Intradiscal electrothermal therapy in the treatment of chronic low back pain: experience with 93 patients.
BACKGROUND
Low back pain (LBP) has become a main cause of absenteeism and disability in industrialized societies. Chronic LBP is an important health issue in modern countries. Discogenic LBP is one of the causes of chronic low back pain. The management of chronic discogenic LBP has been limited to either conservative treatment or operative treatment. Intradiscal electrothermal therapy (IDET) is now being performed as an alternative treatment.


METHODS
Ninety-three consecutive patients undergoing IDET at 134 disc levels from October 2004 to January 2007 were prospectively evaluated. All patients had discogenic disease with chronic LBP, as determined by clinical features, physical examination and image studies, and had failed to improve with conservative treatment for at least 6 months. Follow-up period was from 1 week to 3 or more years postoperatively.


RESULTS
There were 50 male and 43 female patients, with a mean age of 46.07 years (range, 21-65 years). The results were classified as symptom free (100% improvement), better (≥50% improvement), slightly better (<50% improvement), unchanged and aggravated. Eighty-nine patients were followed up in the first week; of them, 77 (86.52%) patients had improvement (4, symptom free; 45, better; and 28, slightly better). The improvement rate gradually decreased to 80.90% in 1 year; and 73.91%, in 3 years.


CONCLUSIONS
In conclusion, IDET offers a safe, minimally invasive therapy option for carefully selected patients with chronic discogenic LBP who have not responded to conservative treatment. Although IDET appears to provide intermediate-term relief of pain, further studies with long-term follow-up are necessary.
Tsou
Hsi-Kai
HK
Department of Neurosurgery, Taichung Veterans General Hospital, 160 Sec3 Chung-Kang Road, Taichung - 407 05, Taiwan, R.O.C. tsouhsikai@yahoo.com
Chao
Shao-Ching
SC
Kao
Ting-Hsien
TH
Yiin
Jia-Jean
JJ
Hsu
Horng-Chaung
HC
Shen
Chiung-Chyi
CC
Chen
Hsien-Te
HT