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intradiscal electrothermal therapy

Standiford Helm Ii, Thomas T Simopoulos, Milan Stojanovic, Salahadin Abdi, Mohamed Ahamed El Terany
BACKGROUND: Discogenic low back is a distinct clinic entity characterized by pain arising from a damaged disc. The diagnosis is clouded by the controversy surrounding discography. The treatment options are limited, with unsatisfactory results from both conservative treatment and surgery. Multiple interventional therapies have been developed to treat discogenic pain, but most have not yet been validated by high quality studies.The best studied treatment for discogenic pain is the use of heat, which has been labeled as thermal intradiscal procedures (TIPs) by the Centers for Medicare and Medicaid Services (CMS)...
September 2017: Pain Physician
Eugena Stamuli, Withawin Kesornsak, Michael P Grevitt, John Posnett, Karl Claxton
STUDY DESIGN: Cost-effectiveness analysis. OBJECTIVE: To evaluate the cost-effectiveness of intradiscal electrothermal therapy (IDET) relative to circumferential lumbar fusion with femoral ring allograft (FRA) in the United Kingdom. SUMMARY OF BACKGROUND DATA: Circumferential lumbar fusion is an established treatment for discogenic low back pain. However, IDET could be a cost-effective treatment alternative as it can be carried out as a day case...
September 12, 2017: Pain Practice: the Official Journal of World Institute of Pain
Vuslat Kecik Bosnak, Ilkay Karaoglan, Ibrahim Erkutlu, Mustafa Namiduru
Intradiscal electrothermal therapy (IDET) is a method applied for treatment of pain caused by the disc and involves reaching spinal disc through a catheter under fluoroscopy and solidifying disc interior by heating. We retrospectively evaluated ten patients treated and followed up with diagnosis of nosocomial spondylodiscitis after IDET. Ten patients, to whom IDET was applied for low back pain treatment in a tertiary healthcare organization, came with complaints of fever and low back pain during postoperative process...
August 2017: JPMA. the Journal of the Pakistan Medical Association
Soonjoon Kim, Sun-Ho Lee, Eun-Sang Kim, Whan Eoh
A 42-year-old man was admitted to our hospital with complaints of low back pain and intermittent right thigh pain. Twelve weeks before admission, the patient received intradiscal electrothermal therapy (IDET) at a local hospital. The patient still reported low back pain after the procedure that was managed with narcotic analgesics. Follow-up magnetic resonance imaging (MRI) was performed, and his referring physician thought the likely diagnosis was spondylodiscitis at the L4-5 spinal segment with a small epidural abscess...
January 1, 2017: Journal of Korean Neurosurgical Society
Atilla Kircelli, Ilker Coven, Tufan Cansever, Erkin Sonmez, Cem Yilmaz
AIM: Intervertebral disc degeneration can cause severe low back pain. Intradiscal electrothermal therapy (IDET) is a minimally invasive treatment option for patients with symptomatic internal disc disruption unresponsive to conservative medical care. We aimed to evaluate 12-month pain and functional outcomes and predictors of clinical success in patients with discogenic back pain treated with IDET with respect to the Dallas Discogram Scale (DDS). MATERIAL AND METHODS: This was a retrospective analysis of patients undergoing IDET for low back pain from 2009 through 2014 at Baskent University, Department of Neurosurgery...
2017: Turkish Neurosurgery
Saeid Abrishamkar, Masih Kouchakzadeh, Ahmad Mirhosseini, Homayoun Tabesh, Majid Rezvani, Amir Moayednia, Babak Ganjeifar, Amir Mahabadi, Elham Yousefi, Ali Mehrabi Kooshki
BACKGROUND: Intervertebral disc herniation is a major cause of low back pain. Several treatment methods are available for lumbar disc herniation including Chemonucleolysis, open surgery, nucleoplasty, laser disc decompression, and intradiscal electrothermal therapy. The high prevalence of lumbar disc herniation necessitates a minimally invasive yet effective treatment method. In this study, we compared the outcomes of open surgery and nucleoplasty method in patients with single lumbar disc herniation...
December 2015: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
Young Lu, Javier Z Guzman, Devina Purmessur, James C Iatridis, Andrew C Hecht, Sheeraz A Qureshi, Samuel K Cho
STUDY DESIGN: Systematic review of the literature. OBJECTIVE: A systematic evaluation of the literature was performed to investigate current nonoperative management of the treatment of discogenic low back pain. SUMMARY OF BACKGROUND DATA: Back pain is a major health care concern with up to 39% being discogenic in origin according to one study. Nonoperative therapy is likely to be the initial treatment strategy for discogenic low back pain...
