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Understanding the anatomy of the back is the key in evaluating a person with back pain. The spine is positioned so that
individual vertebrae (bones of the spine) provide a flexible support structure while also protecting the spinal cord.
Separating each individual vertebrae are discs that act as cushions to minimize the impact that the spinal column
receives. The discs are designed to provide support, but are not as firm as the surrounding bone. The discs have a
tendency to herniate backwards through the outer segment and can cause irritation to adjacent nerves. Discs are made
of concentric layers of collagen (like the layers in an onion). The layers can tear and disc material can leak outside of the
disk causing nerve irritation. Small pain fibers can grow inside of discs and cause pain with everyday activities. Disk
disease is one of the most common causes of chronic back pain and accounts for approximately 10% of all low back pain
complaints.
Procedure
In IDET (intradiscal Electro-Thermal) Annuloplasty, your pain physician uses an innovative technology to generate heat in
order to destroy the painful nerves that are causing your pain. The entire procedure is done under a local anesthetic
(numbing agent) and a sedative. Your pain physician will inject a local anesthetic with a small needle to numb the area
first. Once the area is numb, a larger needle is placed in the affected disc and a catheter is advanced around the inside
of the disc using x-ray guidance.
The entire procedure takes less than an hour to complete and is done as an outpatient procedure. Upon completion, the
catheter and needle are removed and a Band-Aid is placed over the needle insertion site.
Benefits
Discogenic pain (pain caused by the disc) is a common cause of back pain. IDET therapy has several advantages for the
treatment of discogenic pain. It is a minimally invasive procedure with high success rates. No hospitalization is required
and the procedure is performed under local anesthetic rather than general anesthetic. There is little post-procedure
discomfort and you are able to quickly resume your normal activities. Another advantage to IDET is that the area treated
is controlled, minimizing the risk of damaging adjacent structures. Often the procedure will provide prolong relief of pain,
but if the pain recurs, this minimally invasive treatment may be repeated as many times as necessary.
Risks
As with all medications and surgical procedures, there is always a risk of complications.
With a minimal amount of risks, IDET is considered an appropriate treatment for many patients who suffer from back pain.
The most common complaint is mild irritation at the needle insertion site after the procedure anesthetic has worn off.
Other more serious and far less common complications include, bleeding, nerve damage, or infection. Many of these
risks are decreased with the use of sterile technique, being off blood-thinning medications, and x-ray guidance during the
procedure.
Outcome
Although there are many surgical and interventional options for back pain, the most commonly recommended methods
are conservative. These methods include interventional procedures, medications, physical therapy, cognitive behavioral
therapy, biofeedback, diet, exercise, and alternative techniques (Manchikanti 2007). Often, the pain does not respond to
conservative treatments and more advanced interventions like the IDET are required to control pain.
In a large study, the outcomes of multiple research trials evaluating the effectiveness of IDET were compared. The
patients that were studied all had low back pain of at least 3 months duration and had failed conservative care. Every
study suggested a positive outcome for the patients who had IDET treatment. These patients demonstrated an increase
in physical function and decreased levels of pain. The study concluded that pain resulting from disc disease may, not
only be reduced, but be diminished by IDET (Wetzel 2002). This is an extremely important concept for people dealing with
chronic back pain and more specifically discogenic pain. IDET has shown to not only provide a temporary pain relief
solution, but it can cease the pain from returning.
If you are suffering from chronic back pain that has been refractory to other treatments contact Arizona Pain Specialists
today to see if you can benefit from this modern treatment.
Articles
Evaluation of Lumbar Facet Joint Nerve Blocks in the Management of Chronic Low Back Pain: Preliminary Report of a
Randomized, Double-Blind Controlled Trial: Clinical Trial NCT00355914 Laxmaiah Manchikanti, MD, Kavita N.
Manchikanti, BA, Rajeev Manchukonda, BDS, Kimberly A. Cash, RT, Kim S. Damron, RN, Vidyasagar Pampati, MSc, and
Carla D. McManus, RN, BSN 2007;10;425-440.
The effect of uniform heating on the biomechanical properties of the intervertebral disc in a porcine model. Wang JC,
Kabo JM, Tsou PM, Halevi L, Shamie AN. Spine J. 2005 Jan-Feb;5(1):64-70.
Intradiscal electrothermal therapy used to manage chronic discogenic low back pain: new directions and interventions.
Wetzel FT, McNally TA, Phillips FM.Spine. 2002 Nov 15;27(22):2621-6
individual vertebrae (bones of the spine) provide a flexible support structure while also protecting the spinal cord.
Separating each individual vertebrae are discs that act as cushions to minimize the impact that the spinal column
receives. The discs are designed to provide support, but are not as firm as the surrounding bone. The discs have a
tendency to herniate backwards through the outer segment and can cause irritation to adjacent nerves. Discs are made
of concentric layers of collagen (like the layers in an onion). The layers can tear and disc material can leak outside of the
disk causing nerve irritation. Small pain fibers can grow inside of discs and cause pain with everyday activities. Disk
disease is one of the most common causes of chronic back pain and accounts for approximately 10% of all low back pain
complaints.
