"Pig Tail" technique in intradiscal electrothermal therapy

Area of Science:

• Minimally Invasive Spine Procedures
• Pain Management Interventions
• Biomedical Engineering in Therapeutics

Background:

• Standard intradiscal electrothermal therapy (IDET) catheter insertion can be challenging.
• Difficulty achieving optimal catheter positioning may require contralateral reinsertion.
• This can lead to increased patient discomfort and radiation exposure.

Purpose of the Study:

• To describe a novel, single-insertion catheter technique for IDET.
• To address challenges in achieving optimal catheter placement in IDET.
• To enhance the safety and efficacy of IDET for difficult cases.

Main Methods:

• A new 180-degree cannula rotation technique, termed the "pig tail" method, is introduced.
• Instead of withdrawing, the cannula is rotated to redirect the catheter.
• The catheter is then navigated across the midline to treat the posterior annulus.

Main Results:

• The technique was successfully applied in 42 consecutive patients with difficult initial navigation.
• The method proved simple to perform and did not increase patient discomfort.
• No additional local anesthesia or radiographic exposure was required compared to standard techniques.

Conclusions:

• The "pig tail" technique is a safe and effective alternative for IDET catheter insertion in patients with navigation difficulties.
• This method avoids the need for a second needle insertion, reducing patient burden.
• It allows for adequate thermal treatment of the posterior annulus, improving therapeutic outcomes.