Intradiscal electrothermal therapy (IDET) is a minimally invasive herniated disc surgery procedure sometimes also called intradiscal electrothermal annuloplasty (IDEA). This surgical technique has been used for many years as a method of treating certain types of herniated discs in various areas of the spine. IDET is an excellent alternative to discectomy and generally performs better over time with fewer risks for indicated patients.
This article will detail intradiscal electrothermy and how it can reduce the size and severity of some types of disc bulges.
The IDET procedure is performed as an outpatient surgery and patients generally are up and around immediately after the operation. The procedure takes about 45 minutes to 1 hour to perform and is usually done under fluoroscopy to better visualize the interior of the body.
The surgeon inserts a thin catheter directly into the bulging disc and then heats up the nucleus pulposus. This direct heat burns off some of the collagen molecules inside the disc nucleus, reducing pressure on the annulus fibrosus and causing the herniation to shrink in size.
Once the required amount of nucleus material has been treated effectively, the small incision is closed and the patient is free to go home. This is simple spinal surgery at its finest, causing the least amount of collateral damage as possible to healthy tissues.
This surgical solution is used only for contained disc herniations in which the annulus fibrosus remains completely intact. The doctor must rule out a ruptured disc or noticeable annular tear in order for this procedure to remain effective.
This procedure is older than the newer and improved nucleoplasty version. Although IDET is more common than nucleoplasty, I prefer the latter if a choice has to be made.
Remember, IDET might be a less invasive operation than open spinal surgery, but it is a surgery, nonetheless. All herniated disc surgeries should be a last resort once all possible conservative treatment modalities have failed. I would recommend nonsurgical spinal decompression virtually every time when compared to any type of surgical intervention.
Surgeons also use IDET to treat discogenic pain in some patients. In these cases, symptoms are thought to exist due to nerves entering the disc through tiny annular tears. This is a speculative use, but is growing in acceptance since the procedure is easy, fast and highly profitable. In these instances, the heat generated can disable these tiny nerves, enacting pain relief. In this regard, IDET can be considered a type of nerve ablation.
The IDET technique demonstrates acceptable results for relieving some types of disc pain, although numerous doctors feel this might be due to the placebo effect in some patients. This technique is usually used to treat mild to moderate disc bulges, which are typically not traditionally chronically symptomatic.
I investigated this procedure, as well as many others, during my worst times suffering from acute back pain. I hoped I would never have to endure any invasive treatment, and so far, I haven't. However, it is good to know these types of procedures exist, just in case.
If you are evaluating IDET, or any surgical technique, consider your options carefully, since any intervertebral procedure must be taken very seriously. While IDET is one of the least risky, there are still many possible negative effects to consider. Be sure to discuss all the potential risks with your surgeon in advance of deciding if this approach to care is right for you.