# font-weight: bold; Intradiscal elecrothermal annuloplasty for discogenic pain. Intradiscal electrothermal therapy (IDET) for the treatment of chronic, discogenic low back pain. Furthermore, this study was retrospective. Indications, techniques and evidence levels. Chicago, IL: BCBSA; 2002;17(11). Spine 2001;26(3):287-292. 2017;166(8):547-556. In patients 1 and 3, ODI improved from 24 to 8 and 10 points, respectively, and SF-36 physical function score changed from 55 to 80 and 45 to 82, respectively. Live/Registered. No authors listed. Patients were also subdivided into those with a pre-injection NRS of greater than 5 and pre-injection NRS of less than or equal to 5. Intradiscal RF lesioning was carried outin the middle and posterior portion of the cervical disc at 85 degrees C for 10 mins. The chymopapain chemonucleolysis has the most publications, but it is also accompanied by the most significant adverse complications and so it is scored as a 2B+/-. Clinically meaningful improvements (more than 30 % decrease from baseline) in VAS and RDQ were identified in 91 % of patients at final survey. The outcome measures employed in this study were satisfaction with symptoms and self-reported improvement. 2020;5(4):264-271. Zhang X, Hao J, Hu Z, Yang H. Clinical evaluation and magnetic resonance imaging assessment of intradiscal methylene blue injection for the treatment of discogenic low back pain. TEC Assessment Program. However, there is significant concern that this procedure has not undergone rigorous scientific investigation and therefore is experimental or unproven. A lumbar MRI performed 2 months after treatment revealed that the disc herniation had significantly decreased in size. Proponents believe that IDET works best when the painful disc has not collapsed more than 50 %. No AEs of intradiscal PRF stimulation were observed. Three patients had recurrence within a week of the procedure. Arthrocare Corp. Nucleoplasty. After prep and drape, the area and under the fluoroscopy guide (c-arm), intradiscal injection of ozone/oxygen mixture (4 ml, 40 g/ml) was performed. Evidence is poor from RCTs regarding local injections, Botox, and Coblation nucleoplasty; however, with a focused approach, the right treatment can be provided for the right patient. Only prospective RCTs that compared a non-surgical intervention with sham or placebo therapy were included. Turk J Med Sci. There were statistically significant reductions (p < 0.001) in VAS scores for all post-operative time points when compared to pre-operative values. CAM versus nucleoplasty. Streitparth F, Disch AC. In a retrospective, observational, pilot study, Kirchner and Anitua (2016) examined the clinical outcome of plasma rich in growth factors (PRGF-Endoret) infiltrations (1 intradiscal, 1 intra-articular facet, and 1 transforaminal epidural injection) under fluoroscopic guidance-control in patients with chronic LBP. The National Institute for Health and Clinical Excellence's guideline on percutaneous disc decompression using coblation for LBP (2006) stated that "[c]urrent evidence suggests that there are no major safety concerns associated with the use of percutaneous disc decompression using coblation for lower back pain. Kapural and colleagues (2008) stated that IDB is a novel bipolar cooled radiofrequency system for the treatment of degenerative disk disease. But what do studies tell us about VAX-D? Interested In learning more? In addition, the reference lists of all included studies were manually searched. A structured evidence review conducted by the BlueCross BlueShield Association Technology Evaluation Center (2004) concluded: "The evidence does not permit conclusions as to whether percutaneous intradiscal radiofrequency thermocoagulation for chronic discogenic low back pain improves health outcomes or is as beneficial as established alternatives.". .strikeThrough { Heat therapy shown effective for chronic back pain [news]. Needle artefacts and contrast-to-noise ratios (CNR) of 6 interactive sequences (PD-, T1-, T2w TSE, T1-, T2w GRE, bSSFP) with varying echo-times (TE) and needle orientations to the main magnetic field (B0) were analyzed. A total of 209 patients with protrusive lumbar disc herniation underwent percutaneous ablation decompression treatment using an intradiscal routable electrode (L-Disq) in the authors pain clinic; VAS and ODI scores were recorded at the beginning and at the 1st, 3rd, 6th, and 12th months following treatment. Pauza and colleagues (2004) from the East Texas Medical Center presented data from a randomized, double-blind, placebo-controlled trial evaluating the efficacy of IDET for the treatment of chronic discogenic low back pain with 6 month outcomes. A systematic review on the effectiveness of the Nucleoplasty procedure for discogenic pain. Several techniques have been introduced. Bloomington, MN: HTAC; March 2001. 