Intradiscal electrothermal therapy (IDET): a viable alternative to surgery for low back pain in workers' compensation patients?

Abstract

OBJECTIVE This prospective study was conducted to evaluate improvements in pain and disability in a series of 53 consecutive worker's compensation patients with discogenic low back pain following treatment with the intradiscal electrothermal therapy (IDET) procedure. MATERIAL AND METHODS Between 2002 and 2004, a total of 53 consecutive patients, who were claimants of worker's compensation, were treated using IDET for their discogenic low back pain. The outcomes of these patients were analyzed statistically for the current study by physical exam and self-assessment questionnaires of pain and disability at baseline and at 24-months post-procedure. Pain and disability outcomes were assessed by visual analog pain score (VAS) on a 0-100 mm scale and Oswestry Disability Index respectively. RESULTS The mean patient age was 41.83 years (range 20 to 61 years). Caucasians (53 %), African-Americans (30%), and Hispanics (17%) formed the majority of population. Forty-nine percent were using narcotic pain medications at the time of initial assessment. The first definitive end point was considered at 24 months after the procedure. Median follow-up period was 56 months (range 29-72 months). A mean reduction (p < 0.001) of 63% in the VAS score and 70% in the Oswestry scores was noted after IDET. The patient's initial VAS and Oswestry scores (p < 0.05) significantly affected the final outcomes. Forty-seven percent of the patients returned to some degree of economic productivity and only seven (initial 26) consumed narcotic analgesics. CONCLUSION IDET procedure can be a useful, safe and cost-effective option in the management of carefully selected workers' compensation claimants with chronic low back pain of discogenic etiology.

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