Overview

Multi-Gen Monopolar Procedure Animation (5:54)
Part Number: 1000-001-146 Rev None

Stryker MultiGen is indicated for use in various types of radiofrequency neurotomy procedures. Though for this example, we’ll demonstrate four thermal lesions with a simultaneous start on the lumbar spine. This particular neurotomy procedure works by disrupting the pain signals that are sent from the inflamed nervous tissue in the lumbar spine to the brain. To begin, up to four cannulae are carefully introduced in the area to be treated. Electrodes are then inserted into each cannula. On the MultiGen touch screen, the sensory phase of the procedure is active and the user has the option to modify the default or saved settings to more customized procedural settings. When setting adjustments are complete, the sensory stimulation tests are administered individually at each needle site. During the sensory test, the patient will respond to a slight pain sensation the closer the needles are to the problem nerves. Needles may need to be repositioned if these tests fail. After the sensory phase is complete, the motor button is selected and the screen changes from green to orange. The user again has the option to modify the default or saved motor stimulation settings. When setting adjustments are complete, the motor stimulation tests are administered individually at each needle site. The motor stimulation test will help confirm correct needle placement in all four locations while helping to ensure that each needle is not on a motor nerve. Though the lesions themselves will be run simultaneously, the sensory and motor tests are done individually at each location to help ensure accurate results. After the sensory and motor diagnostic tests have been confirmed, the user moves to the lesion screen and either selects thermal or pulsed radiofrequency or a combination of the two. For this demonstration, thermal radiofrequency is performed with simultaneous starts in all four locations. The user activates all four needle placements and presses the start button. As an added safety feature, the start button is pressed a second time to confirm that the user is ready to begin. High frequency current heats the surrounding nerve tissue creating four simultaneous lesions. MultiGen also allows either thermal or pulsed radiofrequency. In this example, we’ll show individual starts for thermal lesions. After the sensory and motor tests conclude, the user goes to the lesion screen, which defaults to the first needle placement, and presses start. The user confirms they are ready to begin by pressing the start button a second time and the procedure begins at the specified location. These steps are repeated for each needle placement. The user can wait for a lesion to finish before starting the next, or can use a staggered technique and begin at the next location while the previous is still burning. After all lesions are complete, the screen goes back to its default settings. In this final demonstration, we’ll use simultaneous starts in all four locations while performing pulsed radiofrequency through needles one and two and thermal radiofrequency through needles three and four. The needle placements and therapy types are chosen, the locations are locked into place, and the user presses start. After confirming that they are ready to begin by pressing start a second time, the thermal and pulsed radiofrequency procedures begin simultaneously at the specified location.

MultiGen Parallel Bipolar Procedure Animation (3:23)
Part Number: 1000-001-146 Rev None

For patients with SI joint syndrome, Stryker MultiGen can also perform two parallel bipolar procedures, which allow for efficacious lesioning of the SI joint by creating larger lesions. To begin two parallel bipolar procedures, multiple cannulae are introduced into the sacroiliac joint. An electrode is then inserted into each of the four cannulae. With the sensory phase of the procedure active, the user locks together needles one and two by pressing the parallel button on the touch screen. At this stage, the user has the option to modify default or saved settings to more customized procedural settings using the MultiGen touch screen. The settings will be applied to both needles one and two. Individualized sensory stimulation tests are administered at the site of both needles. The patient will respond to a slight pain sensation the closer the needles are to the problem nerves. The needles may need to be repositioned if these tests fail. Needles three and four are then locked together and the sensory stimulation tests are administered in those locations. Once the sensory settings are confirmed, the user moves directly to the lesioning phase by selecting the lesion button on the MultiGen screen. Motor testing is not done in a bipolar procedure. Both sets of needles are selected. Start is pressed and then pressed again to confirm that the user is ready to begin. High frequency current heats the surrounding nerve tissue and creates two parallel bipolar lesions. The bipolar procedure is now complete. To create even longer lesions, these steps can be repeated with needle placements in a leapfrog fashion. Upon successful completion of the strip lesion, the cannulae are removed. Stryker MultiGen gives users the ability to customize their procedures for optimal patient results. It is the only radiofrequency generator on the market, able to handle up to four lesions simultaneously, and with independent control. Options for customization could include a single bipolar lesion, a mix of bipolar and single lesions and any combination of thermal lesions and pulsed radiofrequency.