[Dr Hussein Mousa]

#5273

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Dear Colleagues,
I have had patient’s that complain about pain due to needling after radiofrequency ablasion. This occurs especially after median nerve block for facet joint of the neck and lumbar region. How do I resolve this?
-Dr.Hussein I.Mousa
FIBMS, AANS, ATLS neurosurgeon

[Gabor B Racz]

#5274

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Hello Dr. Mousa,
I stopped using sharp needles. They are like microtomes and cut. If localized tenderness may try re-injecting. If it is like sunburn reassure the patient.Cryolysis does not cause neuritis. Incomplete RF does cause neuritis. If block works try to repeat lesion but with a blunt (Racz-Finch needle) or if you have a cryo machine try it. Ultrasound guidance and local injection will make this more commonly used in the future.
Best Regards
-Gabor B. Racz, Professor and Chairman Emeritus

[Sarfaraz Khan]

#46234

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Reactionary neuritis after a radiofrequency lessening is reported in majority of the cases. Injecting steroid at each location before withdrawing the RF needle and flushing the needle trach with lidocaine while withdrawing may help reduce post procedural pain.
Thanks
Sarfaraz Khan, MD, FIPP

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