Nimbus monopolar technique created a robust 10.91mm diameter lesion.
The standard 18g cannula monopolar technique produces a 5.29mm diameter lesion.
Nimbus monopolar technique created a robust 10.75mm diameter lesion.
The cooled RF monopolar technique produces a similar 10.75mm diameter lesion.
Nimbus monopolar technique created a robust 10.91mm diameter lesion.
The 18g protruding electrode monopolar technique produces a 5.11mm diameter lesion.
Nimbus bipolar technique created a robust 32.12mm diameter lesion.
The 18g protruding electrode bipolar technique revealed an 8.65mm gap, resulting in an incomplete lesion when used under the same conditions.
The tissue in this test was warmed to 37 degree celsius to simulate body temperature in a water bath. The tissue used in these images was chicken breasts.
For the monopolar testing the radiofrequency generator was set to 80 degrees celsius for 80 seconds with a 30 second ramp for both the Nimbus and the standard 18g cannula.
For the bipolar testing the radiofrequency generator was set to 85°C for 150 seconds for 150 seconds with a 30 second ramp for both the Nimbus and the standard 18g cannula.
Nimbus monopolar technique created a robust 10.91mm diameter lesion.
The standard 18g cannula monopolar technique produces a 5.29mm diameter lesion.
Nimbus monopolar technique created a robust 10.75mm diameter lesion.
The cooled RF monopolar technique produces a similar 10.75mm diameter lesion.
Nimbus monopolar technique created a robust 10.91mm diameter lesion.
The 18g protruding electrode monopolar technique produces a 5.11mm diameter lesion.
Nimbus bipolar technique created a robust 32.12mm diameter lesion.
The 18g protruding electrode bipolar technique revealed an 8.65mm gap, resulting in an incomplete lesion when used under the same conditions.
The tissue in this test was warmed to 37 degree celsius to simulate body temperature in a water bath. The tissue used in these images was chicken breasts.
For the monopolar testing the radiofrequency generator was set to 80 degrees celsius for 80 seconds with a 30 second ramp for both the Nimbus and the standard 18g cannula.
For the bipolar testing the radiofrequency generator was set to 85°C for 150 seconds for 150 seconds with a 30 second ramp for both the Nimbus and the standard 18g cannula.
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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.
