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The following 5 retrospective case series of the IDET* procedure have been published:
Endres SM, Fiedler GA, Larson KL. Effectiveness of intradiscal electrothermal therapy in increasing function and reducing chronic low back pain in selected patients. Wis Med J. 2002;101:31-34.
The authors interviewed 54 IDET patients by telephone between 12 and 108 weeks post-procedure.
- 35/54 patients (65%) returned to work.
- 37/54 patients (69%) said they would undergo the procedure again.
- Significant reduction in VAS overall (P<0.001).
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Davis TT, Delamarter RB, Sra P, Goldstein TB. The IDET procedure for chronic discogenic low back pain. Spine. 2004;29:752-756.
Of the 60 consecutive patients at a single surgery center identified as a study cohort, 44 completed a follow-up interview process. No standardized pre-operative measure of pain was available since this was a retrospective study. One year following the IDET procedure:
- 6/44 patients (14%) had undergone lumbar surgery after the IDET procedure (5 fusion, 1 discectomy).
- Of the 38 who did not have subsequent surgery, 53% said they would have the IDET procedure again.
- Two years post-procedure another 4 patients reported surgery (3 fusions, 1 discectomy).
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Webster BS, Verma S, Pransky GS. Outcome of workers’ compensation claimants with low back pain undergoing intradiscal electrothermal therapy. Spine. 2004;29(4):435-441.
In this study, 142 workers’ compensation cases from 23 states and 97 different providers were retrospectively reviewed. The mean follow-up was 22 months (range 10-34).
- 96/142 (68%) did not meet one or more of the published selection criteria for the IDET procedure.
- In 78% of cases the discography was performed by the same provider who performed the IDET procedure.
- Provider self-referral and narcotic use before the IDET procedure were identified as significant risk factors for poor outcomes in this study.
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Bryce DA, Nelson J, Glurich I, Berg RL. Intradiscal electrothermal annuloplasty therapy: A case series study leading to new considerations. WMJ. 2005;104(6):39-46.
This was a retrospective observational case series that examined the records of 86 patients. Seventy-three (85%) included data before and 3 months post-procedure and were included in the analyses.
- Statistically significant improvement (P<0.001), measured by mean change >20 on RMDQ 6 months post-treatment.
- Statistically significant improvement in pain and functional capacity was strongly associated with females aged 18-45 years.
- Improvement was not sustained in males beyond the 3-6 month point.
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Cohen SP, Larkin T, Abdi S, Chang A, Stojanovic M. Risk factors for failure and complications of intradiscal electrothermal therapy: a pilot study. Spine. 2003;28:1142-1147.
This retrospective review was conducted using the medical histories of 80 consecutive patients who underwent the IDET procedure at Walter Reed Army Medical Center (65 patients) and Massachusetts General Hospital (14 patients). Follow-up assessment was at 6 months. One patient in whom the catheter did not cover the posterior anulus was excluded. Fifty patients had one level treated, and 29 had two discs treated. Obesity was the only risk factor for IDET procedure failure identified in this study. Eight patients reported complications; all resolved with treatment.
- 48% (38/79) of patents reported >50% pain relief.
- 10% (8/79) reported >90% pain relief.
- Average pre- and post-procedure VAS scores for patients with successful outcomes were 5.9 and 2.1 respectively.
- Average pre- and post-procedure VAS scores for those with unsuccessful outcomes were 6.2 and 5.1 respectively.
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The procedure
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