July 15, 2014: Spine
Laxmaiah Manchikanti, Sukdeb Datta, Richard Derby, Standiford Helm
The intradiscal electrothermal therapy (IDET) procedure is a minimally invasive technique designed to treat discogenic chronic low back pain. The debate surrounding IDET ranges from the concept of the procedure, the technique and patient selection, to its effectiveness. The procedure provides modest improvement; however, it is considered less invasive and destructive than other modalities of treatments available at the present time, and has lower cost. The effectiveness evidence is limited at the present time, but based on the results of six recently published positive single-arm studies, it appears that patients experienced a perceptible clinical benefit from the IDET procedure...
January 2011: Pain Management
Laxmaiah Manchikanti, Salahadin Abdi, Sairam Atluri, Ramsin M Benyamin, Mark V Boswell, Ricardo M Buenaventura, David A Bryce, Patricia A Burks, David L Caraway, Aaron K Calodney, Kimberly A Cash, Paul J Christo, Steven P Cohen, James Colson, Ann Conn, Harold Cordner, Sareta Coubarous, Sukdeb Datta, Timothy R Deer, Sudhir Diwan, Frank J E Falco, Bert Fellows, Stephanie Geffert, Jay S Grider, Sanjeeva Gupta, Haroon Hameed, Mariam Hameed, Hans Hansen, Standiford Helm, Jeffrey W Janata, Rafael Justiz, Alan D Kaye, Marion Lee, Kavita N Manchikanti, Carla D McManus, Obi Onyewu, Allan T Parr, Vikram B Patel, Gabor B Racz, Nalini Sehgal, Manohar Lal Sharma, Thomas T Simopoulos, Vijay Singh, Howard S Smith, Lee T Snook, John R Swicegood, Ricardo Vallejo, Stephen P Ward, Bradley W Wargo, Jie Zhu, Joshua A Hirsch
OBJECTIVE: To develop evidence-based clinical practice guidelines for interventional techniques in the diagnosis and treatment of chronic spinal pain. METHODOLOGY: Systematic assessment of the literature. EVIDENCE: I. Lumbar Spine • The evidence for accuracy of diagnostic selective nerve root blocks is limited; whereas for lumbar provocation discography, it is fair. • The evidence for diagnostic lumbar facet joint nerve blocks and diagnostic sacroiliac intraarticular injections is good with 75% to 100% pain relief as criterion standard with controlled local anesthetic or placebo blocks...
April 2013: Pain Physician
Harkiran Grewal, Bikramjit S Grewal, Rashita Patel
A variety of nonoperative interventions are available to treat back pain. Careful assessment, discussion, and planning need to be performed to individualize care to each patient. This article discusses good to fair evidence from randomized controlled trials that injection therapy, percutaneous intradiscal radiofrequency thermocoagulation, intradiscal electrothermal therapy, and prolotherapy are not effective. Evidence is poor from randomized controlled trials regarding local injections, Botox, and coblation nucleoplasty; however, with a focused approach, the right treatment can be provided for the right patient...
September 2012: Primary Care
Sei Fukui, Kazuhito Nitta, Narihito Iwashita, Hisashi Tomie, Shuichi Nosaka, Olav Rohof
BACKGROUND: We have developed an intradiscal pulsed radiofrequency (Disc PRF) technique, using Diskit II® needles (NeuroTherm, Wilmington, MA, USA), as a minimally invasive treatment option for chronic discogenic low back pain (LBP). The purpose of this study was to compare the representative outcomes of Disc PRF and Intradiscal Electrothermal Therapy (IDET) in terms of pain relief and reduction of disability. METHODS: Thirty-one patients with chronic discogenic LBP who underwent either Disc PRF (n = 15) or IDET (n = 16) were enrolled in the study...
July 2012: Korean Journal of Pain
Standiford Helm Ii, Timothy R Deer, Laxmaiah Manchikanti, Sukdeb Datta, Pradeep Chopra, Vijay Singh, Joshua A Hirsch
BACKGROUND: Persistent low back pain refractory to conservative treatment is a common problem that leads to widespread impairment, resulting in significant costs to society. The intervertebral disc is a major source of persistent low back pain. Technologies developed to treat this problem, including various surgical instrumentation and fusion techniques, have not reliably provided satisfactory results in terms of either pain relief or increased function. Thermal annular procedures (TAPs) were first developed in the late 1990s in an attempt to treat discogenic pain...
