Treatment of Discogenic Low Back Pain with Intradiscal Electrothermal Therapy (IDET): 24 Months Follow-Up in 50 Consecutive Patients

Assietti, Roberto; Morosi, Mario; Migliaccio, Giovanni; Meani, Luigi; Block, Jon E.

doi:10.1007/978-3-211-99370-5_15

Cited by 19 publications

(19 citation statements)

References 15 publications

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“…In some cohort studies, intradiscal electrothermal therapy was reported to have success rates as high as 75% 7980. The mechanism of action was believed to be a sort of thermal annealing of AF damage as well as thermal disruption of nerve fibers.…”

Section: Implication For Treatmentsmentioning

confidence: 99%

Mechanisms of Intervertebral Disk Degeneration/Injury and Pain: A Review

Ito

Creemers

2013

Global Spine Journal

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Degeneration of the intervertebral disk and its treatments are currently intensely investigated topics. Back pain is a condition whose chronic and debilitating nature combined with its prevalence make it a major health issue of substantial socioeconomic importance. Although researchers, and even sometimes clinicians, focus on the degenerated disk as the problem, to most patients, pain is the factor that limits their function and impacts their well-being. The purpose of this review is to delineate the changes associated with disk degeneration and to outline mechanisms by which they could be the source of back pain. Although the healthy disk is only innervated in the external layer of its annulus fibrosus, adjacent structures are plentiful with nociceptive receptors. Stimulation of such structures as a consequence of processes initiated by disk degeneration is explored. The concept of discogenic pain and possible mechanisms such as neoinnervation and solute transport are discussed. Finally, how such pain mechanisms may relate to current and proposed treatment strategies is discussed.

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Section: Implication For Treatmentsmentioning

confidence: 99%

Mechanisms of Intervertebral Disk Degeneration/Injury and Pain: A Review

Ito

Creemers

2013

Global Spine Journal

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“…The goal of all these techniques is to close the gap between failed conservative treatment and open surgery, especially for contained herniated discs. 16 – 27 …”

Section: Introductionmentioning

confidence: 99%

Treatment of contained lumbar disc herniations using radiofrequency assisted micro-tubular decompression and nucleotomy: four year prospective study results

Hellinger

2014

Int J Spine Surg

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BackgroundPatients with radiculopathy caused by contained disc herniations are less likely to have good outcomes following discectomy surgery than patients with disc herniations that are not contained. The author presents his 4-year results from a prospective trial regarding the efficacy and safety of a tubular transforaminal radiofrequency-assisted manual decompression and annulus modulation of contained disc herniations in 58 patients.MethodsFifty-eight patients with lumbar radiculopathy due to a contained disc herniation were enrolled in a prospective clinical study. Visual analog scores (VAS) for back pain and leg pain, quality of life assessment, Macnab criteria, and SF-12 were collected from patients before treatment, at 2-years and 4-years post-treatment.ResultsAt 4 years, results were obtained from 47 (81%) of patients. Compared to mean pre- treatment assessments, mean 4-year VAS for back pain improved from 8.6 to 2.3 points, and mean VAS for leg pain improved from 7.8 to 2.3. Eighty-three percent of respondents reported that they were “satisfied” or “very satisifed” with their quality of life at 4-years as per SF-12. At 4 years, recurrence was noted in 3 (6.4%) of respondents and no complications were reported.ConclusionsThe 2-year and 4-year study results are nearly identical, suggesting durable benefit out to 4 years. These results also suggest that in carefully selected patients with sustained contained disc herniations who have failed conservative treatments, manual decompression combined with radiofrequency-assisted decompression and annulus modulation are very likely to have good outcomes 4 years post-treatment.

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“…Several minimally invasive methods have been proposed for the management of pain 9, 10. Intradiscal electrothermal therapy involves ablation of the nociceptive receptors in the ligaments and annulus fibrosus by heat 11, 12; however, with the complete elimination of pain, the removal of the pain receptors also results in the loss of the indicator role of pain. Disc protrusion caused by uncontrolled mechanical loading by the patient can lead to nerve damage or function loss at the innervated field by increasing the pressure in the nucleus pulposus 13.…”

Section: Introductionmentioning

confidence: 99%

Marital Status and Outcome of Patients Presenting with Acute Coronary Syndrome: An Observational Report

Khafaji

Habib

Asaad

et al. 2012

Clinical Cardiology

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Background & hypothesis:Data on the clinical characteristics and outcome of patients presenting with acute coronary syndrome (ACS) according to their marital status is not clear.Methods:A total of 5334 patients presenting with ACS in 65 hospitals in 6 Middle East countries in the 2nd Gulf Registry of Acute Coronary Events (Gulf RACE‐2) were studied according to their marital status (5024 married, 100 single, and 210 widowed patients).Result:When compared to married patients, widowed patients were older and more likely to be female. Widowed patients were more likely to have diabetes mellitus, hypertension, history of heart failure, and peripheral vascular disease and were less likely to be tobacco users when compared to the other groups. Widowed patients were also more likely to present with atypical symptoms and have advanced Killip class. Widowed patients were more likely to present with non‐ST‐elevation myocardial infarction (NSTEMI) when compared to the other 2 groups. Widowed patients were more likely to have heart failure (P = 0.001), cardiogenic shock (P = 0.001), and major bleeding (P = 0.002) when compared to the other groups. No statistically significant difference was observed in regard to duration of hospital stay, door to needle time in STEMI patients, or cardiac arrhythmias between the various groups. Widowed patients had higher in‐hospital, 30‐day, and 1‐year mortality rates (P = 0.001). Marital status was an independent predictor for in‐hospital mortality.Conclusion:Widowed marital status was associated with worse cardiovascular risk profile, and worse in‐hospital and 1‐year outcome. Future work should be focused on whether the provision of psychosocial support will result in improved outcomes among this high‐risk group. Clin. Cardiol. 2011 DOI: 10.1002/clc.22034Gulf RACE is a Gulf Heart Association (GHA) project and was financially supported by the GHA, Sanofi Aventis, and the College of Medicine Research Center at King Khalid University Hospital, King Saud University, and Riyadh, Saudi Arabia.The authors have no other funding, financial relationships, or conflicts of interest to disclose.

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Treatment of Discogenic Low Back Pain with Intradiscal Electrothermal Therapy (IDET): 24 Months Follow-Up in 50 Consecutive Patients

Abstract: The findings of this study suggest that durable clinical improvements can be realized after IDET in highly selected patients with mild disc degeneration, confirmatory imaging evidence of annular disruption and concordant pain provocation by low pressure discography.

Cited by 19 publications

References 15 publications

Mechanisms of Intervertebral Disk Degeneration/Injury and Pain: A Review

Mechanisms of Intervertebral Disk Degeneration/Injury and Pain: A Review

Treatment of contained lumbar disc herniations using radiofrequency assisted micro-tubular decompression and nucleotomy: four year prospective study results

Marital Status and Outcome of Patients Presenting with Acute Coronary Syndrome: An Observational Report

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