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Radio frequency lesion size controversy

Gabor B Racz on August 7, 2017 at 9:44 pm
  • Author
    • Gabor B RaczGabor B Racz
      Joined: Mar 28, 2016
      Posts: 30

      Supposedly the cooled RF has the biggest tissue lesion size. We found by comparison that the 16 gauge 10 mm active tip sharp/blunt Coude’ (curved) lesion size exceeded the Cooled RF. This was done about a year and a half ago with 80 degrees centigrade for 90 second duration and then rotating the needle 180 degrees to the other side for a second lesion. The lesion size was bigger for less than a fraction of the cost! If anyone is interested, I can post the bar graph data and pictures.


      • Brian DurkinBrian Durkin
        Joined: Nov 9, 2015
        Posts: 1

        Have seen lesion size in chicken breast and don’t agree. Have no finacial interest in Cooled RF. Agree, Ithink ,that Cooled RF is grossly overpriced, but I don’t pay for it in the hospital.

        • Wael SaleemWael
          Joined: Mar 14, 2017
          Posts: 1

          I am interested to see the graph data. How about the bipolar RF lesion size compared to both techniques you have mentioned Dr Racz?

            • Gabor B RaczGabor B Racz
              Joined: Mar 28, 2016
              Posts: 30

              I regret for the delay, but I’m on vacation. Here is the 16g 10mm RF coudé compared to the 17g Cooled RF. The measurements on different needle sizes with and without 180° rotation are also available if you’re interested.

              You must be logged in to view attached files.
            • A Kemal ErdemogluA Kemal Erdemoglu
              Joined: Jan 25, 2017
              Posts: 5

              I am interested the graph, too. Do you suggest to turn 180 degree during for facet lesioning, too
              my email is
              Dr Erdemoglu

                • Gabor B RaczGabor B Racz
                  Joined: Mar 28, 2016
                  Posts: 30

                  Yes, for facet. The primary use for larger active tip is splanchnic, lumbar sympathetic, but double lesioning for lumbar facets will cover any anatomical variations without jeopardizing the nerve root. Cervical posterior approach, one lesion is usually adequate diagonally without rotation.

                  Particularly anterior lateral approach is where we see undesirable lesioning with a very large lesion, and I do not ever see the need for a very large lesion in the neck.

                  Peripheral nerves, I very much prefer cryolysis over a very large radiofrequency lesion. No neuritis with cryolysis. Large lesions in proximity to motor nerves can give motor deficit. Must use motor nerve stimulation preferably to 2V. Costs do matter, especially when you can get the same or better result for very much less.

                • Hatem
                  Joined: Sep 8, 2018
                  Posts: 0

                  can you please send me the data and the picture

                  Thank you

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