Procedure
In IDET (intradiscal Electro-Thermal) Annuloplasty, your pain physician uses an innovative technology to generate heat in
order to destroy the painful nerves that are causing your pain. The entire procedure is done under a local anesthetic
(numbing agent) and a sedative. Your pain physician will inject a local anesthetic with a small needle to numb the area
first. Once the area is numb, a larger needle is placed in the affected disc and a catheter is advanced around the inside
of the disc using x-ray guidance.
The entire procedure takes less than an hour to complete and is done as an outpatient procedure. Upon completion, the
catheter and needle are removed and a Band-Aid is placed over the needle insertion site.
Benefits
Discogenic pain (pain caused by the disc) is a common cause of back pain. IDET therapy has several advantages for the
treatment of discogenic pain. It is a minimally invasive procedure with high success rates. No hospitalization is required
and the procedure is performed under local anesthetic rather than general anesthetic. There is little post-procedure
discomfort and you are able to quickly resume your normal activities. Another advantage to IDET is that the area treated
is controlled, minimizing the risk of damaging adjacent structures. Often the procedure will provide prolong relief of pain,
but if the pain recurs, this minimally invasive treatment may be repeated as many times as necessary.
Risks
As with all medications and surgical procedures, there is always a risk of complications.
With a minimal amount of risks, IDET is considered an appropriate treatment for many patients who suffer from back pain.
The most common complaint is mild irritation at the needle insertion site after the procedure anesthetic has worn off.
Other more serious and far less common complications include, bleeding, nerve damage, or infection. Many of these
risks are decreased with the use of sterile technique, being off blood-thinning medications, and x-ray guidance during the
procedure.
Outcome
Although there are many surgical and interventional options for back pain, the most commonly recommended methods
are conservative. These methods include interventional procedures, medications, physical therapy, cognitive behavioral
therapy, biofeedback, diet, exercise, and alternative techniques (Manchikanti 2007). Often, the pain does not respond to
conservative treatments and more advanced interventions like the IDET are required to control pain.
In a large study, the outcomes of multiple research trials evaluating the effectiveness of IDET were compared. The
patients that were studied all had low back pain of at least 3 months duration and had failed conservative care. Every
study suggested a positive outcome for the patients who had IDET treatment. These patients demonstrated an increase
in physical function and decreased levels of pain. The study concluded that pain resulting from disc disease may, not
only be reduced, but be diminished by IDET (Wetzel 2002). This is an extremely important concept for people dealing with
chronic back pain and more specifically discogenic pain. IDET has shown to not only provide a temporary pain relief
solution, but it can cease the pain from returning.
If you are suffering from chronic back pain that has been refractory to other treatments contact Arizona Pain Specialists
today to see if you can benefit from this modern treatment.
Articles
Evaluation of Lumbar Facet Joint Nerve Blocks in the Management of Chronic Low Back Pain: Preliminary Report of a
Randomized, Double-Blind Controlled Trial: Clinical Trial NCT00355914 Laxmaiah Manchikanti, MD, Kavita N.
Manchikanti, BA, Rajeev Manchukonda, BDS, Kimberly A. Cash, RT, Kim S. Damron, RN, Vidyasagar Pampati, MSc, and
Carla D. McManus, RN, BSN 2007;10;425-440.
The effect of uniform heating on the biomechanical properties of the intervertebral disc in a porcine model. Wang JC,
Kabo JM, Tsou PM, Halevi L, Shamie AN. Spine J. 2005 Jan-Feb;5(1):64-70.
Intradiscal electrothermal therapy used to manage chronic discogenic low back pain: new directions and interventions.
Wetzel FT, McNally TA, Phillips FM.Spine. 2002 Nov 15;27(22):2621-6
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Arizona Pain Specialists can
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IDET (Intradiscal Electro-Thermal) Annuloplasty
by Nicole Berardoni M.D, Paul Lynch M.D, and Tory McJunkin M.D
IDET therapy is a modern technique for the treatment of back
pain originating from the intervertebral discs. IDET essentially is
inserting a probe into the painful disc and applying heat through
a catheter in the disc. This local effect causes the collagen
component of the disc to thicken and change form, therefore
destroying painful nerves located nearby the disc (Wang 2005).
by Nicole Berardoni M.D, Paul Lynch M.D, and Tory McJunkin M.D
IDET therapy is a modern technique for the treatment of back
pain originating from the intervertebral discs. IDET essentially is
inserting a probe into the painful disc and applying heat through
a catheter in the disc. This local effect causes the collagen
component of the disc to thicken and change form, therefore
destroying painful nerves located nearby the disc (Wang 2005).
