Combined Bipolar and V-Shaped Lesions for Lumbar Facet Radiofrequency Ablation: A Technical Report

• DOI: 10.1093/pm/pnab136
• Publication Date: 2021-04-07T20:02:15Z
• Authors: Afrin Sagir; Robert Bolash
• Keywords: Facet (psychology); Spinal cord stimulator; Neurolysis; Pulsed radiofrequency

Radiofrequency ablation (RFA) is a demonstrated safe and effective treatment for chronic low back pain. RFA delivers high density electrical current near lumbar medial branch nerve. The success of contingent upon creating lesion that overlaps the sensory nerve supplying affected facet joint(s). Both bipolar-RFA V-shaped active tip cannulas increase size in experimental models. We describe successful application concomitant bipolar lesions single patient with pain caused by spondylosis.An 81-year-old male atrial fibrillation on warfarin anticoagulation was previously treated conventional monopolar resulting 75% decrement intensity exceeding eight months. Nine months after procedure, his returned similar pretreatment character unresponsive to additional physical therapy acetaminophen. elected use cannula maximize diameter lengthen intervals between anticoagulant abstinence minimize risk. Intraoperatively, grounding-pad malfunction compelled us convert placing second adjacent cannula, eliminating requirement. Bilateral L3-L4, L4-L5, L5-S1 nerves performed these two without further incident. had sustained analgesia lasted over twelve resultant from treatment.We herein technique combined utilizing proximally cannulas. create larger experiments. While both techniques purport theoretical advantages, clinical superiority warrants continued investigation.