Intradiscal Electrothermal Therapy; Alternative To Surgery For Lower Back Pain

Intradiscal electrothermal therapy (IDET) is a minimally invasive technique for the treatment of diskogenic low back pain. Intradiscal electrothermal therapy is a new technique to for the treatment of spinal disc related chronic low back pain. Intradiscal electrothermal therapy is also known as intradiskal electrothermal annuloplasty (IDEA).

Studies suggest that intradiscal electrothermal therapy is effective in almost 70% of patients with chronic low back pain.

How intradiscal electrothermal therapy works?

Intradiscal electrothermal therapy uses heat to modify the nerve fibers of a spinal disc and destroy pain receptors in the area.

Intradiscal electrothermal therapy procedure:

Before intradiscal electrothermal therapy procedure, patients usually have a preliminary discogram test in which the lumbar disc or discs that are abnormal thought to be the cause of a patient’s back pain are injected with dye.

The procedure includes the steps which are listed below;

  • The procedure is performed with a local anesthetic and mild intravenous sedation.
  • A hollow introducer needle is inserted into the painful lumbar disc space using a portable X-ray machine for proper placement.
  • An electrothermal catheter or you can say a heating wire is then passed through the needle and positioned along the back inner wall of the disc (the annulus), the site believed to be responsible for the chronic pain.
  • The catheter tip is then slowly heated up to 90 degrees Celsius for 15-17 minutes.
  • The heat then contracts and thickens the collagen fibers making up the disc wall, thereby promoting closure of the tears and cracks. Tiny nerve endings within these tears are burned, making them less sensitive.
  • The catheter is removed along with the needle.
  • After a short period of observation, the patient can go home.
  • A lumbar support is worn for 6 to 8 weeks, followed by an appropriate course of physical therapy.
  • Lifting and bending precautions are necessary during this time to allow for adequate healing of the disc.

The intradiscal electrothermal therapy takes an hour to complete.

What happens after intradiscal electrothermal therapy?

  • Pain relief is not immediate after intradiscal electrothermal therapy. Pain might increase during the first couple of days and after that it gradually starts decreasing.
  • Physical therapy is required for speedy recovery.
  • Do easy stretches and walk after first month of intradiscal electrothermal therapy.
  • Wait at least 5 to 6 months before resuming strenuous sports such as skiing, running, or tennis.

Risks:

Although complications are rare as intradiscal electrothermal therapy is relatively a safe procedure, possible risks include;

  • Nerve root injury
  • Post treatment disc degeneration
  • Disc infection

Zaki Anwar MD is an Anesthesiologist and Interventional Pain Management Specialist. He has vast expertise for the diagnosis and treatment of back pain, headaches, migraines, neck pain, sciatica pain and various pain conditions.

For further queries call on 815.412.6166