IntraDiscal ElectroThermal (IDET) Therapy

Cracks or fissures may develop in the annulus (the outer covering of the intervertebral disc).  The cracks may be due to age or injury. This disc annulus has a rich supply of nerve endings.  Disc fissures can therefore create severe and chronic pain. Additionally, the inner disc tissue (nucleus) will bulge (herniate) into these fissures.  The bulges and herniations stimulate other pain sensors in the nerve roots.

IntraDiscal ElectroThermal Therapy (IDET) is a minimally invasive treatment.  Heat energy is applied to the inside of the disc annulus. The heat coagulates and stiffens the collagen of the disc wall.  It may take pressure away from the pain nerves. The therapy may close holes in the disc annulus and may reduce the bulging of the inner, nuclear disk material.

Who may Benefit from IDET Therapy?

IDET works on the tissues of the disc itself.  It can improve back pain but should not be expected to alleviate the pain caused by other spinal structures, such as nerve roots or spinal joints. It is very important for your doctor to make sure that the disc is the source of your back pain. In addition to a clinical examination, your doctor will likely do a discography to confirm the diagnosis. Once your doctor is satisfied that one or more discs are the primary source of your back pain, IDET therapy may be recommended.

The Procedure

IDET is performed on an outpatient basis. Local anesthesia and mild sedation reduce discomfort. You will be awake so that you can provide feedback to the physician.

Using x-ray images, your physician will advance a flexible needle into the disc. Once it is in the appropriate position, the catheter will be heated. During the heating process, your doctor will closely monitor your condition and comfort level.

You may feel lower back pain during the process. Once the therapy is completed, the catheter and needle are removed, and you will likely be sent home with a small bandage over the needle insertion.

After the Procedure

Post-procedure discomfort may take several days to subside, and your doctor may prescribe medication. During the 12 to 16 week healing process, it is very important to treat your discs with care. Your doctor will provide you with physical rehabilitation guidelines.

Patients report that it is during this time that they usually begin to feel lower back pain relief and an increase in their functional abilities. Improvements may continue up to six months following the procedure.

Important Information About IDET Therapy

Like any surgical procedure, IDET therapy has some risks. Not all patients will experience back pain relief, and relieved symptoms may recur over time.

Many factors may persuade your physician from recommending IDET therapy. Such factors may include, but are not limited to, narrow disc height, severe disc herniation, spinal instability, advanced stages of disc degeneration, or general health concerns.

Insurance companies have recently stopped paying for the IDET procedure.
The patient will usually have to pay for the costs.

The insurance companies point out that the success rate is only about 50%. That is true, but it also means that half of patients will not need a fusion if the IDET works.

Go to the next page on Pain Pumps and Stimulators.

Go to the next chapter on major procedures.

Go to the chapter on medicines and orthotics.