{"id":3280,"date":"2025-08-05T09:27:07","date_gmt":"2025-08-05T07:27:07","guid":{"rendered":"https:\/\/www.amsvita.com\/en\/?p=3280"},"modified":"2025-08-07T09:28:07","modified_gmt":"2025-08-07T07:28:07","slug":"how-stratus-radiofrequency-is-performed-step-by-step-procedure","status":"publish","type":"post","link":"https:\/\/www.amsvita.com\/en\/news\/how-stratus-radiofrequency-is-performed-step-by-step-procedure\/","title":{"rendered":"How Stratus Radiofrequency Is Performed: Step-by-Step Procedure"},"content":{"rendered":"\n

Stratus radiofrequency ablation (RFA) is a minimally invasive pain management technique<\/strong> that has been refined to provide long-lasting relief<\/strong> for patients with sacroiliac joint (SIJ) pain and certain cervical pain syndromes. Unlike conventional RF methods, Nimbus Stratus technology utilizes a multi-tined bipolar electrode<\/strong> that creates a continuous strip lesion<\/strong>, capturing a larger portion of the target nerve network.<\/p>\n\n\n\n

Pre-Treatment Assessment and Diagnostic Protocols<\/h2>\n\n\n\n

The effectiveness<\/strong> of Nimbus Stratus RFA depends on precise diagnosis<\/strong>:<\/p>\n\n\n\n

    \n
  • Diagnostic PSN Blocks<\/strong>: Patients undergo sacral lateral branch blocks (PSN) to confirm the SIJ as the pain generator.
    <\/li>\n\n\n\n
  • Response Criteria<\/strong>: A \u226550% pain reduction after diagnostic blocks is required to proceed.
    <\/li>\n\n\n\n
  • For Cervical Indications<\/strong>: Targeting the third occipital nerve (TON) or cervical medial branches requires dual diagnostic blocks to increase specificity.
    <\/li>\n\n\n\n
  • Imaging<\/strong>: MRI or CT scans help rule out alternative causes such as radiculopathy or structural pathology.<\/li>\n<\/ul>\n\n\n\n

    Patient Preparation and Imaging Guidance<\/h2>\n\n\n\n

    Preparation ensures a safe and effective intervention:<\/p>\n\n\n\n

      \n
    • Positioning<\/strong>: Prone positioning for SIJ ablation; slight obliquity for cervical procedures.
      <\/li>\n\n\n\n
    • Sedation<\/strong>: Conscious sedation is typically employed, allowing the patient to respond during testing.
      <\/li>\n\n\n\n
    • Imaging Guidance<\/strong>:
      \n
        \n
      • Fluoroscopy<\/strong>: Standard method for real-time visualization.
        <\/li>\n\n\n\n
      • Ultrasound<\/strong>: Optional in specific cases to minimize radiation exposure.
        <\/li>\n<\/ul>\n<\/li>\n\n\n\n
      • Sterility<\/strong>: Strict sterile field preparation prevents infection.<\/li>\n<\/ul>\n\n\n\n

        Technical Execution and Device Settings<\/h2>\n\n\n\n

        Nimbus Stratus technology allows precise, reproducible lesioning<\/strong>:<\/p>\n\n\n\n

          \n
        • Electrode Placement<\/strong>: Under fluoroscopy, the multitined electrode array is inserted parallel to the sacral foramina for SIJ or along the articular pillar for cervical targets.
          <\/li>\n\n\n\n
        • Stimulation<\/strong>:
          \n
            \n
          • Sensory (50 Hz)<\/strong> confirms proximity to target nerves.
            <\/li>\n\n\n\n
          • Motor (2 Hz)<\/strong> ensures no involvement of motor roots.
            <\/li>\n<\/ul>\n<\/li>\n\n\n\n
          • Ablation Parameters<\/strong>:
            \n
              \n
            • Continuous RF<\/strong>: Typically 85\u00b0C for 180 seconds (COBRA-SIJ protocol).
              <\/li>\n\n\n\n
            • Pulsed RF<\/strong>: Used in cases where neuromodulation without nerve destruction is preferred.
              <\/li>\n<\/ul>\n<\/li>\n\n\n\n
            • Outcome<\/strong>: The bipolar lesion achieves >95% neural capture<\/strong> of PSN, compared to <15% with monopolar RF.<\/li>\n<\/ul>\n\n\n\n

              Duration of Pain Relief and Retreatment Intervals<\/h2>\n\n\n\n

              Findings from the COBRA-SIJ and other protocols show:<\/p>\n\n\n\n

                \n
              • Sustained pain relief<\/strong> for 12\u201324 months in most patients.
                <\/li>\n\n\n\n
              • Functional improvement<\/strong> documented by ODI, EQ-5D, and NPRS scores.
                <\/li>\n\n\n\n
              • Repeatability<\/strong>: Retreatment is safe and effective, typically performed when symptoms recur after 18\u201324 months.<\/li>\n<\/ul>\n\n\n\n