May 2012: Pain Physician
Sang Chul Lee
Severe discogenic pain including axial or radicular pain is not easy to treat properly. Although mechanical correction was made possible to some extent, the high incidence of failed back surgery syndrome frustrates both patients and physicians. For discogenic pain, like other disorders, pain management is the discipline of intervention, principally with the application of certain techniques, such as intradiscal electrothermal therapy, nucleoplasty, Dekompressor and targeted disc decompression (TDD). These techniques are simple to use, have low complication rates and seem to be effective...
March 2012: Acta Anaesthesiologica Taiwanica: Official Journal of the Taiwan Society of Anesthesiologists
Bernd Wegener, Kristina Rieskamp, Andreas Büttner, Venant Habiyambere, Christoph von Schultze-Pellangahr, Veronika Schaffer, Volkmar Jansson, Christof Birkenmaier
BACKGROUND: In 2000 the intradiscal electrothermal therapy (IDET) procedure for the treatment of discogenic pain was introduced. The technique involves the positioning of an intradiscal catheter with a temperature-controlled thermal resistive heating coil at the inner posterior annulus. The therapeutic mechanism of IDET combines the thermo-coagulation of native nociceptors and in-grown nonmyelinated nerve fibers with collagen shrinkage, stabilizing annular fissures. Thermal nerve root injuries were described with IDET...
January 2012: Pain Physician
Roger Chou
INTRODUCTION: Over 70% of people in developed countries develop low back pain (LBP) at some time. But recovery is not always favourable: 82% of non recent-onset patients still experience pain 1 year later. Many patients with chronic LBP who were initially told that their natural history was good spend months or years seeking relief. METHODS AND OUTCOMES: We conducted a systematic review and aimed to answer the following clinical questions: What are the effects of oral drug treatments? What are the effects of injection therapy? What are the effects of non-drug treatments? What are the effects of non-surgical and surgical treatments? We searched: Medline, Embase, The Cochrane Library, and other important databases up to April 2009 (Clinical Evidence reviews are updated periodically; please check our website for the most up-to-date version of this review)...
October 8, 2010: Clinical Evidence
Haktan Karaman, Adnan Tüfek, Gönül Ölmez Kavak, Sedat Kaya, Zeynep Baysal Yildirim, Ersin Uysal, Feyzi Celik
STUDY DESIGN: Prospective observational study. OBJECTIVE: Our aim is to investigate the efficacy and safety of TransDiscal Biacuplasty. SUMMARY OF BACKGROUND DATA: Chronic discogenic pain is one of the leading causes of low back pain; however, the condition is not helped by most non-invasive methods. The results of major surgical operations for these patients are unsatisfactory. Recently, attention has shifted to disk heating methods for treatment...
2010: International Journal of Medical Sciences
Roberto Assietti, Mario Morosi, Giovanni Migliaccio, Luigi Meani, Jon E Block
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)...
2011: Acta Neurochirurgica. Supplement
Qiao-dong Huang, Dai-gui Wei, Guo-dong Zhao, Chong-rong Gao
OBJECTIVE: To observe the clinical efficacy and complications of intradiscal electrothermal therapy for treatment of discogenic low back pain. METHODS: Forty patients with discogenic low back pain were treated with intradiscal electrothermal therapy, and the changes in the VAS, functional status and complications after the treatment were analyzed. RESULTS The VAS score was decreased and the functional status improved obviously after the treatment, which caused no severe complications...
October 2010: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
Hsi-Kai Tsou, Shao-Ching Chao, Ting-Hsien Kao, Jia-Jean Yiin, Horng-Chaung Hsu, Chiung-Chyi Shen, Hsien-Te Chen
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...
2010: Surgical Neurology International
Jan Willem Kallewaard, Michel A M B Terheggen, Gerbrand J Groen, Menno E Sluijter, Richard Derby, Leonardo Kapural, Nagy Mekhail, Maarten van Kleef
An estimated 40% of chronic lumbosacral spinal pain is attributed to the discus intervertebralis. Degenerative changes following loss of hydration of the nucleus pulposus lead to circumferential or radial tears within the annulus fibrosus. Annular tears within the outer annulus stimulate the ingrowth of blood vessels and accompanying nociceptors into the outer and occasionally inner annulus. Sensitization of these nociceptors by various inflammatory repair mechanisms may lead to chronic discogenic pain. The current criterion standard for diagnosing discogenic pain is pressure-controlled provocative discography using strict criteria and at least one negative control level...
November 2010: Pain Practice: the Official Journal of World Institute of Pain
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