Minimally Invasive IDET Procedure

IDET is the acronym for Intradiscal Electrothermoplasty; a type of minimally invasive spine surgery performed to treat low back discogenic pain.  Discogenic pain is caused by a damaged intervertebral disc, often as a consequence of lumbar degenerative disc disease.

Which disc is causing my pain?

MRI studies are obtained before your discography is performed and provide much information about your disc(s), although pain cannot be seen.  Discography may briefly replicate your pain, which helps to identify which disc is generating pain. Discography involves injecting a contrast agent (dye) into one (or more) of your intervertebral discs.  Although you are awake during a discography, you receive calming medication through your intravenous line. The entire procedure is performed in an outpatient setting using fluoroscopy (CT scans in real time).

IDET surgery for treating damaged discs

Bulging Disc

Is IDET right for me?

Criteria to determine if IDET is right for you includes:

  • Non-surgical treatment (medication, spinal injections) is not adequate.
  • You are younger than 55 years.
  • The damaged disc is contained, meaning it is contained within the annulus fibrosus (i.e., bulging disc).
  • Discography is positive for discogenic pain.
  • Disc height is greater than 50%.
  • Back pain is greater than leg pain.
  • No facet joint problems.

Before your IDET procedure

Before surgery, you visit your primary care doctor or general practitioner to obtain a general health clearance.  This means your doctor has carefully evaluated your health in terms of undergoing surgery.  Your assessment may include blood tests, x-rays or other imaging studies, as well as special tests for existing medical problems (i.e., diabetes, heart disease).

Potential risks of IDET surgery

The risks of IDET and potential for complications are low.  Risks include disc infection, nerve root injury, and increased back pain.

IDET procedure

Intradiscal electrothermoplasty is performed as an outpatient. A local anesthetic and mild intravenous sedation is administered.  IDET involves inserting a flexible, hollow catheter into the damaged disc under fluoroscopy. The special catheter/electrode is similar to a thermal coil. During IDET, the coil is heated, and causes the disc to shrink. Free nerve endings around the disc are cauterized (burned), and small tears are sealed. The procedure stimulates your body to produce protein to strengthen the disc.

After IDET surgery

You are moved from the operating room into the recovery area.  Here, the nurses and medical staff closely monitor your vital signs with attention to managing post-operative pain.  You should expect some discomfort.  You may have pain at the incision site, occasional back muscle spasms, or other symptoms.  You wear a lumbar brace.

Discharge instructions include:

  • Schedule your post-operative appointment (call 281.446.3876).
  • Keep your incision dry and clean.
  • You may shower, but keep your incision covered and dry.
  • Rest; you will fatigue easily while your body heals.
  • Do not take a tub bath, go swimming, or sit in a hot tub or pool.
  • Begin physical therapy and/or exercise as instructed.
  • Take medications as prescribed.
  • Do not lift or carry anything heavier than a shoe.
  • Walking is encouraged.
  • Do not drive until cleared by your neurosurgeon.
  • Avoid riding in a car; short distances are permitted.
  • Do not smoke or use tobacco.
  • Eat well, your body needs nutritious food to heal.

Call your neurosurgeon’s office (281.446.3876)

  • Fever 101 degrees Fahrenheit or higher.
  • Redness and/or swelling around the incision site expands.
  • Change in the amount, odor or appearance of the incision drainage.
  • Incision pain increases.
  • Bowel or bladder dysfunction develops.
  • Genital area numbness develops.

Recovery from IDET at home

Your symptoms may increase the first couple of days after IDET.  Your neurosurgeon recommends an over-the-counter or prescription anti-inflammatory and pain medication.

  • It is necessary to wear the lumbar brace for about 6 weeks.
  • Physical therapy typically is started 8 to 12 weeks after an IDET procedure.
  • During this time, avoid lifting and bending.

We hope this information about IDET—intradiscal electrothermoplasty has answered your immediate questions.  Remember, your neurosurgeon is your most valuable source to answer your questions about symptoms, treatment and your healthcare.

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