For years, the recommended treatment for patients whose chronic low back pain stemmed from degenerative disc disease has been fusion surgery—the use of bone grafts to solidify the disc and spine. On the plus side, the procedure provides relief in 90 percent of cases, on the minus, it requires a huge incision and removal of a rib to reach the spine. As a result, many patients go on to experience more back pain and fatigue—not because of the disc, but from tissue damage and muscle weakness from the surgery. 
| Khaled Kebaish says a new minimally invasive procedure reduces spinal pain without major surgery. |
Now, miraculously, an outpatient procedure, called Intradiscal Electrothermal Annuloplasty, or IDET, is making it possible for some to reap the benefits of fusion surgery without undergoing the huge operation. In other words, disc pressure and pain are being treated without an incision and without destroying tissue. Orthopedic surgeon Khaled Kebaish who performs the IDET, explains how the technique works anatomically: Spinal degenerative disease occurs when tiny nerves in the annulus, or outer wall, of the disc begin to bulge and tear. The body attempts to heal the area by sending in small blood vessels carrying nerve fibers. But like an open sore, these nerves themselves become a source of pain. With IDET, Kebaish guides a wire through a catheter into the disc space and coils it. He then heats the wire for about 15 minutes and burns away the small, pain-inducing nerves in the annulus. The result, studies show, is that disc pressure and pain decrease dramatically in about 80 percent of patients. But not everyone with degenerative disc disease is a candidate for the procedure. Ideal cases are those with limited damage to the annulus and only one or two damaged discs. Additionally, the treatment is not recommended for patients with herniated discs or those who already have had fusion surgery. Still, Kebaish says, in the correct patient IDEP is a very attractive option. "It gives a surgeon more room to do something that is not irreversible, and it doesn't involve sacrificing the disc." — Gary Logan
Hopkins Medical News, Winter 2002 |
