Institutional members access full text with Ovid®

Share this article on:

The IDET Procedure for Chronic Discogenic Low Back Pain

Davis, Timothy T. MD*; Delamarter, Rick B. MD*; Sra, Parveen MPH*; Goldstein, Theodore B. MD

doi: 10.1097/01.BRS.0000119403.11472.40
Case Series

Study Design. Retrospective study with independent evaluation of patient outcomes approximately 1 year post-intradiscal electrothermal therapy (IDET).

Objective. To assess functional status, symptoms, and subsequent treatments of patients treated with IDET.

Summary of Background Data. IDET was introduced as a procedure for discogenic pain. Several studies reported improvement in >70% of patients.

Methods. Seventeen physicians referred 60 patients. Each patient had a positive discogram and had been treated with IDET. Patients were contacted approximately 1 year post-IDET, answered a telephone interview, and completed a self-administered questionnaire. Overall patient satisfaction, pain, functional and work status, analgesic usage, and subsequent treatments were noted. Kaplan-Meier survival curve was generated to predict the percentage that would undergo lumbar surgery after IDET.

Results. Average age was 40 years (range 25–64 years) with 66% males and 34% females. Of the 44 patients who responded, 6 patients had a lumbar surgery within 1 year. Their outcomes were excluded from descriptive analysis; 97% continued to have back pain, 11 (29%) reported more pain post versus pre-IDET, 15 (39%) had less pain, and 11 (29%) reported no change; 11 (29%) reported using more pain medication post-IDET, 10 (26%) used the same, 12 (32%) used less, and 5 (13%) used none; 19 (50%) were dissatisfied with IDET, 14 (37%) were satisfied, and 5 (13%) were undecided; 20 (53%) would have the procedure again, 12 (31%) would not, and 6 (16%) were unsure. Most patients wore a brace >6 hours/day after surgery (duration 1–15 months). Sixteen (42%) were employed full-time pre-IDET and 11 (29%) were employed full-time post-IDET.

Conclusion. At 1-year post-IDET, half of patients were dissatisfied with their outcome. The percentage of patients on disability remained constant. The estimated proportion of patients undergoing fusion was predicted to be 15% at 1 year and 30% at 2 years.

An independent evaluation of the post-intradiscal electrothermal therapy (IDET) procedure for discogenic back pain found that 58% of patients reported more or the same amount of pain at 1 year postprocedure compared to preprocedure. Thirty-seven percent of the patients were satisfied with the results of IDET and 14% of patients had a subsequent fusion for treatment of their pain within 1 year.

*Spine Institute at Saint John’s Health Center, Santa Monica, CA; and

†California Orthopaedics and Rehabilitation, Beverly Hills, CA.

Acknowledgment date: October 25, 2002.

First revision date: May 1, 2003.

Acceptance date: June 25, 2003.

The device(s)/drug(s) is/are FDA-approved or approved by corresponding national agency for this indication.

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence to Timothy T. Davis, MD, Spine Institute, 1301 20th Street, Suite 400, Santa Monica, CA 90404; E-mail: tdavis@espineinstitute.com

© 2004 Lippincott Williams & Wilkins, Inc.