Intradiscal Electrothermal Therapy (IDET)
Intradiscal electrothermic therapy (IDET) is a relatively new, minimally invasive treatment for spinal disc – related chronic low back 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. This is related to the breakdown (degeneration) of the tough outer layers (annulus) of the disc. The pain may also be from injury to the disc, causing the material in the center (nucleus) of the disc to move into the outer layers of the disc. This material from the nucleus is irritating to the outer layers, where the nerves are, and causes pain.
Discography is generally done before IDET to try to clearly identify the disc problem. After discography, your doctor will decide whether it is likely that your disc problem can be helped by IDET. Before an IDET procedure, you are given a sedative and a local anesthetic. Using “live” X-ray imaging (fluoroscopy), a doctor inserts a hollow needle containing a flexible tube (catheter) and heating element into the spinal disc. The catheter is positioned in a circle in the outer layer (annulus) of the disc and is then slowly heated to about 194F. The heat is meant to destroy the nerve fibers and toughen the disc tissue, sealing any small tears. Antibiotics, either given in a vein (intravenous) or injected into the disc, are used to prevent a disc infection.