IDET or Intradiscal Electrothermal Annuloplasty is a procedure to treat disc-related back pain. It is a new alternative to other surgical procedures for patients who suffer from back pain caused by certain types of disc problems. It is an outpatient non-operative procedure which is minimally invasive, meaning there is no incision and can be done using local anesthetic and sedation. The procedure works by heating the nerve endings within the disc wall to help block the pain signals.
IDET is currently indicated for patients with chronic back pain that does not respond to at least 6 months of conservative (nonsurgical) treatment.
Conservative treatment typically includes a combination of:
- Medication
- Rest
- Activity modification
- Physical therapy and/or appropriate exercise program
Approximately 90% of people get better with the above treatments and do not require additional treatment. For those who fail to respond and have significant limitations in their daily function, additional testing such as MRI imaging and lumbar discography are useful in determining which discs, if any, may be responsible for the chronic pain.
Candidates for IDET include patients with back pain caused by:
- Small herniations-preserved disc height of greater than 50%
- Internal disc tears or a contained disk herniation
- Mild disc degeneration limited to one or two levels
- Ideal candidates are patients with a single affected disk as determined by magnetic resonance imaging (MRI) and diskography. Patients with the main complaint of axial pain with or without some non-radiating limp pain are suitable candidates.
- Axial pain greater than leg pain for 3-6 months- a type of mechanical pain, and is confined to one spot or region. It may be described a number of ways, such as sharp or dull, comes and goes, constant, or throbbing. A muscle strain is a common cause of axial back pain as are facet joints and tears in discs
- Motivated patient with no major psychological issues
- No facet disease
- Patient younger than 55 years
- Failure to improve after at least 6 weeks of conservative treatment
- Diskogenic pain confirmed by provocation diskography.