Testing for RFA

[MitchLevi]

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To my knowledge, apart from anatomical variations, there is no multifidus innervated by the L5 MB. The normal response would be no twitch, with root stimulation being a sign that the nerve root itself is being stim'd, meaning the needle is too ventral.

No.

I get L5 DPR stim on occasion, and it’s exclusively buttock and those pts have zero leg stimulation with normal ablation outcomes. No L5 or S1 nerve root involvement.

 

[hyperalgesia]

ASPN Guidelines recommend sensory and motor testing.

Does anyone have guidelines to share that don't recommend testing?

Latest Evidence-Based Application for Radiofrequency Neurotomy (LEARN): Best Practice Guidelines from the American Society of Pain and Neuroscience (ASPN) - PMC

Radiofrequency neurotomy (RFN), also known as radiofrequency ablation (RFA), is a common interventional procedure used to treat pain from an innervated structure. RFN has historically been used to treat chronic facet-joint mediated pain. The use of ...

pmc.ncbi.nlm.nih.gov

 

[MitchLevi]

SIS for one does not recommend it, and I have never heard an argument for it. We didn’t do it at Emory, a few ppl did at Stanford, and I never saw it at two VAs where I rotated.

 

[clubdeac]

SIS for one does not recommend it, and I have never heard an argument for it. We didn’t do it at Emory, a few ppl did at Stanford, and I never saw it at two VAs where I rotated.

We did it at Hopkins, a few do it at Harvard and others advocate for it at Yale.

 

[MitchLevi]

We did it at Hopkins, a free do it at Harvard and others advocate for it at Yale.

I’ve never heard an argument for sensory stim.

 

[clubdeac]

I’ve never heard an argument for sensory stim.

I just wanted to name drop too…magenta

In all seriousness, I do motor for safety but no sensory

 

[MitchLevi]

I’m n

I just wanted to name drop too…magenta

In all seriousness, I do motor for safety but no sensory

I’m not name dropping, merely stating at 4 institutions, I’ve only seen like 2 attending do it.

 

[clubdeac]

I’m n

I’m not name dropping, merely stating at 4 institutions, I’ve only seen like 2 attending do it.

I know I was just messin

 

[hyperalgesia]

SIS for one does not recommend it, and I have never heard an argument for it. We didn’t do it at Emory, a few ppl did at Stanford, and I never saw it at two VAs where I rotated.

Do you have a clip of the SIS guidelines on this topic?

 

[lobelsteve]

Do you have a clip of the SIS guidelines on this topic?

Buy my book. 😁

 

[Laryngospasm]

Buy my book. 😁

Which book? Do you have a link? Or dm me if you can’t self promote.

 

[lobelsteve]

Which book? Do you have a link? Or dm me if you can’t self promote.

IPSIS. Technical Manual. I contributed on a chapter or two.

 

[Drd105]

IPSIS. Technical Manual. I contributed on a chapter or two.

is this the first time this has been announced? What the heck. Amazing. Buying.

 

[Gnarvin]

is this the first time this has been announced? What the heck. Amazing. Buying.

IPSIS sent like one email when it came out.

 

[lobelsteve]

https://www.ipsismed.org/page/TechManual

 

[BoardingDoc]

I have the new IPSIS technical manual. It's really solid. Highly recommend. Also, agree on no sensory. I know I'm a noob, but I don't do it at all. I also talked to one of the IPSIS manual editors at length about it. He had more to say about the nuance of MBB and RFA than I thought possible and he didn't think that there's a point to sensory either.

 

[Ferrismonk]

https://www.ipsismed.org/page/TechManual

Thanks, but $1200 is stupid.