Intradiscal electrothermal therapy (IDET) is a minimally invasive procedure used to treat spinal disc-related chronic low back pain, a type of persistent disc pain caused by nerve fibers that overgrow into the disc interior. Discography is performed prior to IDET to diagnose the disc problem and determine if IDET is appropriate. During the IDET procedure, a physician performs the following:
A sedative and local anesthetic is administered to the patient
Using X-ray guidance, a small needle containing a catheter and heating element is inserted into the disc
The catheter is placed in a circle in the outer layer of the disc and slowly heated to 194°F
Antibiotics are administered intravenously or by injection to prevent a disc infection
The procedure results in contraction of the disc wall fissures, a reduction in the bulge of the inner disc material, and desensitization of the pain sensors within the disc. IDET alleviates pain through two mechanisms, including:
Thermal modification of collagen fibers
Destruction of disc pain receptors
Indications for IDET include the following:
Discogenic pain confirmed by discography
Failure to improve after at least 6 weeks of conservative treatment
Patient is younger than 55 years
No facet disease
Patient displays no signs of major psychological issues
Posterior annular deficit
Axial pain greater than leg pain for 3-6 months
Contained disc herniation
Preserved disc height (>50%)