Minimally invasive method of treating pain in diseases of the spine
Intradiscal electro thermal therapy (intradiscal electrothermic therapy - IET) - is a relatively new minimally invasive method of treating pain in diseases of the spine associated with the pathology of intervertebral discs. As you know, the pain associated with irritation of nerve roots coming from the spinal cord, bone structures or hernial protrusion of intervertebral discs. In this case, degeneration of the "outer ring" fibrous disc, through the defects of which begins to leave the nucleus pulposus. It starts to compress the nerve root, thus causing symptoms - pain, numbness and "tingling chills."
Prior to the IETis usually performed, this method of study as discography, whose purpose is to determine the exact pathology in a given intervertebral disk. Only after that the doctor can decide whether there is a need for intradiscal therapy electro thermal or not.
The procedure itself is carried out either IETunder local anesthesia, or under the influence of sedatives. Under fluoroscopy , which takes place in real time, the doctor inserts into the affected intervertebral disc, a hollow needle into the lumen of a catheter with a heating element. This catheter is installed in the outer layer of annulus fibrosus of the intervertebral disc, and then slowly heated to 90 degrees Celsius. Under the influence of this heat is a destruction of nerve fibers in the intervertebral disc, as well as strengthening its tissues. Small cracks in the thickness of the outer layer of the disc with a sort of "sealed". In addition, for the prevention of infectious and inflammatory complications, direct drive, or intravenous antibiotics.
What to expect after the procedure IET
Of course, pain relief after intradiscal therapy elektrotermalnoy does not occur immediately. In contrast, during the first 1-2 days after VET pain may even intensify. But this is a temporary phenomenon. After the procedure, Intradiscal electro thermal therapy is also recommended conducting physical therapy (exercise therapy). During the first month it could be walking and light stretching exercises of the muscles of spine. During the first 2-3 are advised to avoid heavy physical exertion, heavy lifting, excessive bending of the spine and long sitting. Sports activity is also postponed for a period of six months.
Why a elektrotermalnaya intradiscal therapy
Usually Intradiscal electro thermal therapy shows those patients in whom conservative therapy for 3-6 months has no effect. Intradiscal electro thermal therapy is not recommended for patients with severe degeneration of the intervertebral discs, spinal stenosis or spondylolisthesis.
How effective Intradiscal electro thermal therapy
Since its introduction into practice in 1990, the effectiveness of procedures for intradiscal therapy elektrotermalnoy evaluated in several small studies. Extensive studies of this method is not available, since in most cases, patients did not meet the criteria of evidence Intradiscal electro thermal therapy . Therefore, the current method of Intradiscal electro thermal therapy Possible complications and risks of Intradiscal electro thermal therapy
Generally, intradiscal therapy electro thermal rarely accompanied by complications. In one study, the method of Intradiscal electro thermal therapy , which involved 58 patients, there was no any complication. In another study, which involved 33 patients, complications occurred in 5 (15%) patients. This is mainly manifested in the increasing radicular pain, which, however, is well resisted treatment with epidural injections.
Although complications are rare in the Intradiscal electro thermal therapy , but they can be. Among them: Damage to the nerve root, Damage to the intervertebral disc, Infectious complication in the area of the disk.
What you need to know about the intradiscal therapy elektrotermalnoy
You should know in which cases the IET is shown, and in which - is contraindicated.
Indications for intradiscal therapy electro thermal:
Age less than 18 years.
Back pain attributed to disorder in the intervertebral disc, for at least 6 months.
Lack of improvement in symptoms of pain within 6 months after conservative treatment.
The pain mostly in the back, but not in the lower limbs.
Increased pain in the sitting position.
The defeat of the intervertebral disc is noted in the posterior part of its outer layer.
Contraindications to IET:
Ineligible, as specified above.
The presence of severe degeneration of the intervertebral disc.