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

Contact: Megan KellerLippincott Williams & Wilkins(215) 521-8374[email protected]

EMBARGO DATE MAY 1, 2002

"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 health.

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' follow-up.

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 steroids.

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.

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