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Qualitative Review Of Chronic Lower Back Pain Clinical Studies Finds Minimally Invasive Procedure Spares Patients From Spine Surgery


A systematic literature review of outcomes from 51 clinical studies and case series finds that the Intradiscal ELECTROTHERMAL* Therapy (IDET*) procedure would spare up to 65 percent of patients with chronic lower back pain from spinal fusion surgery. In addition, the study also found that IDET patients experienced similar outcome benefits when compared against spinal fusion. The study is published in the July issue of Pain Physician, the official journal of the American Society of Interventional Pain Physicians (ASIPP).


Study authors Dr. Gunnar B.J. Andersson, professor and chairman of orthopedic surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, and Dr. Nagy A. Mekhail, chairman, Department of Pain Management, Cleveland Clinic Foundation in Ohio, systematically reviewed 33 spinal fusion and 18 IDET procedure studies to extract and summarize data on patient characteristics, surgical methods and clinical outcomes.


Currently, spinal fusion is one of the most commonly performed surgeries for chronic lower back pain, however this study found that 14 percent of spinal fusion patients experienced complications, as compared to zero percent of patients undergoing the IDET procedure. Potential patient complications from spinal fusion include infection, bleeding, nerve injury, severe pain, and repeat operations.


"Patients with chronic lower back pain often must face the harsh reality that they do not have a good prognosis for recovery with conservative, non-operative management alone," said Dr. Andersson. "Consequently, a patient is confronted with the option of living with persistent back pain or electing to undergo invasive surgery.

This systematic review confirms what we've known for some time, that, for the properly selected patient, the IDET™ procedure is a viable alternative to spinal fusion."


The systematic review also demonstrates that direct costs associated with the IDET procedure have been estimated at $7,000 and the costs associated with spinal fusion have been reported in excess of $50,000. These estimates do not include costs associated with the management of postoperative complications, which can be substantial with spinal fusion.


"Based on the similar clinical improvements, such as pain severity and functional impairment, it is reasonable for physicians to consider the IDET procedure prior to considering spinal fusion surgery," said Dr. Mekhail.

Studies were selected if patients were diagnosed with disc degeneration or disruption and if follow-up outcome data included evaluations of back pain severity, functional impairment and/or health-related quality of life. Qualitative comparisons in outcomes were made between spinal fusion and the IDET procedure, as well as each intervention and non-operative conservative management.


About the IDET Procedure


Intradiscal ELECTROTHERMAL* Therapy (IDET) is a minimally invasive outpatient surgical procedure for patients suffering from chronic disc-related lower back pain who have failed a program of aggressive non-operative therapy. During the procedure, controlled levels of thermal heat are applied directly to the affected disc. The heat contracts and thickens the collagen fibers within the disc wall, cauterizing the tiny nerve endings that cause the pain and potentially closing the cracks and tears.

The IDET procedure can be performed in less than one hour, is safe and has a low incidence of complications. Since 1998, over 60 peer-reviewed articles have been published on the IDET procedure supporting the procedure's efficacy and safety.


For more information about the IDET procedure, please visit


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