year ago. No difference in pain as long as you give a minute or so of 2% lidocaine pre burn.

 

[$hadow]

See the Cosman paper regarding lesion size. That is why I switched to 90 degrees about a year ago. No difference in pain as long as you give a minute or so of 2% lidocaine pre burn.

This one? https://academic.oup.com/painmedicine/article-abstract/15/12/2020/1817249?redirectedFrom=fulltext

 

[SpineandWine]

I’m going to switch my default setting to 90 C.
Anyone have issues with increased neuritis?

 

[Taus]

I’m going to switch my default setting to 90 C.
Anyone have issues with increased neuritis?

Nope

 

[DODOCSS]

I’m going to switch my default setting to 90 C.
Anyone have issues with increased neuritis?

negative

 

[hopefulgasman]

I just came across this article which suggests that RFA at 90°C provides longer duration relief than 80°C. I have been performing monopolar Lumbar RFA using 18G conventional needles with 10 mm active tip at 80°C for 120 seconds x 2 lesions (IPSIS technique). Based on this study, I am considering increasing temperature to 90°C for Lumbar RFA.

Have any of you been routinely performing Lumbar RFA at 90°C for 120 seconds? Anything to be concerned about or possible complications to watch out for as opposed to 80°C?

Impact of temperature on the magnitude and duration of relief after lumbar facets medial branch nerves radiofrequency ablation: a randomized double-blinded study | Regional Anesthesia & Pain Medicine

For the second lesion, do you rotate the needle 180 or do you pull back some?

 

[nvrsumr]

90 for years now. Cervical as well.

 

[giddyup]

Are most doing 90 deg x 120 sec for 2 lesions or 1?

 

[RoloTomassi]

90x90x1 w/Sidekick cannula. Nothing wrong with 120 x1 or x2, just takes too long for me

 

[DoYouEvenLiftBro]

I just came across this article which suggests that RFA at 90°C provides longer duration relief than 80°C. I have been performing monopolar Lumbar RFA using 18G conventional needles with 10 mm active tip at 80°C for 120 seconds x 2 lesions (IPSIS technique). Based on this study, I am considering increasing temperature to 90°C for Lumbar RFA.

Have any of you been routinely performing Lumbar RFA at 90°C for 120 seconds? Anything to be concerned about or possible complications to watch out for as opposed to 80°C?

Impact of temperature on the magnitude and duration of relief after lumbar facets medial branch nerves radiofrequency ablation: a randomized double-blinded study | Regional Anesthesia & Pain Medicine

The median time to repeat RFA in the 80°C group was 112 (49–252) days, while it was 217 (198–348) days in the 90°C group (p<0.04)

Surprised by how low the days to repeat is but 90 gets u to 6 months everytime per these results

 

[hopefulgasman]

Anyone know if you can still lesion 90c with Stryker venom needles

 

[Taus]

Anyone know if you can still lesion 90c with Stryker venom needles

Yep

 

[Scottie_Dog]

Gosh I feel out of the loop, I’ve been doing 80 degrees for 90 seconds x2. Good to know 90 is safe.

Are you guys doing 90 degrees for 120 seconds x1 or doing two burns?

Same thing for the neck? 90 for 120?

 

[DOctorJay]

I do 80 degrees for 90 seconds cervical
and 90 degrees for 90 seconds lumbar (and thoracic)

single burns for the past couple years, prior to that would do the needle turn with second burn and haven't noticed a change in duration of relief after switching to single burns