Potential Risks of IDET to the Discs
Intradiscal electrothermal therapy (IDET) is a fairly new way of treating relatively simple disc problems in the low back. IDET involves inserting a probe into the injured tissue and then superheating it. No one knows exactly how it works. But the scar tissue and healing process seem to relieve symptoms from some disc problems. The benefit is that IDET often helps people avoid more complicated spine surgeries.
There can be serious complications from IDET, as with any type of procedure done to the spine. Because IDET is still so new, there is little evidence about what kind of complications can occur. This is precisely why doctors published this case report of one patient.
The patient was a tall 29-year-old soldier who had more than two years of low back pain that radiated down his left thigh. The problem was identified as a "contained" herniated disc, meaning the disc material was bulging but hadn't squeezed out of the disc.
The problems were limited to two vertebrae in the lumbar spine. The pain continued despite all sorts of medications, physical therapy, and chiropractic treatments. Eventually his doctors did an IDET procedure. It went well with no complications, and the patient seemed to follow the rehabilitation plan. However, five days later he had worse low back pain and new pain all the way down to his left foot. Eventually the pain turned into leg weakness.
A new MRI scan showed a brand new problem: a large herniated disc that affected the nerve root in the low back. Eventually the patient needed a lumbar fusion surgery. After surgery the patient's pain went away, he got off pain medications, and he went back to work.
The authors cannot say for sure that the new disc herniation was caused by IDET. It might have been a preexisting condition that finally worsened on its own. However, the timing of the problem suggests that IDET either caused this new problem or aggravated a small problem the doctors didn't know about. The authors stress the need for studies of many patients to help doctors understand the possible risks of IDET.
Steven P. Cohen, et al. Case Report: A Giant Herniated Disc Following Intradiscal Electrothermal Therapy. In Journal of Spinal Disorders & Techniques. December 2002. Vol. 15. No. 6. Pp. 537-541.