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Surgery
IDET |
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Intradiscal Electrothermal Therapy (IDET) is a
relatively new procedure, developed over the last few years. It is designed to treat one
of several conditions that affect the inter-vertebral discs, namely:
- small herniations
- internal disc tears
- mild disc degeneration, limited to one or two levels
During the procedure, an electrothermal catheter (or heating wire) is inserted into the
painful disc region; the tip of the wire is then heated to 90°C for up to 15 minutes. The
resulting heat causes the outer wall of the disc to thicken and contract, thereby
promoting the closure of small tears in the wall; the heat also burns the nerve endings
around the tip of the wire, making them less sensitive.
Typically, the procedure involves the following steps (under local anaesthetic):
- a hollow needle is inserted into the wall of the painful disc
- an electrothermal catheter (or heating wire) is passed through the needle and positioned
near the herniation
- the tip of the wire is then heated to 90°C for up to 15 minutes
- the heat causes the wall of the disc to thicken, and burns the nerve endings around the
tip of the wire
- the catheter is then removed, along with the needle
- a lumbar support is worn for up to eight weeks following the procedure
- a course of physical therapy is then recommended
- lifting and bending should be restricted during this time
There are a number of conditions that preclude the use of IDET, usually because
they’re made worse by the procedure (the medical term for these is
contra-indications). The contra-indications for IDET include:
- severe disc degeneration
- spinal stenosis
- neurological symptoms (e.g. weakness in the leg)
- large disc herniations
- short leg syndrome
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Efficacy
Of all the operations one can have on the back, IDET is one of the least invasive –
scar tissue and adhesions are likely to form, but, compared to those formed in open
surgery, their impact will be limited. However, IDET does not treat the cause of
the problem.
In practice, every condition associated with the intervertebral discs is caused by
mechanical stress. Tears and herniations are caused by compression of the spine, although
the disc itself may have been weakened by degeneration. Cauterising (or burning) the disc
may repair some of these effects, but it won’t reduce any of the mechanical forces
present, nor will it slow degeneration.
IDET may weaken the spine and leave it more susceptible to injury, although again, the
effects are noticeably reduced compared to open surgery. |
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Conclusions
Of all the operations on the spine, IDET is probably the least invasive – it
therefore carries the least risk. In our opinion, however, IDET isn’t necessary.
Instead, we believe the correct approach is to decompress, or mobilise, the spine using
completely non invasive techniques – techniques that are based on orthopaedic medicine.
Most, if not all, problems associated with the spinal discs can be successfully treated by
non invasive, mechanical decompression. |
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To receive non-invasive
treatment, you can visit our Back Pain Clinic.
You can also receive a Free Diagnosis
(online). For those people who can neither afford personal treatment, nor make the trip to
London, we recommend that you purchase a backrack.
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Price
IDET: approximately £15,000.
Usually paid by the NHS or private insurance; complications during/after surgery will
result in additional cost. |
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