IDET is also called intradiscal electrothermal therapy or intradiscal electrothermal annuloplasty (IDEA). The procedure is a minimally invasive back surgery which is usually performed under local anesthetic.
The operation is generally recommended for patients with contained prolapsed discs, but is not indicated for patients who are suffering from ruptured discs or annular tears.
Intradiscal electrothermal therapy is one of the most popular of all modern back surgeries for disc pain syndromes. There are currently several types of the basic procedure, with many more procedural variations in development. In fact, some specialists are now using surgical electrotherapy to seal holes in ruptured disc tissues in an attempt to resolve chemical radiculitis concerns affecting local neurological tissues.
The area is numbed with local anesthetic and a thin catheter is inserted directly into the affected disc, through a tiny incision. The procedure is viewed using live spinal x-ray to monitor all the activities of the operation and improve the accuracy of each step.
The catheter is warmed up slowly, introducing heat directly into the nucleus pulposus of the disc. The heat breaks down the collagen in the nucleus, taking pressure off the bulging annulus fibrosus and causing the disc to shrink back to its original shape. The procedure takes about one hour and the patient is able to leave the hospital the same day.
Traditional use of intradiscal electrothermal treatment is not indicated for discs which are not structurally stable. When a hole or rupture exists in the disc structure, the procedure may not be effective and may even cause complications in rare instances.
After surgery, there are no special rehabilitation needs for most patients and conditions. However, successfully treated patients often find physical therapy to assist them in regaining physicality which may have been lost during the time they suffered from chronic pain.
The patient is advised to avoid positions or activities which place inordinate stress on the operated area of the spine. This may mean limits on physical activity for a period of about 6 to 8 weeks. The patient can expect full healing in about 4 months on average.
The procedure is not always permanent, as the disc can degenerate, herniate again or rupture, requiring additional treatment. However, this procedure does not contraindicate additional or more invasive back surgery solutions, should they become necessary.
This surgical approach is strikingly similar to the newer nucleoplasty technique. However, most doctors give the edge to nucleoplasty, as it is simply more precise. With intradiscal electrothermal therapy, sometimes too much disc material is removed. Other times, not enough disc material is removed. If both procedures are options for treatment, nucleoplasty may be a better choice, but your doctor will be able to make this recommendation based on the specific criteria of your case and diagnosis.
Some doctors are using newer variations on this operative technique to seal annular tears and kill off small nerves which are theorized to enter the disc and cause pain. This supposes discogenic pain, which is a speculative diagnostic theory at best, and demonstrates worse curative results than simple disc nucleus shrinkage.
However, being that the processes used in intradiscal electrothermal therapy are truly minimally damaging and moderately effective, alternative uses for the treatment are being developed regularly and may offer renewed treatment hopes for many back and neck pain patients.