Heat Treatment Gives Good Long-Term Results for Chronic Back Pain
Library: MED
Description: A nonsurgical procedure called "intradiscal electrothermal
therapy" provides lasting improvement for patients with chronic disc-related
back pain that does not respond to conventional treatments. (Spine,

Megan Keller
Lippincott Williams & Wilkins
(215) 521-8374


"Heat Treatment" Gives Good Long-Term Results for Chronic Back Pain

PHILADELPHIA, PA May 1, 2002 - A nonsurgical procedure called "intradiscal
electrothermal therapy" (IDET) provides lasting improvement for patients
with chronic disc-related back pain that does not respond to conventional
treatments, reports a study in the May 1 issue of the journal Spine.

Drs. Jeffrey A. Saal and Joel S. Saal of the SOAR Physiatry Medical Group in
Menlo Park, Calif., report on the two-year follow-up results in 58 patients
undergoing IDET. In the IDET procedure, the surgeon inserts a miniature
catheter with a heating element into the center of the degenerated disc
causing the patient's pain. Heat toughens and seals the disc, as well as
destroying any abnormal nerve endings.

With six months after IDET, the patients' pain scores decreased
significantly: from an average of 6.6 to 3.7 on a 0-to-10 scale. The
patients also had improvement in physical functioning. This included
improvement in the ability to tolerate sitting upright, which is one of the
most bothersome symptoms of disc degeneration. Average sitting time
increased from 33 to 48 minutes.

At two years' follow-up, the patients had further improvement in both pain
and physical functioning. Average pain scores had decreased to 3.4, while
sitting time increased to 85 minutes. IDET also brought improvements in
various aspects of quality of life, including emotional state and mental

Only about five percent of patients referred for evaluation of chronic low
back pain were candidates for IDET. All had "unremitting, persistent" low
back pain that did not improve with comprehensive treatment, including
medications, physical therapy, exercise, and steroid injection. The patients
had been in pain for an average of five years.

IDET was done using local anesthesia and did not require hospitalization.
None of the study patients had any complications.

IDET offers a new alternative to disc fusion surgery or potent narcotic
drugs for patients with chronic disc-related back pain. Drs. Saal and Saal,
among others, have previously reported promising short-term results with
IDET; the new study extends these good results through at least two years'

The long-term results are "reassuring," writes Dr. Timothy S. Carey of
University of North Carolina in an accompanying editorial. However, Dr.
Carey notes that many unanswered questions about IDET remain. He calls for a
definitive scientific study in which patients with "intractable" back pain
are randomly assigned to three treatment groups: IDET, surgery, or injected

Recognized internationally as the leading journal in its field, Spine
reports on today's most important diagnostic and therapeutic advances
regarding spinal pain, deformity, and disability. Distinguished by its broad
scope of coverage and emphasis on patient care, this popular biweekly has
earned must-read status in the orthopaedic community. For more information,
call 1-800-638-3030 or visit www.spinejournal.com.
Lippincott Williams & Wilkins (www.LWW.com) is a global publisher of
medical, nursing and allied health information resources in book, journal,
newsletter, looseleaf, and electronic media formats.


__________________________________________________ __
Maksim (Max) Bily
mail to : max777@sympatico.ca

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