Vertebral osteonecrosis associated with the use of intradiscal electrothermal therapy: a case report.
METHODS
This report describes a case of vertebral body osteonecrosis associated with the use of intradiscal electrothermal therapy.


OBJECTIVE
To alert clinicians to a previously unreported complication, vertebral body osteonecrosis, after an intradiscal electrothermal therapy procedure.


BACKGROUND
The intradiscal electrothermal therapy procedure is a new treatment that has been advocated in the management of chronic low back pain of discogenic origin. The intradiscal electrothermal therapy procedure uses a fluoroscopically guided thermal catheter to heat the intervertebral disc. A review of the literature regarding this procedure has not revealed osteonecrosis as a complication.


METHODS
The patient's work-up and postoperative course are documented, and all medical records were reviewed retrospectively.


RESULTS
The patient's pain had improved only minimally at initial follow-up after L5-S1 combined anterior and posterior spinal fusion, undertaken after intradiscal electrothermal therapy failure.


CONCLUSIONS
Intradiscal electrothermal therapy has gained increasing popularity in the treatment of discogenic low back pain, in large part because of its minimally invasive nature and perceived low risk for major complications. Previous reports in the literature have not noted any major complications associated with the proper use of this device. Clinicians should be advised that intradiscal electrothermal therapy can be associated with complications, which in the current case, led to osteonecrosis of the vertebral body.
Djurasovic
Mladen
M
Department of Orthopaedic Surgery, University of Louisville School of Medicine, Kenton D. Leatherman Spine Center, Louisville, Kentucky, USA.
Glassman
Steven D
SD
Dimar
John R
JR
Johnson
John R
JR
D000328:Adult; D003937:Diagnosis, Differential; D004564:Electrocoagulation / Q000009:adverse effects*; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000628:therapy*; D017116:Low Back Pain / Q000209:etiology; D008159:Lumbar Vertebrae / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D010019:Osteomyelitis / Q000175:diagnosis; D010020:Osteonecrosis / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D011859:Radiography; D013122:Spinal Diseases / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D013123:Spinal Fusion