Intra-Discal Electro-Thermal Therapy (IDET)
What is IDET (IntraDiscal ElectroThermal™ Therapy)?
IntraDiscal ElectroThermal Therapy is a recently developed technique for the treatment of pain coming from a spinal disc. A special probe is inserted into the disc and heated. This causes the collagen in the disc wall to contract, thicken, and may numb the nerves in the wall of the disc.
Am I a candidate for IDET?
If you have back pain from a damaged disc (discogenic pain) that does not respond to less invasive therapies, you may benefit from an IDET procedure. Most back pain gets better on its own in the first month or two, so TPM physicians do not consider IDET until at least a month after the onset of back pain. Also, if your back pain is not severe enough to limit your activities, you probably should not have IDET.
How do I know if my pain is from a damaged disc?
With age or from an injury, the wall of the spinal discs can get cracks (fissures). This condition is called Internal Disc Disruption or Degenerative Disc Disease. Also, the wall can weaken and bulge out (a herniated disc). When the disc causes pain, the pain is usually felt as a deep, aching pain in the back and sometimes in the buttocks and into the thigh. However, pain from facet joints in the back and from the sacroiliac joints (SI joints) can be in the same location and feel the same. The best way to tell if the pain is from a damaged disc is with discography.
How long does the IDET take?
It takes about thirty to sixty minutes to perform the procedure.
How is it actually performed?
IDET is usually performed as an outpatient procedure. The procedure is performed in the operating room to maintain sterility. You lie face down on a x-ray table. Local anesthesia and mild sedation will be used to make you more comfortable during the procedure. Using fluoroscopy (x-ray), a needle is inserted into the disc and through the needle a flexible catheter to positioned in the disc. Once in proper position, this catheter is heated for about 17 minutes. When done, the catheter and needle are removed and you are ready to go home about an hour later with a Band-Aid over the needle insertion site.
Will the procedure hurt?
Local anesthesia and mild sedation will be used to make you more comfortable during the procedure. During the heating, you may feel a reproduction of your usual lower back pain. This is an excellent sign that the heating is being done in the correct area.
Will I be "put out" for this procedure?
IDET is usually performed as an outpatient procedure. Local anesthesia and mild sedation will be used to make you more comfortable during the procedure. You will need to be awake enough to tell your physician what you are experiencing during the procedure.
What should I expect after the procedure?
You will probably have a flare-up of your back pain for a few days —sometimes up to a week. You will be advised to use ice packs initially and you may need extra medication during this period. Almost everyone is back to at least their usual level of pain within a week.
Who should not have this procedure?
If you are on a blood thinning medication (e.g. Coumadin®), or if you have an active infection going on, you should not have the procedure.