The IDET procedure for chronic discogenic low back pain

Study Design. Retrospective study with independent evaluation of patient outcomes approximately 1 year post-intradiscal electrothermal therapy (IDET). Objective. To assess functional status, symptoms, and subsequent treatments of patients treated with IDET. Summary of Background Data. IDET was introduced as a procedure for discogenic pain. Several studies reported improvement in > 70% of patients. Methods. Seventeen physicians referred 60 patients. Each patient had a positive discogram and had been treated with IDET. Patients were contacted approximately 1 year post-IDET, answered a telephone interview, and completed a self-administered questionnaire. Overall patient satisfaction, pain, functional and work status, analgesic usage, and subsequent treatments were noted. Kaplan-Meier survival curve was generated to predict the percentage that would undergo lumbar surgery after IDET. Results. Average age was 40 years ( range 25 - 64 years) with 66% males and 34% females. Of the 44 patients who responded, 6 patients had a lumbar surgery within 1 year. Their outcomes were excluded from descriptive analysis; 97% continued to have back pain, 11 (29%) reported more pain post versus pre-IDET, 15 ( 39%) had less pain, and 11 ( 29%) reported no change; 11 ( 29%) reported using more pain medication post-IDET, 10 (26%) used the same, 12 (32%) used less, and 5 (13%) used none; 19 (50%) were dissatisfied with IDET, 14 (37%) were satisfied, and 5 ( 13%) were undecided; 20 (53%) would have the procedure again, 12 (31%) would not, and 6 (16%) were unsure. Most patients wore a brace > 6 hours/ day after surgery ( duration 1 - 15 months). Sixteen (42%) were employed full-time pre-IDET and 11 ( 29%) were employed full-time post-IDET. Conclusion. At 1-year post-IDET, half of patients were dissatisfied with their outcome. The percentage of patients on disability remained constant. The estimated proportion of patients undergoing fusion was predicted to be 15% at 1 year and 30% at 2 years.