Intradiscal electrothermal therapy idet for low back pain. Therapy a novel approach to lumbar disc degeneration and herniation. The targeted patients have no clinical or radiologic evidence of significant disc herniation or nerve root compression. Coverage issues guidelines and medical technology assessment recommendations are developed to determine coverage for avmed s benefits, and are published to provide a better understanding of the basis upon which coverage decisions are made. Percutaneous annuloplasty eg, intradiscal electrothermal annuloplasty, intradiscal radiofrequency annuloplasty, or intradiscal biacuplasty for the treatment of chronic discogenic back pain is considered investigational. After several trials on cadaveric and animal models, the authors concluded that the whole nucleus pulposus was reduced by 7 percent and the focal point of contact between the disc and electrode was reduced by 20 percent. Pdf the intradiscal electrothermal therapy idet procedure is a minimally invasive technique designed to treat discogenic chronic low back pain. Intradiscal electrothermal therapy idet request pdf. Intradiscal electrothermal therapy was first introduced in 1997 and utilizes a heated thermal coil, inserted through a catheter to destroy painreceiving nerves in the intervertebral disc. Mar 23, 2018 intradiscal electrothermal annuloplasty idea or intradiscal electrothermal therapy idet, as it is known commercially, is a new and minimally invasive technique for the treatment of discogenic low back pain. Idet procedure performed on a bulging lumbar disc to help reduce compression on spinal nerves. Differences in efficacy are affected by differences in selection criteria and technique. Intradiscal electrothermal therapy in the treatment of. Idet intradiscal electrothermal annuloplasty mendelson.
Idet involves passing a wire into a damaged painful disk and placing it against the injured portion of the disk. Intradiscal electrothermal annuloplasty idea or intradiscal electrothermal therapy idet, as it is known commercially, is a new and minimally invasive technique for the treatment of discogenic low back pain. Intradiscal electrothermal therapy idet for low back. Discogenic low back pain resulting from internal disc disruption can be severely disabling, clinically challenging, and expensive to treat. Intradiscal electrothermal therapy idet for lower back pain. Intradiscal electrothermal therapy idet is a new procedure for the treatment of chronic, nonspecific low back pain attributed to degenerative disc disease. Lumbar idet intradiscal electrothermal therapy procedure. Intradiscal electrothermal therapy idet page 2 of 2 disclaimer information. To compare the efficacy of idet with that of a placebo. A new therapy now available shows promise for the treatment for lower back pain caused by specific types of disc damage. Intradiscal electrothermic therapy idet is a relatively new, minimally invasive treatment for spinal discrelated chronic low back pain.
Jun 12, 2001 the reason the article on cauda equina syndrome from intradiscal electrothermal therapy 1 was published is somewhat mysterious to me. The debate surrounding idet ranges from the concept of. Idet is a safe and effective treatment for herniated discs, and other painful degenerative disc diseases ddd. The primary indication for idet is the presence of axial symptoms not indicating radicular pain. Heat contracts and thickens the disc wall, resulting in contraction or closure of the disc wall tears, hence reducing the bulge of the inner disc material. Called intradiscal electrothermal therapy idet, targeted intradiscal therapy, or intradiscal electrothermal coagulation, the procedure is based on a similar therapy used to treat patients with shoulder problems.
Idet involves the percutaneous threading of a flexible catheter into the disk under fluoroscopic guidance. Pdf intradiscal electrothermal therapy idet for the. Risk factors for failure and complications of intradiscal. Intradiscal electrothermal therapy idet what is it. Intradiscal electrothermal therapy treatment for back pain. This article assesses the current evidence for three such treatments. With idet the major liability was that it really didnt accomplish it goal of pain relief and turned out to be expensive.
This is a minimally invasive procedure that uses controlled levels of thermal energy heat to treat damaged spinal discs the cushions between vertebrae. Learn if intradiscal electrothermal therapy is right to treat your chronic sciatica pain. A relatively new treatment for back pain resulting from problems within the cushioning discs is intradiscal electrothermal annuloplasty, also called intradiscal electrothermal therapy idet. Intradiscal electrothermal therapy idet encino, ca.
Pdf intradiscal electrothermal therapy treatment for back. Electrothermal heat is generated in the heat ing section of the catheter starting at 65 c and increasing incrementally to 90 c, a process that can take 14 to 17 minutes. Intradiscal electrothermal therapy intradiscal electrothermal therapy idet, also known as intradiscal electrothermal annuloplasty, is a technique designed to thermocoagulate and destroy nerves in the intravertebral disc of individuals presumed to have discogenic low back pain. Management of discogenic lumbar pain with intradiscal.
