AN EARLY EUROPEAN EXPERIENCE WITH IDET – AVERAGE FOLLOW UP OF 20 MONTHS

Abstract

A prospective series of patients undergoing intradiscal electrothermal therapy for treatment of lower back pain refractory to physiotherapy.

33 patients with a mean follow up of 16 months were assessed pre- and postoperatively at Mayday University Hospital between 1999–2001 using visual analogue scores and SF-36. These patients failed to show an improvement with physiotherapy and had no evidence of a significant disc prolapse according to MRI with their back pain being reproduced at one or more disc levels on provocative discography. All procedures were performed as day cases with a temperature of 90 degrees being reached in all patients.

Baseline and follow-up outcome measures indicated the SF-36 mean improvement of pcs to be 7.05 (P< 0.001) and the mean improvement of mcs 10.05 (P< 0.001) following IDET with a mean change of 1.5 in the visual analogue score. Overall 25 patients reported a noticeable improvement in their back pain symptoms with 3 patients recording worsening symptoms and the other 5 patients remaining unchanged

Surgical complications included 1 breakage of the catheter within the patient and a disc prolapse at the level of surgery that required subsequent discectomy. 30% of patients were noted to have a temporary foot drop postoperatively which was due to inadvertently performing a lumbar plexus block on infusion of local anaesthetic before catheter insertion. There was no reported discitis, deep infection or nerve root injury.

Patients with proven discogenic lower back pain that have not responded to physiotherapy have generally improved following IDET in this series. However, this improvement is not as dramatic as first indicated in preliminary studies and includes a small number of patients which noted a deterioration in their symptoms, one of which requiring a discectomy as a direct result of the procedure.