Treatment of chronic discogenic low back pain with intradiskal electrothermal therapy.
The treatment of chronic, nonradicular, discogenic low back pain remains controversial. The posterior anulus fibrosus appears to be a potential site of origin of the pain, which is mediated by nociceptors in the inner layers of the anulus. Diagnosis requires a thorough history, physical examination, and imaging protocol; provocative diskography is key. Nonsurgical treatment options have been limited to physical therapy and pharmacotherapy. Success rates of spinal fusion range from 39% to 96%. Reported therapeutic success rates of intradiskal electrothermal therapy, a possible intermediate treatment, range from 60% to 80%. Despite this apparent therapeutic effect, however, a more precise quantification of clinical benefits remains to be proved in randomized prospective trials.
Wetzel
F Todd
FT
Section of Orthopaedic Surgery and Rehabilitation Medicine and Anesthesia and Critical Care, University of Chicago Spine Center Chicago, IL, USA.
McNally
Thomas A
TA
D002404:Catheterization; D004599:Electric Stimulation Therapy; D006801:Humans; D006979:Hyperthermia, Induced; D007403:Intervertebral Disc; D007405:Intervertebral Disc Displacement / Q000150:complications* / Q000628:therapy*; D017116:Low Back Pain / Q000209:etiology* / Q000628:therapy*