Please consult your physician about the risks and potential complications of spinecath idet therapy. The rationale for heating intervertebral discs was strongly influenced by animal and clinical investigations testing the ability of heat to stabilize joints by modifying collagen. In intradiscal electrothermal therapy, a physician applies precisely controlled heat to a broad section of the affected disc wall. Nevada advanced pain intradiscal electrothermal therapy. Nov 01, 2005 a randomized, doubleblind, controlled trial. Intradiscal electrothermal therapy, which is performed on an outpa. Important information about spinecath idet therapy spinecath idet therapy, like any surgical procedure, has some risks. Idet is usually performed only after discography or other diagnostic testing indicates that a patient may. This type of persistent disc pain is thought to be caused by nerve fibers that have grown from their normal location in the outer layers of the disc, reaching into the disc. Objective this prospective study was conducted to evaluate improvements in pain and disability in a series of 53 consecutive workers compensation patients with low back pain lbp after treatment with the intradiscal electrothermal therapy idet procedure. Medicare hmo bluesm and medicare ppo bluesm members.
Intradiscal electrothermal therapy idet is performed by the introduction of a flexible catheter containing a resistive coil into the disc and thermal transmission for neural tissue damage. Metaanalysis of the efficacy and safety of intradiscal electrothermal therapy idet. Using three data bases pubmed, cochrane and scopus we searched for clinical studies evaluating nonoperative methods of treating discogenic back pain that were published between 20042012. It aims to reduce the symptoms of the disrupted disc by thermocoagulating annular tissue and contracting collagen fibrils. The intradiscal electrothermal therapy idet procedure is a minimally invasive technique designed to treat discogenic chronic low back pain. Mar, 2018 what is intradiscal electrothermal therapy idet.
Freeman bj1, fraser rd, cain cm, hall dj, chapple dc. Sometimes the discs can become damaged and cause pain. This outpatient procedure applies high heat directly to the inside of the disc. Cervical spine idet is a popular surgical procedure that is used to treat contained herniated intervertebral spacers in the neck. It has also been referred to as intradiscal electrothermal annuloplasty iea and intradiscal electrothermal catheterization. Management of discogenic low back pain with intradiscal. Intradiscal electrothermal therapy idet intervertebral discs act as cushions between the vertebrae. This study was to evaluate the outcome of intradiscal electrothermal therapy idet and microendoscopic discectomy medinterbody. Idet for sciatica is a wellestablished minimally invasive spine surgery procedure used to relieve pressure on nerve structures caused by contained disc herniations. Intradiscal electrothermal therapy idet is a treatment devised to relieve the pain of internal disc disruption. Not all patients will find relief for their back pain and relieved symptoms may recur over time. Intradiscal electrothermal annuloplasty provides a new alternative to other surgical procedures for patients who suffer from back pain caused by certain types of disc problems.
With age, or due to injury, cracks or fissures may cause fissures to develop in the wall of the intervertebral disc. Intradiscal electrothermal therapy idet is a minimally invasive procedure for treating lowerback pain caused by worn spinal discs. The tip of the catheter is positioned inside the bulging disc nucleus and heated in an effort to both. Percutaneous intradiscal electrothermal annuloplasty, radiofrequency annuloplasty, and biacuplasty. Over the past decade, there has been a surge of minimally invasive techniques aimed at treating both discogenic low back pain lbp and radicular pain. Survey data have shown that idet is not always performed on properly selected patients.
During this portion of the procedure, it is normal for the patient to feel some discomfort deep in the back. Intradiscal therapy is a minimallyinvasive and revolutionary treatment for chronic low back pain. Since degeneration of the intervertebral disc can be the source of severe lbp, idet has been proposed as an alternative treatment to spinal fusion for those individuals with. Intradiscal electrothermal therapy idet methodist health. Cauda equina syndrome from intradiscal electrothermal therapy. Intradiscal electrothermal therapy has become a diverse category of invasive techniques, with many different procedural options now available. Intradiscal electrothermal therapy idet nevada pain. The procedure involves placing a thermal catheter spinecath, oratec interventions, inc. Intradiscal electrothermal therapy idet is performed by the introduction of a flexible. Jan 14, 2020 intradiscal electrothermal therapy idet is a relatively new treatment for low back pain. Management of discogenic lumbar pain with intradiscal electrothermal therapy idet juan david uraza murcia department of neurosurgery, san ignacio university hospital, pontifical javierian university, bogota, colombia abstract aim.
Intradiscal electrothermal therapy johns hopkins medicine. National coverage determination ncd for thermal intradiscal procedures tips150. Intradiscal electrothermal therapy idet for the treatment of discogenic low back pain. Intradiscal electrothermal therapy idet is a controversial procedure. Pdf intradiscal electrothermal therapy, percutaneous. The technique involves applying heat to the annulus fibrosus through a catheter with a temperaturecontrolled thermal resistive heating coil.
