Treatment of discogenic low back pain with Intradiscal Electrothermal Therapy (IDET): 24 months follow-up in 50 consecutive patients.
BACKGROUND
Degeneration of the intervertebral disc can be the source of severe low back pain. Intradiscal electrothermal therapy (IDET) is a minimally invasive treatment option for patients with symptomatic internal disc disruption nonresponsive to conservative medical care.


METHODS
Using MRI and discographic findings, 50 patients with lumbar discogenic pain were identified, underwent IDET treatment and were followed for 24 months. Outcomes included assessments of back pain severity by an 11-point numeric scale and back function by the Oswestry disability index (ODI).


RESULTS
There was an average 68 and 66% improvement in pain and ODI, respectively, between pre-treatment and 24 months (p < 0.0001 for both comparisons). The global clinical success rate was 78% (39 of 50). Clinical success was associated with discographic concordance (p < 0.0001), HIZ (p = 0.003), Pfirrmann grade (p = 0.0002), and percent annulus coverage (p < 0.0001).


CONCLUSIONS
The findings of this study suggest that durable clinical improvements can be realized after IDET in highly selected patients with mild disc degeneration, confirmatory imaging evidence of annular disruption and concordant pain provocation by low pressure discography.
Department of Neurosurgery Ospedale Fatebenefratelli E Oftalmico, Milano, Italy.
Roberto
R
Assietti
Mario
M
Morosi
Giovanni
G
Migliaccio
Luigi
L
Meani
Jon E
JE
Block
D004599:Electric Stimulation Therapy / Q000379:methods*; D005500:Follow-Up Studies; D006801:Humans; D006979:Hyperthermia, Induced / Q000379:methods*; D007405:Intervertebral Disc Displacement / Q000150:complications; D017116:Low Back Pain / Q000209:etiology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D010147:Pain Measurement; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome