RFA doesn't last

[DODOCSS]

F/E films?

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[oneforfighting]

F/E films?

haven't done them. no spondylolisthesis seen on plain films, so wasn't concerned for it.

 

[MitchLevi]

IMO, all lumbar films should be AP, lateral, flex and ext.

Your RFA pics are good. Sometimes ppl hurt and there's nothing you can do it in some cases. It's perfectly okay to tell pts that...I do all the time.

 

[DrMDAware]

1) Any Modic changes on MRI? If so, can be good candidate for possible Intracept.
2) How are the discs? Consider discogenic causes?
3) Re-evaluate. Pain is in same area or elsewhere? Could try therapeutic Facet Block if there's significant fluid in that joint still.

I’m curious what are you offering for discogenic pain?

 

[Ducttape]

it hasnt been mentioned before, but there will be a percentage of people that will fail even the best placed RFA. 15%?

but if your repeat RFA is not lasting at least 3 months, you might have to rethink your diagnosis


unless it is a comp patient...

 

[DrSpine]

I’m curious what are you offering for discogenic pain?

I don't know the story of this patient or seen the MRIs. Just thinking of other options outside of surgery if that's not what they want. Re-evaluate, and if Modic Changes, Intracept. If there's degeneration of the disc, can think about Via Disc. Anything else, re-evaluate.

 

[Dr. Ice]

I don't know the story of this patient or seen the MRIs. Just thinking of other options outside of surgery if that's not what they want. Re-evaluate, and if Modic Changes, Intracept. If there's degeneration of the disc, can think about Via Disc. Anything else, re-evaluate.

Why are people touting via disc? Isn’t it kinda ridiculous that people will do this because the fda “backs it” but people have an aneurysm over intradiscal PRP..no industry backing?

 

[DrMDAware]

Why are people touting via disc? Isn’t it kinda ridiculous that people will do this because the fda “backs it” but people have an aneurysm over intradiscal PRP..no industry backing?

I see what you’re saying. For me personally the PRP is too variable whereas the ViaDisc is more standardized. In addition the latter has more data. And finally the former isn’t covered by insurance. I don’t do either but those are my general thoughts.

 

[Ferrismonk]

I realize this is Coolief propaganda, but there is some evidence that more than simple lesion size or meticulous placement, the amount of energy delivered to the tissue may lead to longer relief.