Intradiscal electrothermal therapy (IDET)

What is IDET?

Intradiscal electrothermal therapy (IDET) was developed in the late 1990s. Its purpose is to reduce low back pain caused by the lumbar disc. IDET is an outpatient procedure performed with local anesthesia and light sedation. This invasive procedure utilizes fluoroscopic (x-ray) guidance to thread an electrothermal catheter through a needle into the lumbar disc. When the catheter is in place, power is turned on and the disc is heated for 15 to 20 minutes. Patients return home the day of the procedure.

How does IDET work to reduce low back pain?

IDET presumably works by heating the outer layer of the disc where the pain receptors are located. The heat theoretically alters the collagen fibers within the disc and also destroys pain receptors located there. Pain relief has been reported within a few days of the procedure and up to six months following the procedure. The long-term side effects of this procedure on the disc are not known at this time.

Who is a candidate for IDET?

Low back pain due to a painful disc can often be successfully treated with therapeutic exercise, medications, manual therapy, epidural cortisone injection, bracing, and other pain management approaches. When pain continues despite these treatments, IDET might be an alternative prior to considering a surgical consultation. Some recent studies indicate that the potential benefits of IDET are limited to a very specific group of patients, and therefore this treatment is not likely to be used in a widespread manner.

Who performs IDET procedures?

Physicians who specialize in spine care may perform this procedure. These include physiatrists, anesthesiologists, radiologists, orthopedic spine surgeons, and neurosurgeons. Special training is necessary, and patients seeking this treatment option will need to inquire of the physician’s experience in performing IDET.