Intradiscal electrothermal treatment for chronic discogenic low back pain: a prospective outcome study of 39 patients with the Oswestry disability index at 18 month follow-up

Abstract

Objective: The authors evaluate the efficacy of intradiscal electrothermal therapy (IDET) for discogenic pain on outcome of patients using the Oswestry disability index (ODI) after 18 month follow-up.Methods: Thirty-nine patients with chronic discogenic low back pain who failed to improve following conservative treatment were considered for this study. Inclusion criteria included the presence of one- or two-level symptomatic disk degeneration without evidence of nerve root compression. Patients were excluded if there was severe disk degeneration together with loss of more than 50% disk height. We measured the outcome scores at minimum of 18 month period with the Turkish version of the ODI and compared them with pre-treatment scores.Results: All procedures were considered technically successful and there were no device-related complications. Mean ODI scores of 39 patients pre-operatively and post-operatively 6, 12 and 18 months were 45.7436 ± 11.6545, 24.7692 ± 10.7861, 23.0256 ± 10.6412 and 21.4872 ± 10.0286, respectively. The effect of treatment was calculated as the difference between the scores before and after treatment. They were 20.9744 ± 12.5394, 22.7179 ± 12.5697 and 24.2564 ± 12.5922 after the same follow-up periods. There was a significant difference (p<0.01) between all the mean scores after treatment (6, 12 and 18 months) compared with the pre-IDET mean ODI.Discussion: Although various alterations in outcome scores have been reported in previous works, we found nearly four in five patients (79.48%) who clearly benefited from this therapy. This procedure may become a middle step for carefully selected group of patients who failed non-operative treatment before surgical intervention.