Intradiscal Electrothermal Annuloplasty (IDET)
Used to treat pain from a pre-herniated vertebral disc, IDET is a simple procedure that gradually heats and contracts the posterior annulus.
What is Intradiscal Electrothermal Annuloplasty (IDET)?
- Treats pain from a weakened and degenerated vertebral disc that has not yet herniated.
- Is a procedural technique that heats the posterior annulus (back part of the outer and tougher exterior of the vertebral disc), gradually up to 90 degrees Celsius, or 194 degrees Fahrenheit.
- Posterior annulus contracts and the tiny nerve endings in the vertebral disc are cauterized to diminish pain.
- Is minimally-invasive, and only takes less than an hour to complete.
Intradiscal Electrothermal Annuloplasty, also known as Intradiscal Electrothermal Therapy (IDET), is a relatively new approach for relief from lumbar (low) back pain. IDET is a procedural technique that repairs the posterior annulus of a pre-herniated vertebral disc that is causing pain and other symptoms in a patient. The posterior annulus is the rear section of the denser outer part of the vertebral disc.
The procedure involves inserting an electrothermal probe into the degenerated disc which gradually heats up to 90 degrees Celsius (194 degrees Fahrenheit). The high temperature contracts the collagen in the vertebral disc's exterior wall, which helps close minuscule tears and prevents disc herniation. The small nerve endings in the affected vertebral disc die from cauterization, thereby reducing nerve sensitivity and pain.
IDET resolves pain experienced from tiny tears from a weakened lumbar disc. Aging, wear and tear, sudden trauma, and injuries may cause the vertebral discs to break down. The collagen in the disc's outer wall may eventually wear and develop tiny cracks, causing pain of various strengths and possibly limiting motor functionality in patients' legs. IDET does not treat vertebral discs that have already fully herniated. A microdiscectomy or discectomy may be required for those cases.
What does it treat?
- Small tears in a vertebral disc (non-herniated)
- Mild complications from Degenerative Disc Disease
- Discogenic pain (pain stemming from the vertebral disc)
Who are good candidates?
Ideal candidates for IDET must not have a fully herniated disc or multiple degenerated discs. Patients, however, should have attempted conservative methods of treatment before opting for IDET. Pain should have affected patient for at least 3 to 6 months. Candidates should also experience one or more of the following symptoms:
- Chronic pain of differing strength in the lumbar region of the back that is deep, dull, shooting, throbbing, sharp, or burning
- Weakness and/or numbness in the legs
- Trouble walking, standing, or sitting for periods of time
- Limited ability to perform daily activities and to participate in social behavior
- Attempts at conservative methods of treatment that were ineffective in treating the pain and healing the vertebral disc
Ideal patients should not have: complex and multi-level vertebral disc conditions, have facet joint syndrome, or have loss of vertebral disc height more than 50 percent. Additionally, they should be positive towards pain management and eventual healing.
What is the procedure like?
IDET is a simple procedure that takes less than an hour from start to finish. Patients are under local anesthesia and are provided a light sedation during the procedure.
The following are the general steps for IDET:
- Local anesthetic is applied to the area on the back where the electrothermal probe will be inserted.
- A hollow needle is inserted into the area and guided by the help of an X-ray machine.
- The electrothermal probe is passed through the hollow needle and placed on the area of the posterior annulus believed to cause the patient's pain.
- The tip of the probe is steadily but gradually heated up to 90 degrees Celsius, or 194 degrees Fahrenheit. The heat is held for about 15 minutes.
- Afterwards, the probe and needle are removed, and the procedure ends.