Electrothermal Therapy. Part 1
Q.I recently saw on TV a new technique for reducing and or eliminating low back pain. It involved inserting wires into a bulging disc and heating the wires under local anesthesia. This firmed the disc and reduced its size. Can you tell me anything more about this procedure? Who is performing it? Is it experimental?
R.O.
A.Intradiscal electrothermal therapy (IDET) is a relatively new procedure that involves insertion of an electrothermal probe into the disc using the trademarked IDET device. This is done percutaneously (through a tiny incision in the skin) under X-ray guidance. Once the probe is in the proper position within the disc, it is heated for a set period of time. It is believed the heating causes shrinkage of the disc material. It is also thought to destroy some of the nerve endings within the disc. Medical literature shows about 50-80 percent benefit from the procedure.
A.When the IDET procedure is done, I feel that it is best done at one level in the spine at a time. Some surgeons prefer to perform a discogram before doing the IDET procedure. The discogram involves inserting a needle into the disc and then injecting fluid into the disc. The discogram is considered positive if the patient’s symptoms increase when the fluid is injected. This is known as a “provocative” test in that it attempts to reproduce the patient’s symptoms.
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