                Post-Procedure Care and Monitoring<\/h2>\n\n\n\n

                Post-procedure care focuses on safety and functional recovery:<\/p>\n\n\n\n

                  \n
                • Observation<\/strong>: 30\u201360 minutes monitoring for immediate adverse reactions.
                  <\/li>\n\n\n\n
                • Pain Management<\/strong>: Mild post-procedural discomfort is common and self-limiting.
                  <\/li>\n\n\n\n
                • Recovery<\/strong>: Patients usually return to normal activity within 24\u201348 hours.
                  <\/li>\n\n\n\n
                • Follow-Up<\/strong>: Scheduled evaluations at 1, 3, 6 months, and annually.<\/li>\n<\/ul>\n\n\n\n

                  Safety Profile and Patient Tolerability<\/h2>\n\n\n\n

                  Nimbus Stratus RFA has a favorable safety profile<\/strong>:<\/p>\n\n\n\n

                    \n
                  • Complication rates<\/strong> are extremely low (<0.1%).
                    <\/li>\n\n\n\n
                  • Adverse Events<\/strong>: Minor and transient (e.g., soreness, numbness).
                    <\/li>\n\n\n\n
                  • Patient Tolerability<\/strong>: High, with minimal recovery time and excellent clinical outcomes.
                    <\/li>\n\n\n\n
                  • Safety Enhancements<\/strong>: The use of sensory and motor stimulation minimizes the risk of nerve injury.<\/li>\n<\/ul>\n\n\n\n

                    References<\/strong><\/h2>\n\n\n\n
                      \n
                    1. Aaron Conger, DO et al.<\/strong>
                      <\/strong> “Conventional or Bipolar Radiofrequency Ablation for the Treatment of Sacroiliac Joint Pain? The COBRA-SIJ Study, a Double-Blind, Randomized, Comparative Trial.”<\/em>
                      <\/em> University of Utah, Department of Physical Medicine and Rehabilitation, Protocol Version 3.0, January 3, 2023.
                      <\/li>\n\n\n\n
                    2. Eldon Y. Loh, MD; Anne M. Agur, PhD; Robert S. Burnham, MD.<\/strong>
                      <\/strong> “Ultrasound-Guided Radiofrequency Ablation for SI Joint Pain: An Observational Study.”<\/em>
                      <\/em> Spine Intervention Society, Elsevier (Pre-proof), 2022.
                      <\/li>\n\n\n\n
                    3. Stratus Medical, Regulatory Division.<\/strong>
                      <\/strong> “Nimbus Electrosurgical Radiofrequency Multitined Expandable Electrode \u2013 Indications for Use and FDA 510(k) Clearance.”<\/em>
                      <\/em> US FDA Device Evaluation, Class II Neurology Device, K-121773, 2012.
                      <\/li>\n\n\n\n
                    4. IRB Approval Document \u2013 Stratus Medical Protocol.<\/strong>
                      <\/strong> “Prospective Cohort Study of Cervical Radiofrequency Ablation for Axial Neck Pain with Nimbus RFA (TON\/C3 & C4 Medial Branch).”<\/em>
                      <\/em> WCG IRB Approval, Sponsor Protocol Number Stratus_001, 2021.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"

                      Stratus radiofrequency ablation (RFA) is a minimally invasive pain management technique that has been refined to provide long-lasting relief for patients with sacroiliac joint (SIJ) pain and certain cervical pain syndromes. Unlike conventional RF methods, Nimbus Stratus technology utilizes a multi-tined bipolar electrode that creates a continuous strip lesion, capturing a larger portion of the […]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[8,46],"tags":[47],"_links":{"self":[{"href":"https:\/\/www.amsvita.com\/en\/wp-json\/wp\/v2\/posts\/3280"}],"collection":[{"href":"https:\/\/www.amsvita.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.amsvita.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.amsvita.com\/en\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.amsvita.com\/en\/wp-json\/wp\/v2\/comments?post=3280"}],"version-history":[{"count":1,"href":"https:\/\/www.amsvita.com\/en\/wp-json\/wp\/v2\/posts\/3280\/revisions"}],"predecessor-version":[{"id":3281,"href":"https:\/\/www.amsvita.com\/en\/wp-json\/wp\/v2\/posts\/3280\/revisions\/3281"}],"wp:attachment":[{"href":"https:\/\/www.amsvita.com\/en\/wp-json\/wp\/v2\/media?parent=3280"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.amsvita.com\/en\/wp-json\/wp\/v2\/categories?post=3280"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.amsvita.com\/en\/wp-json\/wp\/v2\/tags?post=3280"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}