Intradiscal electrothermal therapy for chronic discogenic low back pain: a comparison of two heating protocols

Yıl 2018, Cilt: 4 Sayı: 3, 168 - 173, 04.07.2018

Korgün Ökmen Burcu Metin Ökmen

https://doi.org/10.18621/eurj.328117

Öz

Objectives. This study aims to
evaluate the effect of intradiscal electrothermal therapy (IDET) applied in
patients with chronic low back pain using two heating protocols. Methods.
In this study, data of 50
patients who were exposed to percutaneous IDET using two heating protocols were
retrospectively analyzed. The patients were divided into two groups: in Group 1
(n=25), maximum 75⁰C catheter tipping was used, while in Group 2
(n=25), maximum 90⁰C catheter tipping was performing. Pre-treatment
(M0) and post-treatment results at 3 (M3), 6 (M6), 12 (M12), and 18 months (M18)
were evaluated using the visual analogue acale (VAS), Oswestry disability index
(ODI), and short form-36 (SF-36) scores. Results. There was no statistically significant difference in demografic
characteristics and M0 VAS, ODI values and SF-36 dimensions of the patients between the groups (p > 0.05). It was found that there were statistically significant
improvement than baseline values in the M3, M6, M12, and M18 VAS, ODI, and
SF-36 scores in both treatment groups (p
< 0.05). Between the group
comparison; only the M18 VAS and SF-36 pain values were found statistically
significant in the positive direction in Group 2 (p < 0.05). Conclusion.
Similar successful
results were obtained in our study involving two different heating procedures
up to 12 months of administering IDET treatment. But at the 18^th
month the 90⁰C IDET seems to be more effective in improving the pain
scores. 

Anahtar Kelimeler

intradiscal electrothermal therapy, intradiscal treatment, chronic low back pain, intradiscal treatment

Kaynakça

• [1] Erdine S. Ağrı. Nobel Medical Publishers, 3rd ed. Istanbul, Nobel Medical Publishers 2007, chapter 52,:427-34.
• [2] Schwartzer AC, Aprill CN, Derby R, Fortin J, Kine G, Bogduk N. The prevelance and clinical features of internal disc disruption in patients with chronic low back pain. Spine (Phila Pa 1976) 1995;20:1878-83.
• [3] Freedman BA, Cohen SP, Kuklo TR, Lehman RA, Larkin P, Giuliani JR. Intradiscal electrothermal therapy (IDET) for chronic low back pain in active-duty soldiers: 2-year follow-up. Spine J 2003;3:502-9.
• [4] Ren L,Guo H, Zhang T, Han Z, Zhang L, Zeng Y. Efficacy evaluation of percutaneous laser disc decompression in the treatment of lumbar disc herniation. Photomed Laser Surg 2013;31:174-8.
• [5] Fukui S, Nitta K, Iwashita N, Tomie H, Nosaka S, Rohof O. Intradiscal pulsed radiofrequency for chronic lumbar discogenic low back pain Intradiscal: a one year prospective outcome study using discoblock for diagnosis. Pain Physician 2013;16:E435-42.
• [6] Saal JA, Saal JS, Ashley J. Targeted intradiscal thermal therapy: preliminary feasibility results; Presented at the anual meeting of the international society for the study of the lumbar spine; June 2-6, 1997; Singapore.
• [7] Saal JS, Saal JA. Management of chronic discogenic low back pain with a thermal intradiscal catheter. A preliminary report. Spine (Phila Pa 1976) 2000;25:382-8.
• [8] Saal JA, Saal JS. Intradiscal electrothermal treatment for chronic discogenic low back pain. A prospective outcome study with a minimum 1-year follow-up. Spine (Phila Pa 1976) 2000;25:2622-7.
• [9] Assietti R, Morosi M, Migliaccio G, Meani L, Block JE. Treatment of discogenic low back pain with Intradiscal Electrothermal Therapy (IDET): 24 months follow-up in 50 consecutive patients. Acta Neurochir Suppl 2011;108:103-5.
• [10] Andersson GB, Mekhail NA, Block JE. Treatment of intractable discogenic low back pain. A systematic review of spinal fusion and IDET. Pain Physician 2006;9:237-48.
• [11] Appleby D, Andersson G, Totta M. Meta-analysis of the efficacy and safety of intradiscal electrothermal therapy (IDET). Pain Med 2006;7:308-16.
• [12] Ackerman WE. Cauda eguina syndrome after intradiscal electrothermal therapy. Reg Anaesth Pain Med 2002;27:622.
• [13] Scholl BM, Theiss SM, Lopez-Ben R, Kraft M. Vertebral osteonecrosis related to intradiscal electrothermal therapy. A case report. Spine (Phila Pa 1976) 2003;28:E161-4.
• [14] Huskisson EC. Measurement of pain. Lancet 1974;2:1127-31.
• [15] Yakut E, Düger T, Oksüz C, Yörükan S, Ureten K, Turan D, et al. Validation of the Turkish version of the Oswestry Disability Index for patients with low back pain. Spine (Phila Pa 1976) 2004;29:581-5.
• [16] Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş A. Kısa Form-36’nın Türkçe Versiyonunun Güvenilirliği ve Geçerliliği. İlaç ve Tedavi Dergisi 1999;12:102-6.
• [17] Manchikanti L, Datta S, Derby R, Helm S. Intradiscal electrothermal therapy treatment for back pain. Pain Manag 2011;1:41-51.
• [18] Konno S, Olmarker K, Byrod G, Nordborg C, Strömqvist B, Rydevik B. The European Spine Society AcroMed Prize 1994. Acute thermal nerve root injury. Eur Spine J 1994;3:299-302.
• [19] Wegener B, Rieskamp K, Büttner A, Habiyambere V, von Schultze-Pellangahr C, Schaffer V, et al. Experimental evaluation of the risk of extradiscal thermal damage in intradiscal electrothermal therapy (IDET). Pain Physician 2012;15:E99-E106.
• [20] Bono CM, Iki K, Jalota A, Dawson K, Garfin SR. Temperatures within the lumbar disc and endplates during intradiscal electrothermal therapy: formulation of a predictive temperature map in relation to distance from the catheter. Spine (Phila Pa 1976) 2004; 29:1124-9; discussion 1130-1.
• [21] Kleinstueck FS, Diederich CJ, Nau WH, Puttlitz CM, Smith JA, Bradford DS, et al. Temperature and thermal dose distributions during intradiscal electrothermal therapy in the cadaveric lumbar spine. Spine (Phila Pa 1976) 2003;28:1700-8.
• [22] Derby R, Seo KS, Kazala K, Chen YC, Lee SH, Kim BJ. A factor analysis of lumbar intradiscal electrothermal annuloplasty outcomes. Spine J 2005;5:256-61.
• [23] Coppes MH, Marani E, Thomeer RT, Groen GJ. Innervation of ''painful'' lumbar discs. Spine (Phila Pa 1976) 1997;22: 2342-50.
• [24] Engin K. Biological rationale and clinical experience with hyperthermia. Control Clin Trials 1996;17:316-42.
• [25] Bogduk N, Lau P, Govind J, Karasek M. Intradiscal electrothermal therapy. Tech Reg Anesth Pain Manage 2005;9:25-34.