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Intradiscal Electrothermal Annuloplasty (IDET)
IDET, or Intradiscal
Electrothermal Therapy, is a procedure that treats discogenic back pain,
which is back pain primarily caused by discs, and not the other spinal
components. IDET uses a probe inserted into the disc to heat the tissues
within the affected disc. Heating the inside of the disc causes the tissues
to shrink, making the disc less protruded. It also cauterizes, or burns,
the small nerve fibers in the periphery of the disc for pain relief. For
more information, go to
www.neurotherm.com.
When is IDET an
appropriate procedure?
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Back pain for at least 3 months
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No prior spine surgery at the affected level
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Abnormal disc seen on MRI
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Positive (concordant) discogram
How is IDET performed?
IDET is performed as an outpatient procedure. The entire procedure uses only
local anesthesia and some mild sedation. Using x-ray to guide the small
probe into proper position, the IDET probe is place into the affected disc.
Once positioned, the probe is slowly heated to about 90 degrees Celsius. It
is maintained at this temperature for about five minutes. After the IDET is
completed, the patient is monitored for a period of one or two hours. The
patient is then sent home with instructions to rest and to avoid lifting,
twisting, and bending.
How long is the recovery
from IDET?
Patients often have mild pain for the first day or two following an IDET
procedure. The symptoms are usually easily controlled with mild
anti-inflammatory or pain medications. Improvement is commonly seen about
2-3 weeks after the procedure, but may take as long as 10-12 weeks, and
rehabilitation exercises are started 8- 12 weeks after the IDET.
How well does IDET work?
The results of studies show encouraging results for IDET. The most important
aspect is ensuring the right patients are being selected for this treatment.
Patients must fit the criteria as mentioned above in order to have the best
chance at success. IDET is a minimally invasive safe procedure with few
reported complications. Most studies show about 60-80% of patients find
significant improvement in the months following an IDET procedure, but if
candidate are chosen carefully, the results could be much better.
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