Intradiscal Electrothermal Annuloplasty (IDET): A Novel Approach for Treating Chronic Discogenic Back Pain

Objective. This one-year pilot outcome study was designed to investigate prospectively a series of patients with chronic discogenic back pain who underwent intradiscal electrothermal annuloplasty (IDET). Patients with chronic discogenic low back pain usually respond poorly to conservative medical care. Spinal fusion procedures have yielded mixed results. IDET is a new procedure to heat the intervertebral disc for the purpose of relieving discogenic pain. This study presents the one-year results for the first 32 patients undergoing the IDET procedure. The objective of this article is to determine the safety and efficacy of the IDET procedure in patients with chronic discogenic back pain. Methods. Utilizing standard discographic technique, the disc was heated using a navigable intradiscal catheter with a temperature-controlled thermal resistive coil. Six-month and one-year outcomes were assessed comparatively within subjects using a Roland-Morris (RM) questionnaire and a Visual Analog Scale (VAS), and between subjects using the NASS Low Back Pain Outcome Assessment Instrument Satisfaction Index and a general activity scale modified from the back pain/disability scale from the same instrument. The results from the individual outcome measures were combined to generate an overall outcome of favorable, nonfavorable, and no change. Results. There were no significant differences between overall outcome measures at 6-month and 12-month follow-ups. At 12 month follow-up the VAS had a mean decrease of 1.84 (sd = 2.38) and the RM had a mean decrease of 4.03 (sd = 4.82). 78.1% of patients stated that the procedure met their expectations or that they would undergo the same treatment for the same outcome. 53.1% of patients stated that their overall activity level was either better or much better compared to before the procedure. Overall, 62.5% had a favorable outcome, 12.5% nonfavorable, and 25% no change. Patients with excellent or good catheter positions and those with low pressure sensitive discs on preoperative discography had the most favorable outcomes. There were no significant complications. Conclusions. One-year pilot study outcome results suggest that IDET may be an effective, minimally invasive treatment for chronic discogenic low back pain.