Intradiskal electrothermal therapy: A preliminary histologic study

Shah, Rinoo V.; Lutz, Gregory E.; Lee, Joe; Doty, Stephen B.; Rodeo, Scott A.

doi:10.1053/apmr.2001.23897

Cited by 79 publications

(37 citation statements)

References 42 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…149 The clinical significance of collagen denaturation and coalescence remains unclear. There is no evidence indicating that these changes can stabilize the annulus and disc, even though IDET has not been found to destabilize the spinal motion segment in vitro.…”

Section: Idetmentioning

confidence: 99%

Diagnosis and Minimally Invasive Treatment of Lumbar Discogenic Pain – A Review of the Literature

Zhou

Abdi

2006

The Clinical Journal of Pain

View full text Add to dashboard Cite

Diagnosis and treatment of lumbar discogenic pain due to internal disc disruption (IDD) remains a challenge. It accounts for 39% of patients with low back pain. The mechanism of discogenic pain remains unclear and its clinical presentation is atypical. Magnetic resonance imaging (MRI) can find high-intensity zone as an indirect indication of IDD. However, relative low sensitivity (26.7% to 59%) and high false-positive (24%) and false-negative (38%) rates reduce the value of MRI in screening for the existence of painful IDD. Provocative discography can provide unique information about the pain source and the morphology of the disc. It may also provide information for selecting appropriate treatment for the painful annular tear. Adjunctive therapies, including nonsteroidal anti-inflammatory drugs, physical therapy, rehabilitation, antidepressants, antiepileptics, and acupuncture, have been used for low back pain. The value of these treatments for discogenic pain is yet to be established. Intradiscal steroid injection has not been proved to provide long-term benefits. Intradiscal electrothermal therapy may offer some pain relief for a group of well-selected patients. No benefits have been found for the intradiscal radiofrequency thermocoagulation. A block in the ramus communicans may interfere with the transition of painful information from the discs to the central nervous system. Disc cell transplantation is in the experimental stage. It has the potential to become a useful tool for the prevention and treatment of discogenic pain. Minimally invasive treatments provide alternatives for discogenic pain with the appeal of cost-effectiveness and, possibly, less long-term side effects. However, the value of most of these therapies is yet to be established. More basic science and clinical studies are needed to improve the clinical efficacy of minimally invasive treatments.

show abstract

Section: Idetmentioning

confidence: 99%

Diagnosis and Minimally Invasive Treatment of Lumbar Discogenic Pain – A Review of the Literature

Zhou

Abdi

2006

The Clinical Journal of Pain

View full text Add to dashboard Cite

show abstract

“…Others suggest that denaturation of collagen leads to a contraction of collagen and inevitable stiffening of the disc. 25 Destruction of nociceptors requires a temperature of 45°C, while collagen denaturation will not occur unless a tissue temperature of 60°C is reached. Kleinsteuck argues that these temperatures were not reliably achieved during the IDET procedure performed in his cadaveric study.…”

Section: Discussionmentioning

confidence: 99%

“…7 Still other studies suggest that IDET does increase temperatures sufficiently to induce collagen denaturation and coalescence. 25 Kleinstueck's cadaveric samples were tested ex vivo after being frozen and not under truly physiologic conditions. 14 He reports on global intradiscal temperatures including less clinically relevant areas such as the anterior annulus.…”

Section: Discussionmentioning

confidence: 99%

Does Intradiscal Electrothermal Therapy Denervate and Repair Experimentally Induced Posterolateral Annular Tears in an Animal Model?

Freeman

Walters

Moore

et al. 2003

Spine

View full text Add to dashboard Cite

Vascular granulation tissue and posterior annular neo-innervation was observed in the experimentally induced posterolateral annular lesion. IDET delivered at 90C in the sheep consistently heated the posterior annulus and the nucleus to a temperature normally associated with coagulation of nociceptors and collagen contraction. IDET did not denervate the posterior annular lesion. Thermal necrosis was observed within the inner annulus and adjacent nucleus from 6 weeks after IDET. The reported benefits from IDET appear to be related to factors other than denervation and repair.

show abstract

“…In DDS3-4-5 patients, mean ation of collagen fibers, cauterization of granulation tissue, and coagulation of nerve fibers (5,8,26,28). IDET produced sufficient temperatures to induce collagen denaturation and coalescence in human cadaveric lumbar discs (31).…”

Section: A B C D Ementioning

confidence: 99%

“…IDET produced sufficient temperatures to induce collagen denaturation and coalescence in human cadaveric lumbar discs (31). Freeman et al also showed adequate temperatures in an in vivo model to theoretically perform both coagulation of nociceptors and contraction of collagen (9,26).…”

Section: A B C D Ementioning

confidence: 99%

Patient selection and efficacy of intradiscal electrothermal therapy with respect to dallas discogram score

Kircelli

Çöven²,

Cansever³

et al. 2015

Turkish Neurosurgery

View full text Add to dashboard Cite

ABSTRACTatic annular tears can be treated percutaneously with the minimally invasive IDET procedure.Disc morphology was first defined by Adams et al., who showed the morphological view of the disc using a discogram (1). The extent and dimensions of the annular tear are thought to be more important than the disc degeneration itself as the basis for discogenic pain based on computed tomography (CT) discography studies.

show abstract

Intradiskal electrothermal therapy: A preliminary histologic study

Cited by 79 publications

References 42 publications

Diagnosis and Minimally Invasive Treatment of Lumbar Discogenic Pain – A Review of the Literature

Diagnosis and Minimally Invasive Treatment of Lumbar Discogenic Pain – A Review of the Literature

Does Intradiscal Electrothermal Therapy Denervate and Repair Experimentally Induced Posterolateral Annular Tears in an Animal Model?

Patient selection and efficacy of intradiscal electrothermal therapy with respect to dallas discogram score

Contact Info

Product

Resources

About