lcole7465
Expert
OK.. I'm really confused on this one and the information I'm finding is not helping.. hopefully I can find some clarification here. I have a doctor that performed a Lumbar RFA @ L5-S1, he also performed an SI Joint RFA via denervation of L4,L5, lateral branches of S1, S2, S3. The op report reads:
Procedure: Lumbar RFA:
Fluoroscopic evaluation was utilized to target the appropriate treatment areas. The skin was prepped with antiseptic solution and draped sterilely. Then 1% lidocaine was used to anesthetize the skin and subcutaneous tissue. Under Fluoro guidance a 20 gauge x 10 cm x 10 mm active tip was advanced to the medial branch nerve at the indicated levels below to denervate the following facet joints, Left L5-S1. The needles were placed sequentially. Position confirmed radio-graphically with the fluoroscope. Active tip corresponding at the base of the dorsal ramus of L5. Sensory stimulation was used to localize the nerve. Motor stimulation checked at 2hz and confirmed negative for radicular stimulation at 3 times the sensory threshold. After confirmation of of the needle placement the patient received 7cc of 0.5% Marcaine mixed with 10mg dexamethasone to provide anesthesia. Radio-frequency was delivered to the lumbar region. 90 degrees limit 90 seconds in length with no ill effect.
Procedure: Left SI Joint Radio-frequency Ablation via denervation of L4,L5, lateral branches of S1,S2, S3:
Utilizing a 22 gauge 5 inch spinal needle left SI Joint was injected with an anesthetic track of Marcaine was created along the line from the inferior boarder of the SI joint to the ala of the sacrum. Using the Simplicity RFA probe, and from a caudal cranial direction the probe was placed against the sacrum between the neuroforamen and the SI Joint. The RFA probe was advanced under fluoroscopy guidance, using AP and lateral views to confirm appropriate probe placement. Then using the neurotherm RFA generator and SI joint protocol, two bipolar and three uni-polar lesions were created with an 85 degree temperature limit with a 90 seconds treatment cycle for each lesion levels and nerves indicate. A 20 gauge x 10cm x 5mm active tip was advance to the dorsal ramus of L4 and L5 at this location.
Any help on this one would be appreciated..
Procedure: Lumbar RFA:
Fluoroscopic evaluation was utilized to target the appropriate treatment areas. The skin was prepped with antiseptic solution and draped sterilely. Then 1% lidocaine was used to anesthetize the skin and subcutaneous tissue. Under Fluoro guidance a 20 gauge x 10 cm x 10 mm active tip was advanced to the medial branch nerve at the indicated levels below to denervate the following facet joints, Left L5-S1. The needles were placed sequentially. Position confirmed radio-graphically with the fluoroscope. Active tip corresponding at the base of the dorsal ramus of L5. Sensory stimulation was used to localize the nerve. Motor stimulation checked at 2hz and confirmed negative for radicular stimulation at 3 times the sensory threshold. After confirmation of of the needle placement the patient received 7cc of 0.5% Marcaine mixed with 10mg dexamethasone to provide anesthesia. Radio-frequency was delivered to the lumbar region. 90 degrees limit 90 seconds in length with no ill effect.
Procedure: Left SI Joint Radio-frequency Ablation via denervation of L4,L5, lateral branches of S1,S2, S3:
Utilizing a 22 gauge 5 inch spinal needle left SI Joint was injected with an anesthetic track of Marcaine was created along the line from the inferior boarder of the SI joint to the ala of the sacrum. Using the Simplicity RFA probe, and from a caudal cranial direction the probe was placed against the sacrum between the neuroforamen and the SI Joint. The RFA probe was advanced under fluoroscopy guidance, using AP and lateral views to confirm appropriate probe placement. Then using the neurotherm RFA generator and SI joint protocol, two bipolar and three uni-polar lesions were created with an 85 degree temperature limit with a 90 seconds treatment cycle for each lesion levels and nerves indicate. A 20 gauge x 10cm x 5mm active tip was advance to the dorsal ramus of L4 and L5 at this location.
Any help on this one would be appreciated..