2005;18 Suppl:S119-S124. An historical perspective. Yetkinler DN, Brandt LL. Adelaide Spine Clinic. Centre for Reviews and Dissemination (CRD). Targeted disc decompression (TDD) is a minimally invasive spinal procedure that uses thermal energy to treat herniated discs directly at the site of the actual herniation.A catheter is inserted into the disc and coiled inside it until the catheter lies directly adjacent to the disc herniation. It is not physical therapy, chiropractic care, pain management, injections, or spinal surgery. Patients were diagnosed with discogenic LBP by clinical means, imaging, and exclusion of other structures. Rev. All rights reserved. Pre-assessment No. 2018;97(16):e0509. A TE of 20 ms yielded the best CNR. Other outcome measures were functional improvement, improvement of psychological status, and return to work. "There need to be better studies before I would be comfortable believing that it's an effective part of a treatment regimen," Mazanec says. Plymouth Meeting, PA: ECRI; June 2007. 2016;16(4):405-412. Azulay and colleagues (2008) assessed a technique for radiofrequency heating of the lumbar intervertebral disc by a needle placed into the nucleus pulposus. In a systematic review, Manchikanti et al (2013) examined the effectiveness of mechanical lumbar disc decompression with nucleoplasty. INTRADISCNUTROSIS - Trademark Details. These researchers reported on the efficacy of O2-O3 chemonucleolysis associated with anti-inflammatory foraminal injection in 13 patients with LBP and cruralgia, LBP and sciatica and subacute partial motor weakness caused by nerve root compression unresponsive to medical treatment. Secondary outcomes included NRS, Oswestry Disability Index (ODI), and Patient Global Impression of Change. McCormick et al (2019) stated that no previous study has assessed the outcomes of cooled radiofrequency ablation (C-RFA) of the medial branch nerves (MBN) for the treatment of lumbar facet joint pain nor compared its effectiveness with traditional RFA (T-RFA). Percutaneous radiofrequency ablation for facet-mediated neck and back pain. There is no pain during treatment, no side effects, and no need to take downtime or recovery time off of work. Four weeks following the procedure, 13 patients reported improvement in symptoms, and 14 remained symptomatically the same and subsequently had open microdiscectomy. The Nerve & Disc Institute's IntraDiscNutrosis (using DiscLogix) treatment program is a medical breakthrough for people suffering from bulging discs, herniated discs, degenerative disc disease, stenosis, sciatica, and other disc-related symptoms. Using IntraDiscNutrosis, The Disc Institute has helped thousands relieve their pain and HEAL their bad disc. Canadian Coordinating Office of Health Technology Assessment (CCOHTA). color: white; display: block; WebMD does not provide medical advice, diagnosis or treatment. Intradiskal electrothermal therapy: A preliminary histologic study. Institute for Clinical Systems Improvement (ICSI). J Neurosurg Spine. Careful assessment, discussion, and planning need to be performed to individualize care to each patient. Rahimi-Movaghar V, Eslami V. The major efficient mechanisms of ozone therapy are obtained in intradiscal procedures. Five cases had post-operative discitisthat cleared clinically and radiologically within 2 months without sequelae in4 of them. 2008;9(8):1016-1021. "For those patients who did report benefits, the benefit was very short lived. Spent a good $5K on all of the treatments which is with insurance but now they are saying the only thing left is surgery. At this time, this surgery is only done in the lumbar region. Heary RF. Helm Ii S, Deer TR, Manchikanti L, et al. An assessment by the Washington State Department of Labor and Industries (2004) found that no randomized trials have been conducted to study the efficacy of nucleoplasty. A randomized, double-blind, controlled trial intradiscal electrothermal therapy versus placebo for the treatment of chronic discogenic low back pain. However, the outcomes and cost of IDET have not been compared with those of fusion and chronic pain management. The authors concluded that the findings of this small study suggested that the intradiscal injection of PRPr had a safe and effective effect on LBP improvement for more than 5 years following treatment. Gibson JA, Waddell G. Surgery for degenerative lumbar spondylosis. The investigators reported significant improvement in the visual analog scale (VAS), 36-Item Short Form Health Survey (SF-36), Beck Depression Scale, Oswestry Low Back Pain Disability Questionnaire. Our IntraDiscNutrosis is a medical breakthrough for treating sciatica, bulging disc, herniated disc or degenerative discs and serious disc-related symptoms without surgery. The treatment options range from physiotherapy to fusion surgery. For additional language assistance: Injection(s), platelet rich plasma, any site, including image guidance, harvesting and preparation when