Cervical spine IDET is a popular surgical procedure that is used to treat contained herniated intervertebral spacers in the neck. IDET has become a diverse category of invasive techniques, with many different procedural options now available. However, all of the approaches to care have certain treatment practices and goals in common. Intradiscal electrothermal therapy has been used for many years to successfully resolve many symptomatic disc pain concerns, including transient central stenosis, transient foraminal stenosis and transient lateral recess stenosis. Since IDET is minimally invasive in all of its many forms, well tolerated and generally successful in its efficacy, the technique has become wildly popular in the herniated disc treatment sector of the back and neck pain industries.
This discussion focuses on the application of IDET to reduce the size and symptomatic capability of intact herniations within the cervical spinal region.
What is Cervical Spine IDET?
Intradiscal electrothermal therapy is also commonly called intradiscal electrothermal annuloplasty. The procedure describes an approach to treating herniated spinal discs that have not ruptured, although in some instances, the operation can be utilized to treat discs that demonstrate minor annular tears, as long as the nucleus tissue remains largely contained.
All variants are minimally invasive and virtually always performed as outpatient procedures, under local anesthetic. The surgery does not involve the use of any large incisions, but instead utilizes the least invasive means of accessing the interior of the affected disc in order to minimize focal inflammation and deformity caused by the herniation.
IDET seeks to decrease the mass of the nucleus in order to shrink the disc back into its original size and shape, hopefully eliminating any pressure that is currently being applied to surrounding neurological tissue, such as the spinal cord or the cervical nerve roots.
IDET is a technique in constant development, since new technologies facilitate improved versions of the procedure, with fewer complications and better treatment outcomes year over year. Of all the surgical approaches to cervical herniated disc care, this one demonstrates the least risk and provides satisfying results for thousands of patients.
All variations of IDET involve the same treatment philosophy. Each method seeks to reduce the mass of the disc nucleus, thereby decreasing its swelling against sensitive neurological tissue. In order to accomplish this objective, all types of IDET follow certain common steps:
The patient is sedated and provided with local anesthetic to minimize discomfort. They will also almost always be monitored by live x-ray equipment to help the surgeon visualize the insertion of the surgical tools into the bulging intervertebral structure. In some cases, live x-ray might be replaced by direct visualization via fiber-optic catheter technology.
Once a hollow catheter is inserted through the skin and into the herniation, the surgeon will use some process of inducing heat into the disc nucleus, in order to heat the molecules and cause them to shrink to an asymptomatic state.
At the point where the disc is judged to be successfully treated, the catheter is removed and the tiny hole is closed in the skin.
The main difference between procedures, and the nomenclature that describes each, comes from variations in how the heat is administered into the body. Some techniques use an actual heating element, while others utilize more technological applications of diathermy, such as ultrasound or radio-waves. Cervical nucleoplasty is an example of the latter type of innovative disc treatment.
Cervical Spine IDET Facts
All varieties of IDET can be successful when used to treat indicated herniations within the neck anatomy. Best results are offered in cases where the disc is fully contained and not structurally compromised to the point of annular tear. However, many specialists have developed IDET techniques that are specifically geared towards not only reducing the mass of bulging discs, but also targeting known annular tears in an attempt to seal the outer disc wall and restore stability to the overall intervertebral structure.
Patients generally tolerate treatment without serious complication. However, some risk factors to consider include the possibility for unsuccessful treatment results, spinal nerve or cord damage, spinal fluid leak, infection or other negative consequences.
Once the procedure is finished, most patients will be able to regain virtually all physical functionality within several days to several weeks.
One of the main downsides of IDET treatment is the recurrence of herniations postoperatively. In many instances, the disc might be damaged beyond repair and will re-herniate back into problematic state, often requiring more invasive surgical intervention. Some doctors remove excessive disc nucleus material to discourage the likelihood of re-herniation, but this can leave the disc hollow and susceptible to dramatic degeneration on a much accelerated timetable.
To learn more about all the options for intradiscal electrothermal therapy in the neck, speak to a surgical service provider and be sure to discuss their recommendations with several different physicians before agreeing to undergo treatment.