What is intradiscal electrothermal therapy (IDET)?

Intradiscal electrothermal therapy, or IDET, is a procedure used to treat back pain caused by the breakdown of the discs between vertebrae. Rather than expensive and invasive spinal surgery, IDET is a non-surgical treatment that involves inserting a thin wire into the affected disk and heating it. This causes structural changes to the disk, decreases the disk size, and kills the pain receptors. Decreasing the size of the disk may “un-herniate” it, if you will, and reduce your pain. The cost of this new treatment is roughly one-seventh of traditional lumbar fusion surgery.

Am I a candidate intradiscal electrothermal therapy (IDET)?

You are a candidate for intradiscal electrothermal therapy if you have suffered from significant back pain caused by a herniated disk that has not responded to conservative therapies such as anti-inflammatory medications, ice/heat therapy, rest, and physical therapy for more than 6 weeks. Patients whose intervertebral disks are less than 50% of their normal height may not have successful IDET. Additionally, if you have conditions that decrease healing (greater than 55 years of age, poorly controlled diabetes, hypertension, cigarette smoking, et al.), the benefits will likely be decreased. Be sure to tell your provider about medications you take, such as medicine to help your blood clot, or medication allergies you have.

How long will the intradiscal electrothermal therapy (IDET) procedure take?

Intradiscal electrothermal therapy takes less than an hour to complete. Your back will be cleaned and numbed with lidocaine, the same medicine dentists use to numb your gums and teeth prior to filling a cavity. Fluoroscopy, or real-time x-ray, is used to guide the needle and catheter into the right spot between the vertebrae and around the disk. Once the correct position is established, the catheter is heated to 149⁰ Fahrenheit. If you can tolerate that temperature for one minute, the temperature of the catheter is increased incrementally over 10-15 minutes until it reaches roughly 176⁰-194⁰ F. Following the procedure, you should rise slowly and move carefully. Do not expect your pain to be eliminated or even decreased. In fact, you should expect your pain to be significantly increased for at least a week.

How long will it take to recover from intradiscal electrothermal therapy (IDET)?

You should anticipate being in much greater pain for the first week after intradiscal electrothermal therapy. Plan to spend the majority of your time resting in bed for the first week; only minimal time sitting or standing is allowed. When up, you will be wearing a corset to stabilize your back. It could take up to three months to experience improvement in your pain level. The treated disk will still be healing at four months out from the procedure. During this time, you will undergo a rehab program that is carefully structured to ensure the best outcome. Your physical activity should be severely limited. No heavy physical work should be done for the 16 weeks following the procedure. At about 6 months post-IDET, you will be able to resume sports or heavy physical work.

Reference:

Thiyagarajah, A. (2015). Intradiscal electrothermal therapy. Medscape. Retrieved from http://emedicine.medscape.com/article/1145641-overview