Radiofrequency (RF) Ablation for pain has been available since the mid-1970s and has largely remained unchanged with most of the treatments being done with standard 18 or 20 gauge needle electrodes. These simple needles provide a small heat generated lesion which is intended to create a neurotomy, which describes ablation (separation) to the nerves responsible for sending pain signals to the brain.
The unmet clinical need for the physicians who do these treatments was a cost effective, easy to use, RF cannula that would provide a large and optimally shaped heat lesion to treat pain. A larger lesion has significant clinical value, as it provides more area for the nerve ablation (neurotomy) to be complete.
NIMBUS provides up to 4x larger lesion than traditional 18 or 20-gauge needles. This large lesion is comparable in size and volume to cooled RF devices, but at a much lower cost, shorter procedure time and improved efficiency.
Background:
Radiofrequency neurotomy (RFN) can be an effective treatment for patients with chronic neck pain and cervicogenic headaches resistant to conservative care. However, the degree and duration of pain relief after RFN is dependent upon the thoroughness of target nerve coagulation.
Case Report:
This is a case of a 37-year-old patient with debilitating neck pain and headaches following a motor vehicle accident. Successful local anesthetic block of the third occipital nerve (TON) confirmed pain of C2-C3 facet joint origin. An initial RFN treatment of the TON, using standard 18G electrodes in bipolar mode, resulted in complete symptom amelioration for 8 months. Repeat RFN, using the same electrode configuration, was unsuccessful in alleviating the severe neck pain and headaches, and produced no demonstrable sensory loss in the distribution of the TON. RFN was then performed using the NIMBUS® electrosurgical RF multitined expandable electrode, which provides a larger zone of coagulation in volume than standard RFN electrodes even when used in bipolar configuration.
Conclusion:
The NIMBUS procedure resulted in successful coagulation of the TON with sensory loss in the TON distribution and reinstatement of palliative relief.
