IDET: Is it an effective treatment for low back pain?
IDET stands for intradiscal electrothermoplasty, a minimally invasive treatment option for patients with low back pain. IDET is intended to reduce or eliminate the pain caused by disc degeneration. The procedure uses heat to seal cracks (called fissures) in the disc wall, thus reducing bulging of inner disc material. As the bulging is reduced, the impingement on adjacent nerve structures diminishes, and pain should be alleviated. It is usually performed on an outpatient basis using local anesthesia and mild sedation to reduce any discomfort during the procedure.How does it work?
The IDET procedure takes about one hour to complete. A hollow needle is inserted into the damaged disc with the guidance of an x-ray machine. A special wire, called an electrothermal catheter, is then threaded down through the needle and into the disc. The wire is heated through electrical current to about 194 degrees Fahrenheit over the course of about 15 minutes. The high heat destroy the small nerve fibers that have grown into the cracks of the disc and that transmit pain. The heat also partially melts the annulus (the outer wall of the disc), which triggers the body to generate new proteins to strengthen the disc.
After the procedure, there is a short observational period prior to release. During recovery, the patient must rest for a few days and may need to wear a back support for several weeks. Pain relief is sometimes seen within a few days of the procedure, or may take several weeks to several months to be noticed. During this time, medications can be prescribed to reduce pain. Physical therapy is necessary to help reduce pain and increase flexibility and spinal strength. In addition, it will be several months before rigorous activity or heavy lifting or twisting can be resumed. In time, however, the pain is expected to decrease and the need for medications can be reduced or eliminated. Activity levels can then increase as well as a return to an active life. However, it should be noted that some patients do not experience any pain relief, and the long-term results of this procedure are not yet known.
Our View of IDET
Initial results from short-term studies show that IDET may be a good option for some patients who have tried non-operative treatments without success. It is a less expensive and less invasive procedure than other kinds of back surgery to treat disc degeneration, and it has a low risk of complications. Because IDET is a relatively new procedure, it is important that you visit a surgeon who is adequately trained.
