IDET, or Intradiscal Electrothermal Therapy, is a procedure that is being done to treat discogenic back pain. IDET uses a probe inserted into the disc to heat the tissues within the affected disc. Heating the inside of the disc causes the tissues to shrink. It also cauterizes, or burns, the small nerve fibers in the periphery of the disc. Whether or not it is one of these factors, or something else, that accounts for the results of IDET is not exactly known.
When is IDET an appropriate procedure?
IDET is considered in the following patients:
How is IDET performed?
IDET is performed as an outpatient procedure. Using a x-ray to guide the small probe into proper position, the IDET probe is place into the affected disc. Once positioned, the probe is slowly heated to about 85 degrees Celsius. It is maintained at this temperature for about five minutes. The entire procedure uses only local anesthesia and some mild sedation.
After the IDET is completed, the patient is monitored for a period of one or two hours. The patient is then sent home with instructions to rest and to avoid lifting, twisting, and bending.
How long is the recovery from IDET?
Patients often have an increase in symptoms the first day or two following an IDET procedure. The symptoms are usually easily controlled with mild anti-inflammatory pain medications. Improvement is commonly seen about 6 weeks after the procedure, and rehabilitation exercises are started 8- 12 weeks after the IDET.
How well does IDET work?
The results of early studies show encouraging results for IDET. The most important aspect is ensuring the right patients are being selected for this treatment. Patients must fit into the criteria as mentioned above in order to have the best chance at success. It is very important that patients have undergone a minimum 3 month trial of regular medications and therapy prior to considering IDET.
IDET is a safe procedure with few reported complications. There are few studies investigating its use, but the best studies show that about 60-80% of patients find improvement in the months following an IDET procedure. Unfortunately, there are no long-term studies to evaluate how these patients are doing years down the road. Some orthopedists do not favor this procedure because of this potential problem. By heating the disc tissue, and destroying some of it, there is a potential for further problems down the road--we simply don't know.