Shivam
Pain Management
Centre
Help Line - 079-26301986, 26308976
     
     
 

IDET 


Indications
 

Intra Discal Electro Thermal Annuloplasty (IDET) is a recently developed technique for relief of discogenic pain

• Those with discogenic low back pain and mild sciatica that does not improve with six months of conservative therapy

• Chronic annular tears and small disc herniations causing persistent sciatica. 
 
 


Contra-indications 

• Severe and widespread disc degeneration 

• Spinal Stenosis 

• Large disc prolapses 

• Those with neurological leg weakness 

Technique

Disc Selection

• The appropriate disc is selected using MRI scans and the results from Provocation Discography

Technique

• A hollow needle is entered into the appropriate disc from the side using X-ray Guidance , under local anaesthetic, Through this hollow needle is inserted an electrode wire (heating wire) which has several centimeters of its tip bared, and the rest insulated. 

• The electrode wire is then curved around the inside of the disc within the nucleus pulposus, until it lies opposite the Posterior Annulus of the disc, usually where the annular tear is situated. Once the position is correct, the electrode wire is heated electrically. 

Mechanism

• Using electro-cautery deadens the nerve endings that supply the posterior annulus i.e. those that are transmitting the discogenic pain ."Cooking" the annulus also causes protein changes adjacent to a chronic Annular Tear, sealing up the hole, preventing leakage of inflammatory mediators into the epidural space, and reducing the sciatic pain in the leg(s). 

Complications 

• Infection 

• Bleeding