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Techniques and Pearls for Bipolar Lumbar RFA

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Yes I posted about a patient with a new micra pacemaker on this forum recently. Sent a clearance form to cardiology but didn’t receive any guidance. Lit search made it seem like a magnet wouldn’t help. So bipolar seems safest.
 
For bipolar, I only make one skin wheal and insert both needles at the same location. Makes it less painful and separating the two needles at the target area isn't a problem. I usually try to place one against the SAP junction and one on the TP about 5-10mm apart.

Intraarticular facet injections are allowed if there is a medical reason someone can't have the RF and having a pacemaker counts. That being said, I agree with Steve. In most of my patients, intraarticular steroids give them about 2-3 months relief. I also don't like to use intraarticular steroids if I can avoid them after seeing that steroids in knees actually worsen arthritis over time.
 
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