Two-year follow-up of a controlled trial of intradiscal electrothermal anuloplasty for chronic low back pain resulting from internal disc disruption.
BACKGROUND
On the basis of observational data, intradiscal electrothermal anuloplasty (IDETA) has been implemented as a treatment for back pain resulting from internal disc disruption.


OBJECTIVE
To assess the efficacy of IDETA.


METHODS
Prospective cohort study with comparison group and 2-year follow-up.


METHODS
Of 53 patients who satisfied the diagnostic criteria for internal disc disruption, 36 were allocated to a treatment group and 17 to a comparison group, according to whether their insurer approved treatment with IDETA.


METHODS
Outcomes were assessed in terms of relief of pain, return to work and use of opioids to treat persisting pain.


METHODS
The treatment group underwent IDETA. The comparison group underwent a conventional rehabilitation program. Outcomes were assessed at 3 months, 12 months and 2 years after treatment.


RESULTS
As a group, the comparison patients exhibited no significant improvement in their pain at any time. One was partially relieved, but no patient was completely relieved at either 12 or 24 months. The patients treated with IDETA exhibited significant improvements in their median pain scores, which were sustained at 12 and 24 months. At 24 months, 54% of these patients had achieved at least 50% relief of their pain, no longer used opioids and were at work. Seven patients (20%) were totally free of pain and at work at 24 months.


CONCLUSIONS
The long-term results of IDETA are stable and enduring. It is not universally successful, but 54% of patients can reduce their pain by half, and one in five patients can expect to achieve complete relief of their pain.
Newcastle Bone and Joint Institute, University of Newcastle, Royal Newcastle Hospital, Newcastle, New South Wales, 2300, Australia. mgillam@mail.newcastle.edu.au
Nikolai
N
Bogduk
Michael
M
Karasek
D000328:Adult; D002908:Chronic Disease; D017587:Diskectomy, Percutaneous / Q000379:methods; D004564:Electrocoagulation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D017116:Low Back Pain / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017060:Patient Satisfaction; D011336:Probability; D011446:Prospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome