Abstract
PDF- 2003;6;443-448Intradiscal Electrothermal Therapy (IDET) for Treatment of Chronic Lumbar Discogenic Pain: A Minimum 2-Year Clinical Outcome Study
An Original Contribution
Michael S. Lee, MD, Grant Cooper, MD, Gregory E. Lutz, MD, Christopher Lutz, MD, and Hoyman M. Hong, MD.
Objective: To determine the long-term efficacy of IDET in the treatment of chronic lumbar discogenic pain. Design: Prospective case series clinical outcome study. Methods: IDET was performed on 62 consecutive patients with chronic discogenic pain of greater than 6 months duration and consecutively enrolled in a non-randomized prospective case series outcome study. Outcome measures included visual numeric pain scale (VNS) for low back (LB) and lower extremity (LE) pain, Roland-Morris disability scale (RM), and North American Spine Society (NASS) patient satisfaction index. Outcome success was defined as a change of more than 2 points on VNS and RM as well as a positive NASS satisfaction response. Data were collected at baseline and post-procedure at 1, 3, and 6 months and then annually for up to 4 years. Results: Fifty-one out of 62 patients (82%) were available for a minimum of 2-year follow-up. Average age was 41.4 years; average symptom duration was 46 months; and average follow-up was 34 months. Overall, there was statistically significant improvement in LB-VNS, RM, and LE pain scores of 3.2, 6.6, and 2.3 (p<0.001), respectively. Twenty-seven of 51 (53%) patients demonstrated clinically significant VNS and RM improvements of greater than 2. On NASS index, 63% (32/51) responded positively. Neither the number of disc levels treated nor the insurance status of patients made any difference in outcome. Conclusion: IDET appears to be an effective treatment for chronic lumbar discogenic pain in a well-selected group of patients with favorable long-term outcome. Keywords: Intradiscal, electrothermal treatment, lumbar discogenic pain