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Intradiscal Electrothermal Therapy (IDET) Is a procedure for disc-related pain in the lower back and/or legs. A thermal treatment with the Intradiscal Catheter is intended to treat the protein wall of your disc and reduce the volume of disc material that causes nerve irritation. IDET is a minimally invasive procedure. Most likely you will be able to go home the same day. The procedure involves a wire (the catheter) which is guided into your disc through a needle. Once in place, it is heated for about 15 minutes. Then the catheter and needle are removed and you will be sent back to recovery.

How should I prepare for the procedure?
Unless otherwise instructed, you should not eat or drink anything 8 hours before the procedure. You should stop taking any blood thinners like aspirin, at least five days before the procedure. You can take all of your other medications except oral diabetic meds with a sip of water the morning of the procedure. Diabetics, please discuss with you physician regarding your other diabetic medications.

How is the procedure performed?
An IV will be placed in your arm and you will be given a light sedative. After you are in position on the table, x-ray equipment will identify the area affected. Your lower back skin and muscle tissue will then be numbed with local anesthetic. Your physician will place a needle into your disc under x-ray guidance. Generally, you may experience mild discomfort during this part of the procedure. Once the needle is in the proper position, your physician may inject an x-ray dye into the disc for diagnostic purposes. This is known as discography. The next step is to insert the electrothermal treatment catheter through the needle. Patients typically do not feel any discomfort during this step. However, some patients have reported a mild discomfort in their back when the catheter moves through the disc. Then the catheter position is confirmed by x-ray, the heating element is activated. The heat is slowly increased and will last for 15-17 minutes. As the heat increases into the treatment range, you might experience your typical disc-related symptoms. Your physician will monitor your responses during the procedure to ensure that any pain you feel is well controlled. At the end of the procedure, a small bandage will be placed on your back, and you will rest in a recovery area until you are ready to go home.

What can I expect after the procedure?
In the first 3 days after your procedure, you may experience a moderate increase in your normal back pain. Rest, ice, pain medication, and anti-inflammatories will minimize possible discomfort during this time. Non-steroidal anti-inflammatories are okay. Any unusual or new symptoms (for example, fever, rash, numbness) should be reported to your physician immediately by telephone. Do not expect your usual pre-procedure symptoms to immediately disappear. You should not exert yourself during this time, even if you experience a marked reduction in your usual pre-procedure pain, because exertion may negatively affect the overall outcome. NO housework, lifting or bending should be done. Short walks (15-20 minutes) are okay, but generally the first few days should be spent resting. You should discuss with your physician your plan to return to work. If your work is sedentary, you can typically return 1-5 days after the procedure. You will be given a prescription for a soft back brace to wear for 1 month. You will schedule follow-up visits with your physician for continuing assessment of your condition.

How long can the healing process take?
For the first month following the procedure, your disc continues to heal. You may begin to feel a reduction in pain. However, pain reduction may occur over 3-4 months. During the first month, you must treat your back carefully. Restrict bending, twisting, or heavy lifting. No sports activities including running, biking, golf, tennis, skiing, etc. Limit your sitting time to tolerance levels and limit long car rides and plane flights to only what is absolutely necessary. You do not have to abstain from sexual activity with your partner, but be careful not to exert your back. You may resume back exercises under your physician's guidance. Anti-inflammatory medications and/or pain medication may be prescribed if needed to control discomfort associated with your normal back pain. Icing 1-2 times per day for 15 minutes is advisable to reduce any low back discomfort.

What about rehabilitation exercises?
Your physician will guide you regarding rehabilitation exercises after your procedure. If you have been performing strenuous rehabilitation exercises before the procedure, you will not immediately return to that level of exercise, but to a more moderate level that will be gradually increased as you improve. Be sure to ask your physician for a post operative exercise program.

What can I expect long term?
In the 2nd , 3rd , and 4th months post-operatively, continue to maintain good body mechanics and do not bend or lift improperly. Your physician and physical therapist will help you advance your exercise program to improve your strength and flexibility. If you plan to return to athletic pursuits, special advanced training will probably help you achieve this goal. Your physician may allow you to resume traveling for work or pleasure and sporting activity 3-4 months after the procedure.