It is a fairly advanced procedure made possible by the development of electrothermal catheters that allow for careful and accurate temperature control. Feb 03, 20 idet procedure performed on a bulging lumbar disc to help reduce compression on spinal nerves. Intradiscal electrothermal therapy idet for ddd and. Aug 04, 2010 a common technique with this approach is termed intradiscal electrothermal annuloplasty or intradiscal electrothermal therapy idet. Pdf intradiscal electrothermal therapy idet for the treatment of.
The tip of the catheter is positioned inside the bulging. It involves threading into the painful disc a flexible wire electrode, which is used to heat the tissues of the posterior annulus fibrosus in an effort to relieve the pain. This type of persistent disc pain is thought to be caused by nerve fibers that have grown from their normal location in the outer layers of the disc, reaching into the disc interior. At advanced pain consultants, we provide stateoftheart pain treatments. Intradiscal electrothermal therapy idet is a minimally invasive procedure performed on patients who suffer from a chronic history of discogenic back pain. Intradiscal electrothermal therapy idet is a minimally invasive procedure that was developed as a treatment for lumbar discogenic pain. Specific selection criteria have been refined that identify patients for treatment with idet, ensuring maximal clinical benefit and appropriate use of. Idet is also a costeffective method for low back pain treatment, especially when compared to. The spinecath intradiscal catheter delivers thermal energy to the posterior. Intradiscal electrothermal therapy intradiscal electrothermic therapy idet is a relatively new, minimally invasive treatment for spinal discrelated chronic low back pain. However, intradiscal electrothermal therapy is a relatively conservative treatment method that can be offered to patients instead of surgery.
Intradiscal electrothermal therapy idet intradiscal electrothermal therapy idet is one type of tip. This type of persistent disc pain is thought to be caused by nerve fibers that have grown from their normal location in. Filled with small nerve endings and blood vessels, these fissures are a chronic source of pain in many. Intradiscal electrothermal coagulation therapy idet and. Intradiscal electrothermal therapy statpearls ncbi. One of the innovative techniques we use to treat persistent low back pain is called intradiscal electrothermal therapy idet. Coverage issues guidelines and medical technology assessment recommendations are developed to determine coverage for avmeds benefits, and are published to provide a better understanding of the basis upon which coverage decisions are made.
Intradiscal electrothermal therapy idet advance pain. Intradiscal electrothermal therapy idet is a percutaneous minimally invasive procedure that uses a disposable intradiscal catheter and electrothermal heat to treat the pain associated with degenerative disc disease. Intradiscal electrothermal therapy idet is a minimally invasive surgical mis procedure for the treatment of discogenic chronic low back pain. Intradiscal electrothermal therapy idet is a treatment for discogenic low back pain the efficacy of which has not been rigorously tested. Percutaneous disc decompression or nucleoplasty procedures that do not utilize a radiofrequency energy source or electrothermal energy such as the disc. Answer intervertebral discs act as cushions between the vertebrae of your spine. Evaluate the effectiveness of intradiscal electrothermal therapy in treating discogenic low back pain. Intradiscal electrothermal therapy idet is a relatively new treatment for low back pain. Intradiscal electrothermal therapy idet, a minimallyinvasive technique performed in the outpatient setting, offers an intermediate intervention between conservative care and surgery. Intradiscal electrothermal therapy idet studies on idet have proven the procedure to be effective for appropriate patients, with about 75 percent of those undergoing treatment reporting satisfactory outcomes of reduced pain and increased mobility. It is very important to mention at the start that idet is not intended to cure every type of back pain. Its also known as idet spine therapy or intradiscal electrothermal therapy. Freeman bj, walters r, moore rj, fraser rd 2001 in vivo measurement of peak posterior annular and nuclear temperatures obtained during intradiscal electrothermal therapy idet in sheep. Intradiscal electrothermal therapy meddiagnostics rehab.
A randomized, placebocontrolled trial of intradiscal electrothermal therapy for the treatment of discogenic low back pain. Pdf intradiscal electrothermal therapy treatment for back pain. Intradiscal electrothermal therapy idet is a relatively new, minimally invasive treatment for spinal discrelated chronic low back pain. Intradiscal electrothermal therapy idet, a minimallyinvasive. Intradiscal electrothermal therapy for discogenic low back pain inesss. Previously, when conservative care had been exhausted, open surgical intervention such as spinal fusion or artificial disc replacement was the only treatment option for these patients. Pdf intradiscal electrothermal therapy treatment for. Intradiscal electrothermal therapy intradiscal electrothermal therapy idet is performed by the introduction of a flexible catheter containing a resistive coil into the disc and thermal transmission for neural tissue damage. Intradiscal electrothermal therapy an overview sciencedirect. Pdf a prospective, randomized, doubleblind, placebocontrolled trial of intradiscal electrothermal therapy idet for the treatment of chronic.
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