Discogenic pain syndromes are incompletely understood but are increasingly believed to be causative of a large number of cases of chronic low back pain. Treatment choices for patients in whom conservative measures fail are limited, and surgical options have considerable cost, morbidity, and only variable effectiveness in pain relief. IDET is a minimally invasive treatment proposed as an alternative to surgery in patients with chronic discogenic low back pain syndromes. Although objective evidence of effectiveness is still being collected, this newly developed procedure is an excellent starting point in the development of minimally invasive techniques in treating discogenic pain and adds another valuable tool to the armamentarium of the practicing spine interventionist.
1. Shekelle P. The epidemiology of low back pain. In: Giles LGF, Singer KP, eds. Clinical Anatomy and Management of Low Back Pain. Oxford: Butterworth-Heinemann; 1997.
Taylor JR, Giles LGF. Lumbar intervertebral discs. In: Giles LGF, Singer KP, eds. Clinical Anatomy and Management of Low Back Pain. Oxford: Butterworth-Heinemann; 1997.
Saal JS, Saal JA. Management of chronic discogenic low back pain with a thermal intradiscal catheter: a preliminary study. Spine 25(3):382-388, 2000. Cooke PM, Lutz GE. Internal disc disruption and axial back pain in the athlete. Phys Med Rehabil Clin North Am 11(4):837-865, November 2000. Hacker RJ. Comparison of interbody fusion approaches for disabling low back pain. Spine 22(6):660-665, March 1997.
Tiusanen H, Seitsalo S, Osterman K, Soini J. Anterior interbody lumbar fusion in severe low back pain. Clin Orthop 324:153-163, March. Tiusanen H, Hurri H, Seitsalo S, Osterman K, Harju R. Functional and clinical results after anterior interbody lumbar fusion. Eur Spine J 5(5):288-292, 1996.
Vamvanij V, Fredrickson BE, Thorpe JM, Stadnick ME, Yuan HA. Surgical treatment of internal disc disruption: an outcome study of four fusion techniques. J Spinal Disord 11(5):375-382, October 1998. Parker LM, Murrell SE, Boden SD, Horton WC. The outcome of postero-lateral fusion in highly selected patients with discogenic low back pain. Spine 21(16):1909-1917, 1996.
Elias WJ, Simmons NE, Kaptain GJ, Chadduck JB, Whitehill R. Complications of posterior lumbar interbody fusion when using a titanium threaded cage device. J Neurosurg 93:1(suppl)45-52, July 2000. Wittenberg RH, Oppel S, Rubenthaler FA, Steffen R. Five-year results from chemonucleolysis with chymopapain or collagenase: a prospective randomized study. Spine 26(17):1835-841, September 2001. Davis GW, Onik G. Clinical experience with automated percutaneous lumbar discectomy. Clin Orthop 238:98-103, 1989.
Choy DS. Percutaneous laser disc decompression (PLDD): a first line treatment for herniated discs. J Clin Laser Med Surg. 19(1):1-2, February 2001. Giles LGF. Innervation of spinal structures. In: Giles LGF, Singer KP, eds. Clinical Anatomy and Management of Low Back Pain. Oxford: Butterworth-Heinemann, 1997.
Ohtori S, Takahashi Y, Takahashi K, Yamagata M, Chiba T, Tanaka K, Hi-rayama J, Moriya H. Sensory innervation of the dorsal portion of the lumbar intervertebral disc in rats. Spine 24(22):2295-2299, 1999. Freemont AJ, Peacock TE, Goupille P, Hoyland JA, O'Brien J, Jayson MIV. Nerve ingrowth into diseased intervertebral disc in chronic back pain. Lancet 350:178-181, July 1997.
Kupural L, Mekhail N. Radiofrequency ablation for chronic pain control. Curr Pain Headache Rep 5(6):517-525, December 2001. Lee J, Lutz GE, Campbell D, Rodeo SA, Wright T. Stability of the lumbar spine after intradiscal electrothermal therapy. Arch Phys Med Rehabil 82(1):120-122, January 2001.
Shah RV, Lutz GE, Lee J, Doty SB, Rodeo S. Intradiskal electrothermal therapy: a preliminary histologic study. Arch Phys Med Rehabil 82(9):1230-237, September 2001.
Saal JA, Saal, JS, Wetzel FT, Thompson K, Maurer P, Hill J. IDET-related complications: a multi-center study of 1675 treated patients with a review of the FDA MDR data base. Presented at North American Spine Society, Seattle, WA, October 2001.
Eckel TS. Intradiscal electrothermal therapy. In: Willams AL, Murtagh FR, eds. Handbook of Diagnostic and Therapeutic Spine Procedures. St. Louis: CV Mosby; 2002.
22. Derby R, Eek B, Chen Y, O'Neill C, Ryan D: Intradiscal electrothermal annuloplasty (IDET): a novel approach for treating chronic low back pain. Neuromodulation 3(2), April 2000.
23. Karasek M, Bogduk N. Twelve-month follow-up of a controlled trial of in-tradiscal thermal annuloplasty for back pain due to internal disc disruption. Spine 25(20):2601-2607, October 2000.
24. O'Neil C, Derby R, Kenderes L. Precision injection techniques for diagnosis and treatment of lumbar disc disease. Semin Spine Surg 11(2):104-118, June 1999.
25. Saal JS, Saal JA. Intradiscal electrothermal treatment for chronic discogenic low back pain: a prospective outcome study with minimum 1-year follow-up. Spine 25(20):2622-2627, October 2000.
26. Thompson KJ, Eckel TS. IDET Nationwide Registry Preliminary Results: twelve-month follow-up on 211 patients. Presented at North American Spine Society, October 2000.
27. Saal JS, Saal JA. Intradiscal electrothermal treatment for chronic discogenic low back pain: prospective outcome study with a minimum 2-year follow-up. Spine 27(9):966-973, May 1, 2002.
28. Saal JA, Saal JS. Intradiscal electrothermal therapy for the treatment of chronic discogenic low back pain. Clin Sports Med. 21(1):167-187, January 2002.
29. Heary RF. Intradiscal electrothermal annuloplasty: the IDET procedure. J Spinal Disord 14(4):353-360, August 2001.
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Deal With Your Pain, Lead A Wonderful Life An Live Like A 'Normal' Person. Before I really start telling you anything about me or finding out anything about you, I want you to know that I sympathize with you. Not only is it one of the most painful experiences to have backpain. Not only is it the number one excuse for employees not coming into work. But perhaps just as significantly, it is something that I suffered from for years.