Book I - Pain Syndromes
Chapter 1 Low Back Pain
Chapter 2 Neck Pain
Chapter 3 Cancer Pain
Chapter 4 Headaches
Chapter 5 Spinal Stenosis
Chapter 6 Sciatica
Chapter 7 Arthritis
Chapter 8 Fibromyalgia
Chapter 9 Motor Vehicle Injuries
Chapter 10 Complex Regional Pain
Syndrome
Chapter 11 Vertebral Body
Fractures
Chapter 12 Hip and Leg Pain
Chapter 13 Diabetic Peripheral
Neuropathy
Book II - Interventional Procedures
Chapter 14 Epidural Steroid
Injection
Chapter 15 Facet Injections/Medial
Branch Blocks
Chapter 16 Radiofrequency Ablation
Chapter 17 Spinal Cord Stimulator
Implants
Chapter 18 IntraDiscal
Electrothermal Therapy (IDET)
Chapter 19
Vertebroplasty/Kyphoplasty
Chapter 20 Discography
Chapter 21 Percutaneous
Discectomy
Chapter 22 Occipital Nerve Block
Chapter 23 Sympathetic Block
Chapter 24 Stellate Ganglion Block
Chapter 25 Intrathecal Pump
Implants
Chapter 26 Caudal Steroid Injection
Chapter 27 Adhesiolysis
Chapter 28 Cervical Steroid
Injection
Chapter 29 Sacroiliac Joint
Injections
Chapter 30 Celiac Plexus Block
Chapter 31 Head and Neck
Procedures
Chapter 32 Joint Injections
Chapter 33 Continuous Catheter
Nerve Blocks
Chapter 34 Peripheral Nerve
Stimulation/Field Stimulation
Chapter 35 Disc Denervation
Book III Other Treatments
Chapter 36 Medication Management
Chapter 37 Acupuncture
Chapter 38 Prolotherapy
Chapter 39 Botox
Chapter 40 Massage
Chapter 41 Alternative and
Complementary Medicines
Chapter 42 Exercise and Nutrition
Counseling
Chapter 43 Prayer
Chapter 44 Cognitive Behavioral
Therapy
Chapter 45 Group Therapy
Chapter 46 Biofeedback
Chapter 47 Chiropractic
Manipulations
Chapter 48 Vitamin Supplements
Chapter 49 Customized
Pharmaceutical Formulations
Chapter 50 Hormone Therapy
Frequently Asked Questions
Chapter 1 Low Back Pain
Chapter 2 Neck Pain
Chapter 3 Cancer Pain
Chapter 4 Headaches
Chapter 5 Spinal Stenosis
Chapter 6 Sciatica
Chapter 7 Arthritis
Chapter 8 Fibromyalgia
Chapter 9 Motor Vehicle Injuries
Chapter 10 Complex Regional Pain
Syndrome
Chapter 11 Vertebral Body
Fractures
Chapter 12 Hip and Leg Pain
Chapter 13 Diabetic Peripheral
Neuropathy
Book II - Interventional Procedures
Chapter 14 Epidural Steroid
Injection
Chapter 15 Facet Injections/Medial
Branch Blocks
Chapter 16 Radiofrequency Ablation
Chapter 17 Spinal Cord Stimulator
Implants
Chapter 18 IntraDiscal
Electrothermal Therapy (IDET)
Chapter 19
Vertebroplasty/Kyphoplasty
Chapter 20 Discography
Chapter 21 Percutaneous
Discectomy
Chapter 22 Occipital Nerve Block
Chapter 23 Sympathetic Block
Chapter 24 Stellate Ganglion Block
Chapter 25 Intrathecal Pump
Implants
Chapter 26 Caudal Steroid Injection
Chapter 27 Adhesiolysis
Chapter 28 Cervical Steroid
Injection
Chapter 29 Sacroiliac Joint
Injections
Chapter 30 Celiac Plexus Block
Chapter 31 Head and Neck
Procedures
Chapter 32 Joint Injections
Chapter 33 Continuous Catheter
Nerve Blocks
Chapter 34 Peripheral Nerve
Stimulation/Field Stimulation
Chapter 35 Disc Denervation
Book III Other Treatments
Chapter 36 Medication Management
Chapter 37 Acupuncture
Chapter 38 Prolotherapy
Chapter 39 Botox
Chapter 40 Massage
Chapter 41 Alternative and
Complementary Medicines
Chapter 42 Exercise and Nutrition
Counseling
Chapter 43 Prayer
Chapter 44 Cognitive Behavioral
Therapy
Chapter 45 Group Therapy
Chapter 46 Biofeedback
Chapter 47 Chiropractic
Manipulations
Chapter 48 Vitamin Supplements
Chapter 49 Customized
Pharmaceutical Formulations
Chapter 50 Hormone Therapy
Frequently Asked Questions