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gecko

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Any recommendations on RF machines? I was considering neurotherm 1000 which has the capability of burning 3 levels at a time. With regards to price of needles, probes, and the overall machine quality, I would be interested to hear what others are using and recommending. Is it worthwhile getting the neurotherm?

Thanks.
 

Aether2000

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Neurotherm is a good machine but the three simultaneous burns saves only a few minutes per case, and the electrodes required are fairly expensive. So the three burn business is fluff. Otherwise the machine is a good solid machine, easy to use. The older neurotherm machines are quite adequate also and you may be able to get these at a discount.
Neurotherm does not teach CRNAs how to do RF in their courses so you would be supporting an organization that is committed to appropriate quality education of physicians.
The support system and sales staffing for Tyco/Valleylab/Radionics is pretty thin, and they haven't upgraded their very heavy dinosaur machine in a decade.
The most compact machine is the Owl and it is also very low priced. It is from Canada. Cosman is the new/old kid on the block ....the son has resurrected the original company that made RF machines for pain medicine. Their machine plus electrodes are the least expensive on the market at a list price of $19K including electrodes. It is a simple machine to use.
Baylis has some of the most innovative technologies including a new SI RF probe and their biaculoplasty that are part of the upgraded base version of their upgradable machine. They are a company that can move very fast into product development and their machine is relatively easy to use. They have a bit of overkill with their graphic display of second by second temperature, but it does give one something to do during the RF.
Stryker is a giant company that is trying to make a hit with pain medicine, has a good machine also, but I found it a bit cumbersome to use although the nursing staff loved it since everything is color coded.
SN makes a machine also but continues to hawk IDET with the machine even though few of us ever perform IDET any longer.

All the machines will do the job adequately, and have adequate power. Some are 25 watt and some are 50 watt machines, but the oldest neurotherm is only 8 watts...that one is adequate for MB RF but may not be adequate for RF near large heat sinks.... Remember, most MB RF requires 2-5 watts only.
You can get discounted rates if the company will sell an older model but all rates are negotiable. It is likely our reimbursement will be cut substantially next year for these procedures so I would not lock into a high priced machine unless you do a lot of RF, which you shouldn't be doing statistically. If you follow ISIS guidelines, approximately 2-4% of your low back pain patients will be eligible for RF due to selection of patients with pure Z-joint disease.
 

Mister Mxyzptlk

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Fortunately I don't follow ISIS guidelines and therefore make a lot higher % of my patients happy with RF.:)

I agree with Algos on the 3-burn system. I would get it if you are using OPM (other people's money). Otherwise, do the math. How many RF minutes will you have to save to earn back the extra money you spent? You will save a few minutes per procedure (which during the actual burn may seem worth thousands of dollars - I think that's the longest 90 seconds in medicine, some sort of Einsteinian time warp) but when you figure in the added costs it's not a good deal.

I have a Neurotherm in my office. Works great,easy to use.
 
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gecko

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That was some great advice. Thanks guys. I'll try an use "OTM" to push for a neurotherm 1000.
 

ParaVert

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Stryker's current machine will allow you to do two burns simultaneously as long as you have the bipolar splitter. It will monitor temp of each probe independantly just like Neurotherm. They have a new box coming out in September with two outputs capable of four simultaneous burns.

I'm planning on getting this machine not only because my job is with a hospital that foots the bill for the technical, but also because I really like the remote control that comes with it. You can put it in a sterile sleeve and do all the adjusting yourself instead of trying to talk a nurse through a lot of button pushing.

I guess eventually they'll have the SpinalTap RF generator that will go to eleven.
 

gecko

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Does anyone have rough quotes on how much each of these RF machines cost, including needles and probes?
 

gecko

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I got a quote on the Neurotherm NT 1000 for $26,000 (includes the unit, stim kit, and 3 electrode probes).

I haven't heard of any problems with the NT 1000 from 3 pain docs that use it...all love it, but also agree that the 3 simultaneous burn is not worth all the hype.

Still, at this price, looks to be a pretty good deal.

Interested in other opinions.
 
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