DET or intradiscal electrothermal therapy is an advanced pain management technique employed in the treatment of discogenic pain. Successful outcomes ranged from 70 to 80% when strict selection criteria are followed. Discogenic pain refers to pain emanating from the disk itself. This type of pain is frequently described as a constant, severe, localized low back pain. Characteristics include sitting intolerance and exacerbation with lumbar flexion.

The cause of discogenic pain is a tear in the outer fibrous lining of the disc called the annulus. The annulus is richly supplied with nerve fibers and when disrupted by a tear can cause debilitating axial back pain. Occasionally inflammatory substances from the inner disc material - the nucleus pulposus - will leak through the tear and irritate nerve roots causing radicular or radiating leg pain.

The diagnosis of discogenic pain requires provocative discography. Reproduction of the patient's symptoms during the discogram with correlation of an annular tear on post discogram CT scan of the spine is necessary to confirm the diagnosis of discogenic pain.

Once the diagnosis of discogenic pain has been made the IDET procedure can be performed to treat the pain at its source. Prior to the development of the IDET procedure, spinal fusion surgery was the only option available to treat this chronic pain problem.

The IDET procedure is performed on an outpatient basis under sedation. A wire is threaded along the inner wall of the annulus under fluoroscopic guidance. After confirmation of accurate wire placement, the wire is heated up to "shrink wrap" the disc and seal the tear.

The recovery period ranges from several weeks to months and is frequently followed by physical therapy reconditioning. This outpatient treatment is minimally invasive, cost-effective, and very successful when used for the appropriate patient population.



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