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To add radiofrequency neurotomy, you'll need a radiofrequency generator, ranging in cost from $5,000 on the refurbished market to
$25,000 for new, that creates the electrical energy needed to ablate the
nerve coverings. The hollow-bore needles are single-use; the probes
are sterilized between cases.
• Implants. If radiofrequency neurotomy is ineffective, perhaps because
of advanced pathology or chronic pain that doesn't respond to other treatments, patients might be candidates for spinal cord stimulation or implantation of a pain medication pump. These last-ditch options are more invasive procedures performed in outpatient settings in 1 to 2 hours — physicians make pockets under the skin's surface to insert a battery (similar in
size to a pacemaker) or a medication pump, then place the stimulator's
electrodes or tunnel the pump's medication catheter along the spinal
nerves.
2. Upgraded imaging. Mini C-arm displays have improved dramatically in recent years, giving physicians full HD images of injection
sites. Fluoroscopic images are shades of gray, so the greater the definition of those shades, the better the overall images with which physicians have to work. Newer machines can also integrate electronic
images into electronic medical records, transmit saved images to a facility's picture archiving system or send them to other clinicians through
secured networks.
Pain management is a volume-driven specialty, which means C-arms
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