Intradiscal Electrothermal Therapy is a minimally invasive procedure. Most likely you will be able to go home the same day. The procedure involves a wire (the catheter) which is guided into your disc through a needle. Once in place it is heated for about 15 minutes. Then the catheter and needle are removed and you will be sent back to recovery.
Pre-Operative Preparation
One week before the procedure:
Stop
all NSAID's, aspirin and aspirin containing compounds.
Do NOT
discontinue heart, blood pressure or diabetes medications, or other medications
prescribed by your physician.Be sure to tell your physician if:
you are
taking blood thinners or have a history of a bleeding disorder
you are
allergic to iodine (for example, shellfish or IVP dye)
you have
an infection in any part of your bodyYou should not eat the day of your procedure. Small amounts of clear liquids are permitted. Rest well the night before the procedure.
Arrange to have someone drive you to and from the medical facility. Due to the sedative medications given during the procedure, you should not drive until the day after your treatment.
During the Procedure
An I.V. will be placed in your arm and you will be given a light sedative. After you are in position on the table, x-ray equipment will identify the area affected. Your lower back skin and muscle tissue will then be numbed with local anesthetic.
IMAGE
1 IMAGE 2  |
The next step is to insert the electrothermal treatment catheter through the needle. Patients typically do not feel any discomfort during this step. However, some patients have reported a mild discomfort in their back when the catheter moves through the disc.
When the catheter position is confirmed by x-ray, the heating element is activated. (IMAGE 2) The heat is slowly increased and will last for 14 to 17 minutes. As the heat increases into the treatment range, you might experience your typical disc-related symptoms. Your physician will monitor your responses during the procedure to ensure that any pain you feel is well controlled.
At the end of the procedure, a small bandage will be placed on your back, and you will rest in a recovery area until you are ready to go home.
Post-operative Management: Immediate
In the first three days after your procedure (the immediate postoperative period), you may experience a moderate increase in your normal back pain. Rest, ice, pain medication and anti-inflammatories will minimize possible discomfort during this time. Non-steroidal anti-inflammatories are OK.
Any unusual or new symptoms (for example, fever, rash, numbness) should be reported to your physician immediately by telephone. Do not expect your usual pre-procedure symptoms to immediately disappear.
You should not exert yourself during this time, even if you experience a marked reduction in your usual pre-procedure pain, because exertion may negatively affect the overall outcome. No housework, lifting or bending should be done. Short walks (15 to 20 minutes) are okay, but generally the first few days should be spent resting.
You should discuss with your physician your plan to return to work. If your work is sedentary, you can typically return 1 to 5 days after the procedure.
You will schedule follow-up visits with your physician for continuing assessment of your condition.
Post-operative Management: Mid Term
For the first month following the procedure, your disc continues to heal. You may begin to feel a reduction in pain. However, pain reduction may occur over 3 to 4 months.
During the first month, you must treat your back carefully. Restrict bending twisting or heavy lifting. No sports activities including running, biking, golf, tennis, skiing, etc.
Limit your sitting time to tolerance levels and limit long car rides and plane flights to only what is absolutely necessary. You do not have to abstain from sexual activity with your usual partner, but be careful not to exert you back.
You may resume back exercises under your physician's guidance. Anti-inflammatory medications and/or pain medication may be prescribed if needed to control discomfort associated with your normal back pain. Icing 1-2 times per day (10-15 minutes) is advisable to reduce any low back discomfort.
Rehabilitation Exercises
Your physician will guide you regarding rehabilitation exercises after your procedure. If you have been performing strenuous rehabilitation exercises before the procedure, you will not immediately return to that level of exercise, but to a more moderate level that will be gradually increased as you improve. Be sure to ask your physician for a post operative exercise program.
Post-operative Management: Long Term
In the 2nd, 3rd and 4th months post-operatively continue to maintain good body mechanics and do not bend or lift improperly. Your physician and physical therapist will help you advance your exercise program to improve your strength and flexibility. If you plan to return to athletic pursuits, special advanced training will probably help you achieve this goal.
Your physician may allow you to resume sporting activity 3-4 months after the procedure and may allow you to resume traveling for work or pleasure during this time as well.
In the end. . .
This procedure can offer a less invasive option for your condition. It may be a promising first step in trying to reduce your symptoms.
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