When is
IDET an
appropriate
procedure?
IDET is
considered
in the
following
patients:
-
Back pain for at least 3 months
-
Nonsurgical treatments have been used for at least 3 months
-
No prior spine surgery at the affected level
-
Abnormal disc seen on MRI
-
Positive (concordant) discogram
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.