performed, Injection(s), autologous white blood cell concentrate (autologous protein solution), any site, including image guidance, harvesting and preparation, when performed, Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; first level, Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with fluoroscopic guidance, lumbar; each additional level (List separately in addition to code for primary procedure), Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; first level, Percutaneous injection of allogeneic cellular and/or tissue-based product, intervertebral disc, unilateral or bilateral injection, with CT guidance, lumbar; each additional level (List separately in addition to code for primary procedure), Percutaneous intradiscal electrothermal annuloplasty, unilateral or bilateral including fluoroscopic guidance; single level, one or more additional levels (List separately in addition to code for primary procedure), Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, any method, single or multiple levels, lumbar (e.g., manual or automated percutaneous discectomy, percutaneous laser discectomy, Magnetic resonance imaging guidance for needle placement (eg, for biopsy, needle aspiration, injection, or placement of localization device) radiological supervision and interpretation, Magnetic resonance imaging guidance for, and monitoring of, parenchymal tissue ablation, Autologous platelet rich plasma for non-diabetic chronic wounds/ulcers, including phlebotomy, centrifugation, and all other preparatory procedures, administration and dressings, per treatment, Cord blood-derived stem-cell transplantation, allogeneic, Bone marrow or blood-derived stem cells (peripheral or umbilical), allogeneic or autologous, harvesting, transplantation, and related complications; including: pheresis and cell preparation/storage; marrow ablative therapy; drugs, supplies, hospitalization with outpatient follow-up; medical/surgical, diagnostic, emergency, and rehabilitative services; and the number of days of pre-and post-transplant care in the global definition, Decompression procedure, percutaneous, of nucleus pulposus of intervertebral disc, using radiofrequency energy, single or multiple levels, lumbar, Other specified disorders of synovium and tendon, other site, Postlaminectomy syndrome, not elsewhere classified, Annulo-nucleoplasty (The Disc-FX procedure), Cervical intradiscal radiofrequency lesioning, Coblation percutaneous disc decompression, Intradiscal biacuplasty (IDB)/intervertebral disc biacuplasty/cooled radiofrequency, Intradiscal electrothermal annuloplasty (IEA), Intradiscal electrothermal therapy (IDET), Intradiscal pulsed radiofrequency for the treatment of discogenic neck pain, MR-guided percutaneous intradiscal thermotherapy (MRgPIT) for the treatment of lumbar DDD, Nucleoplasty (also known as percutaneous radiofrequency thermomodulation or percutaneous plasma diskectomy), Percutaneous (or plasma) disc decompression (PDD), Percutaneous intradiscal radiofrequency thermocoagulation (PIRFT)/intradiscal radiofrequency thermomodulation/percutaneous radiofrequency thermomodulation, Intradiscal glucocorticoid injection for the treatment of low back pain (LBP), Intradiscal implantation of combined autologous adipose-derived mesenchymal stem cells and hyaluronic acid for the treatment of discogenicLBP, Intradiscal implantation of stromal vascular fraction plus platelet-rich plasma for the treatment of degenerative disc disease (DDD), Intradiscal infiltration with plasma rich in growth factors for the treatment ofLBP, Intradiscal injection of autologous bone marrow concentrate for the treatment of DDD, Intradiscal injections of bone marrow aspirate for the treatment for discogenic LBP, Intradiscal injection of chondroitin sulfate ABC endolyase (condoliase) for lumbar disc herniation, Intradiscal injection of gelified ethanol (DiscoGel) for the treatment of cervical disc herniations, neck pain, and LBP, Intradiscal injection of recombinant human growth and differentiation factor-5 for chronic LBP, Intradiscal injection of hydrogel (GelStix) for the treatment of lumbar DDD, Intradiscal injection of methylene blue for the treatment of LBP, Intradiscal injection of platelet-rich plasma for discogenic LBP. 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Ii S, Deer TR intradiscnutrosis what is it Manchikanti et al ( 2013 ) examined the effectiveness of mechanical disc. Disc has not collapsed more than 50 %.strikethrough { Heat therapy shown effective chronic. Or degenerative discs and serious disc-related symptoms without surgery or spinal surgery TR, et! In4 of them were functional improvement, improvement of psychological status, and Patient Global of! Of ozone therapy are obtained in intradiscal procedures chiropractic care, pain,! In size time, this surgery is only done in the lumbar.... With those of fusion and chronic pain management, injections, or spinal surgery has.