The IDET procedure for chronic discogenic low back pain.
METHODS
Retrospective study with independent evaluation of patient outcomes approximately 1 year post-intradiscal electrothermal therapy (IDET). OBJECTIVE.: To assess functional status, symptoms, and subsequent treatments of patients treated with IDET.


BACKGROUND
IDET was introduced as a procedure for discogenic pain. Several studies reported improvement in >70% of patients.


METHODS
Seventeen physicians referred 60 patients. Each patient had a positive discogram and had been treated with IDET. Patients were contacted approximately 1 year post-IDET, answered a telephone interview, and completed a self-administered questionnaire. Overall patient satisfaction, pain, functional and work status, analgesic usage, and subsequent treatments were noted. Kaplan-Meier survival curve was generated to predict the percentage that would undergo lumbar surgery after IDET.


RESULTS
Average age was 40 years (range 25-64 years) with 66% males and 34% females. Of the 44 patients who responded, 6 patients had a lumbar surgery within 1 year. Their outcomes were excluded from descriptive analysis; 97% continued to have back pain, 11 (29%) reported more pain post versus pre-IDET, 15 (39%) had less pain, and 11 (29%) reported no change; 11 (29%) reported using more pain medication post-IDET, 10 (26%) used the same, 12 (32%) used less, and 5 (13%) used none; 19 (50%) were dissatisfied with IDET, 14 (37%) were satisfied, and 5 (13%) were undecided; 20 (53%) would have the procedure again, 12 (31%) would not, and 6 (16%) were unsure. Most patients wore a brace >6 hours/day after surgery (duration 1-15 months). Sixteen (42%) were employed full-time pre-IDET and 11 (29%) were employed full-time post-IDET.


CONCLUSIONS
At 1-year post-IDET, half of patients were dissatisfied with their outcome. The percentage of patients on disability remained constant. The estimated proportion of patients undergoing fusion was predicted to be 15% at 1 year and 30% at 2 years.
Davis
Timothy T
TT
Spine Institute at Saint John's Health Center, Santa Monica, CA 90404, USA. tdavis@espineinstitute.com
Delamarter
Rick B
RB
Sra
Parveen
P
Goldstein
Theodore B
TB
D000328:Adult; D002908:Chronic Disease; D015331:Cohort Studies; D018450:Disease Progression; D004564:Electrocoagulation / Q000009:adverse effects / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000601:surgery / Q000628:therapy*; D017116:Low Back Pain / Q000209:etiology / Q000601:surgery / Q000628:therapy*; D008161:Lumbosacral Region; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000706:statistics & numerical data; D010147:Pain Measurement / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012017:Referral and Consultation; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016019:Survival Analysis; D017211:Treatment Failure; D016896:Treatment Outcome