Intradiscal Electrothermal Therapy (IDET)

Description

Intradiscal electrothermal therapy (IDET) is a minimally invasive procedure used to treat spinal disc-related chronic low back pain, a type of persistent disc pain caused by nerve fibers that overgrow into the disc interior. Discography is performed prior to IDET to diagnose the disc problem and determine if IDET is an appropriate treatment. During the IDET procedure, a physician performs the following:

  • A sedative and local anesthetic is administered to the patient

  • Using X-ray guidance, a small needle containing a catheter and heating element is inserted into the disc

  • The catheter is placed in a circle in the outer layer of the disc and slowly heated to 194°F

  • Antibiotics are administered intravenously or by injection to prevent a disc infection

The procedure results in contraction of the disc wall fissures, a reduction in the bulge of the inner disc material, and desensitization of the pain sensors within the disc. IDET alleviates pain through two mechanisms, including:

  • Thermal modification of collagen fibers

  • Destruction of disc pain receptors

Indications

Indications for IDET include the following:

  • Discogenic pain confirmed by discography

  • Failure to improve after at least 6 weeks of conservative treatment

  • Patient is younger than 55 years

  • No facet disease

  • Patient displays no signs of major psychological issues

  • Posterior annular deficit

  • Axial pain greater than leg pain for 3-6 months

  • Contained disc herniation

  • Preserved disc height (>50%)