Intradiscal Electrothermal Annuloplasty (IDET)

Intradiscal electrothermal annuloplasty, or IDET, is a procedure that can help alleviate discogenic pain – or pain that originates directly from an intervertebral disc.

The IDET technique – which is also called intervertebral disc annuloplasty or intradiscal electrothermic therapy – provides an alternative treatment to patients suffering from pain related to the spine’s intervertebral discs. Each intervertebral disc has a soft center – called the nucleus pulposus – that’s surrounded by a tough but flexible outer layer known as the annulus fibrosus. When healthy, these discs allow for complex motions, and act as shock absorbers for the multitude of pressures placed daily on our back and neck.

As we age, however, our discs can become weak and susceptible to tearing. A tear in the disc can cause fluids from inside the disc to leak out and irritate the nerves in the outer layer, sometimes causing pain.

During an intradiscal electrothermal annuloplasty, a surgeon inserts a probe (electrothermal catheter) into the patient’s affected disc. Once inside, the probe is slowly heated to 90 degrees Celsius (194 degrees Fahrenheit). The heat shrinks and thickens the disc wall’s collagen fibers to assist in the closing of the tear. Nerve endings within the disc are then cauterized to help block pain signals. The procedure lasts about one hour, and after a short observation period, the patient is able to go home. Studies have shown that IDET can relieve pain and improve mobility with a 50-60% success rate, but the healing process takes time.

You may have increased pain for a few days following the procedure, and physical therapy is always part of the recovery process. Relief of discogenic pain typically takes at least six weeks following IDET, and strenuous activities should be avoided for 5-6 months.

It is important to note that weakened discs also may lead to a bulging disc or ruptured disc, and intradiscal electrothermal annuloplasty is not used to treat these more serious issues. Likewise, severe disc deterioration or degenerative disc disease requires more extensive treatment than IDET can provide.

If you’re experiencing back or neck pain and your symptoms aren’t responding to conservative treatments as prescribed by your doctor, you may need more progressive procedures to return to a pain-free lifestyle. We perform minimally invasive treatments on an outpatient basis, with 87% of our patients reporting symptom relief within three months. Offering a quicker recuperation time and far fewer side effects than other procedures like open-back surgery, our progressive approach will have you back in the swing of things in no time.

When IDET is an appropriate procedure

• Back pain for at least 3 months

• No prior spine surgery at the affected level

• Abnormal disc seen on MRI

• Positive (concordant) discogram

How IDET is performed

IDET is performed as an outpatient procedure. The entire procedure uses only local anesthesia and some mild sedation. Using x-ray to guide the small probe into proper position, the IDET probe is place into the affected disc. Once positioned, the probe is slowly heated to about 90 degrees Celsius. It is maintained at this temperature for about five minutes. After the IDET is completed, the patient is monitored for a period of one or two hours. The patient is then sent home with instructions to rest and to avoid lifting, twisting, and bending.

Recovery from IDET

Patients often have mild pain for the first day or two following an IDET procedure. The symptoms are usually easily controlled with mild anti-inflammatory or pain medications. Improvement is commonly seen about 2-3 weeks after the procedure, but may take as long as 10-12 weeks, and rehabilitation exercises are started 8- 12 weeks after the IDET.

IDET Results

The results of studies show encouraging results for IDET. The most important aspect is ensuring the right patients are being selected for this treatment. Patients must fit the criteria as mentioned above in order to have the best chance at success. IDET is a minimally invasive safe procedure with few reported complications.  Most studies show about 60-80% of patients find significant improvement in the months following an IDET procedure, but if candidate are chosen carefully, the results could be much better.