SI Ablation

[HouseofPain]

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Is anyone getting decent results with RFA of the SI joint using standard RF? When I did them in fellowship we always used cooled but as we all know that isn’t cost effective in private practice. I’m debating wether to do just a strip lesion in bipolar mode and ablating the L5 Dorsal Ramus or making some burns around the S1, S2, S3 foramen and abating L5 dorsal Ramus.

 

[soccrwz]

 

[HouseofPain]

View attachment 262621

What study is this?

 

[soccrwz]

 

[pmrmd]

This was a topic at the SIS winter meeting in Tucson. I’ll continue with Simplicity III. Recommendation against monopolar approach.

 

[swamprat]

I used standard 10 mm active tip neurotherm. I ablate standard L4 and L5 and then I make a strip lesion by placing all the cannulas close together just lateral to the foramen going down - more time consuming as I ablate essentially 2-3x but I have had surprisingly good results

 

[HouseofPain]

After reading the article above I’m going to give the bipolar palisade technique a shot. I went back and read the original article regarding this technique by Cosman et al and they were burning at 90C for 3 min using standard 10mm active tip. Seems somewhat excessive IMO but going to give it a shot as I’ve never used any bipolar techniques

 

[Ferrismonk]

I used monopolar Stryker Venom at L5 dorsal ramus, then far lateral (near joint) of S1, S2, and S3. Total four burns, get good results.

I do test sensory and motor.

 

[HouseofPain]

I used monopolar Stryker Venom at L5 dorsal ramus, then far lateral (near joint) of S1, S2, and S3. Total four burns, get good results.

I do test sensory and motor.

I use the Stryker venom too. I’m assuming you are laying the needles parallel at the joint line and not coming in perpendicular?