Surgical treatment options: IDET

IDET stands for intradiscal electrothermoplasty. It is a procedure that is intended to reduce or eliminate back pain caused by disc degeneration. IDET uses heat to seal cracks (called fissures) in the disc wall, thus reducing bulging of inner disc material. As the bulging is reduced, the impingement on adjacent nerve structures diminishes, and pain is expected to improve. It is usually performed on an outpatient basis using local anesthesia and mild sedation to reduce any discomfort during the procedure.

How does it work?

IDET involves the insertion of a needle into the damaged disc with the guidance of an x-ray machine. A special wire is then threaded down through the needle and into the disc. The wire is heated in order to destroy the small nerve fibers that have grown into the cracks of the disc. The heat also partially melts the annulus (the outer wall of the disc), which triggers the body to generate new proteins to strengthen the disc.

During the healing process, which can take anywhere from several weeks to several months, patients may continue to feel some discomfort. However, medications can be prescribed to reduce pain. Physical therapy will also be prescribed to help reduce pain and increase flexibility and spinal strength. In time, the pain is expected to decrease and the need for medications can be reduced or eliminated. Activity levels can then increase as well as a return to an active life.

Our View of IDET

The scientific evidence that IDET is effective is not convincing. There are instances when IDET appears to work effectively, and other cases where the results are disappointing. It appears that the results may deteriorate with time.

However, in instances where the procedure may be indicated, and when the patient is aware of IDET's limitations, this technique can be considered. Your physicians at the San Diego Center for Spinal Disorders will be pleased to discuss this option with you further.