Intradiscal Electrothermal Therapy (IDET)

A relatively new procedure, intradiscal electrothermal therapy (or IDET), is designed to treat persistent low back pain. It’s a minimally invasive surgery that uses electric heat delivered directly to problem areas of your spine.

Sometimes overgrown nerve fibers — from injury or illness — can cause chronic disc pain. The fibers get squeezed by the disc, which causes the pain.

IDET works by heating the outer layer of the problem disc. The heat performs two tasks: it reduces the fibers within the disc and destroys pain receptors. Patients have reported relief in as little as three days, and it can last up to six months.

OVERVIEW

This minimally invasive, hour-long procedure helps eliminate or reduce the low back pain caused by disc disease or mild herniated discs. Our board-certified surgeons usually perform the IDET procedure on an outpatient basis, meaning you recuperate in your own home. You can remain awake during the procedure, as the surgeons often use local anesthesia and light sedation to reduce your discomfort. The procedure is detailed below. Talk to your surgeon about your risks and recovery expectations.

1. INSERTING THE NEEDLE

Our surgeons use the latest technology to determine the location of the affected disc in your spine. Once your surgeon has confirmed its location, they use fluoroscopic X-ray imaging to guide a hollow needle directly into the disc. See illustration 1.

2. INSERTING THE HEATING WIRE

The surgeon then inserts the heating wire, an electrothermal catheter, through the needle, maneuvering it to find the diseased portion of the disc, as shown in illustration 2. You should not feel any pain at this point in the procedure.

3. TREATING THE DISC WALL

When the electrothermal catheter is in place, power is turned on, and the temperature of the wire gradually increases to 195 degrees Fahrenheit (90 degrees Celsius). Your surgeon monitors the process, heating the damaged disc wall for about 15 to 20 minutes. See illustration 3.

4. REPAIRING THE DISC WALL

The heat shrinks and repairs the tears in the disc wall area. It also cauterizes small nerve endings to make them less sensitive. If you feel some pain during this process, it’s from the heat being applied to your disc.

5. RECOVERING FROM THE PROCEDURE

After 15 to 20 minutes, the surgeon removes the electrothermal catheter and the needle. They cover the insertion point with a small bandage. You can return home the same day, where you should rest. You should begin to feel relief from your low back pain in a few days.