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Intradiscal Electrothermal Annuloplasty

Chou, Larry H. MD; Lew, Henry L. MD, PhD; Coelho, Paul C. MD; Slipman, Curtis W. MD

American Journal of Physical Medicine & Rehabilitation: July 2005 - Volume 84 - Issue 7 - p 538-549
doi: 10.1097/01.phm.0000167231.31541.f1
Invited Review: Back Pain
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Chou LH, Lew HL, Coelho PC, Slipman CW: Intradiscal electrothermal annuloplasty. Am J Phys Med Rehabil 2005;84:538–549.

Low back pain is a common problem, and although the majority of cases of low back pain resolve, a subset of patients will continue to have intractable pain despite appropriate conservative treatments. Intradiscal electrothermal annuloplasty is a minimally invasive spinal procedure that has been proposed to treat provocation discography–proven internal disk disruption syndrome. The early uncontrolled and nonrandomized intradiscal electrothermal annuloplasty literature suggests it may provide some relief in a small proportion of strictly defined patients; however, more recent randomized, placebo-controlled trials have not substantiated these initial findings. This article will review the published literature, indications, contraindications, safety, and efficacy of the intradiscal electrothermal annuloplasty procedure for the treatment of chronic, intractable, axial back pain.

From Sports and Spine Rehabilitation, Department of Physical Medicine and Rehabilitation, Penn Medicine at Radnor, University of Pennsylvania, Radnor, Pennsylvania (LHC); Stanford University School of Medicine, Comprehensive Rehabilitation Center, VAPAHCS, Physical Medicine and Rehabilitation, Palo Alto, California (HLL); Interventional Physiatry, Kaiser Permanente, Richmond, California (PCC); and Penn Spine Center, Department of Physical Medicine and Rehabilitation, University of Pennsylvania, Philadelphia, Pennsylvania (CWS).

All correspondence and requests for reprints should be addressed to Larry H. Chou, MD, Sports and Spine Rehabilitation, Penn Medicine at Radnor, Penn Medicine–Radnor, 250 King of Prussia Road, Radnor, PA 19087.

© 2005 Lippincott Williams & Wilkins, Inc.