Intradiscal electrothermal annuloplasty: The IDET procedure. The authors concluded that Nucleoplasty appears to be safe and effective; however, they noted that randomized, controlled studies are needed to further evaluate its long-term effectiveness. The mean T2 values did not significantly change after treatment. padding: 15px; These researchers noted that due to minimal invasiveness and long-lasting benefits, this kind of treatment should be proposed to designated group of patients as 1st-line therapy. Available at: http://www.nucleoplasty.com/dph/information/temperature_comparison_nuc_IDET.pdf. For the purpose of analysis, the maximum allowable daily dose for that opioid was calculated and utilized. Acutherm uses a shorter catheter than is utilized with IDET. The outcome measure was short-term pain relief of at least 6 months or long-term pain relief of more than 6 months. Three patients had recurrence within a week of the procedure. Ceylan A, Ak . Wolff M, Shillington JM, Rathbone C, et al. Thermal intradiscal procedures are also known as: Aetna considers the following intradiscal procedures experimental and investigational because their effectiveness has not been established (not an all-inclusive list): Note: TIPs are also identified or labeled based on the name of the catheter/probe that is used (e.g., Accutherm, discTRODE, SpineCath, or TransDiscal electrodes). Radio-frequency (thermo) lesions in lumbosacral spinal column - primary research. We take what we do very serious and have had third party research done to validate our outcomes, which was published in a peer-reviewed medical journal.We are also pleased to announce that one of the co-author's of our research paper is a world famous neurosurgeon who was the head professor of . The objective of the study was to test the safety of IDET compared with sham treatment for low back pain of at least 3 months duration. Clinically meaningful improvements (more than 30 % decrease from baseline) in VAS and RDQ were identified in 91 % of patients at final survey. Gibson JN, Waddell G. Surgical interventions for lumbar disc prolapse: Updated Cochrane Review. No intra-operative and post-operative complications were reported. IDET was designed to reduce pain via two mechanisms: heat-induced changes in the structure of the collagen within the disc and ablation of the nerve endings in the outer third of the annulus. These investigators performed a comprehensive literature search using all electronic databases from 1966 through September 2011. There were no infections or nerve root injuries associated with the procedure. 2001;11(4). In a prospective cohort study, McCormick et al (2016) determined long-term outcomes of Dekompressor percutaneous laser disc decompression (PLDD) for discogenic radicular pain. Available at: http://www.emedicine.com/neuro/topic707.htm. 2019;44(3):389-397. From these, these researchers identified 11 RCTs from which data analysis was performed. There were significant differences among the pre-operative, 1-week post-operative, and 3-year post-operative VAS and ODI scores, but not between the 3- and 5-year post-operative scores. Mills -- places that do only VAX-D -- tend to be profit motivated. Two actively treated and2 sham-treated patients reported increased pain levels, and in both groups a higher number was unemployed after 12 months. The ODI score was also significantly decreased compared with baseline. Looks like just another Chiro office offering something called "IntraDiscNutrosis," which has not been tested or found to be a viable form of treatment by any study. Intradiscal electrothermal anuloplasty. There was a 1.7-point reduction (improvement) on a 7-point PGIC scale, and a 0.13-point increase (improvement) in the EQ-5D Health Index; 50 % of cross-over subjects responded to IDB + CMM intervention. Ceylan A, Asik I, Ozgencil GE, Erken B. Funayama et al (2022) stated that although post-operative recurrent LDH (rec-LDH) is uncommon, it is a challenging situation that requires revision surgery when conservative treatment fails. Recommendations were based on the criteria developed by Guyatt et al. Furthermore, some providers use bi-polar lead placement, longer lesion duration times, higher lesioning temperatures or longer active tips when employing C-RFA, all of which expanded the size of the lesion and may increase the chance of successful MBN capture. 2004;4(1):27-35. Intradiscal biacuplasty (also referred to as simply "biacuplasty") is a newer minimally invasive intradiscal radiofrequency technique that is proposed as another treatment for back pain. Second, among 14 patients in a previous prospective clinical trial, 11 patients were examined for the LBP intensity and disability, and 7 patients were available for lumbar radiographic evaluation (including 1 patient who received the additional PRPr injection) in this long-term follow-up study. Intradiscal electrothermal treatment for chronic discogenic low back pain: A prospective outcome study with minimum 1-year follow-up. There were no complications with the procedure. Subjects and coordinators were blinded to randomization until 6 months. A critique of this systematic evidence review by the Centre for Review and Dissemination (2010) noted that theresults were mainly extracted from observational studies in settings where the studied procedure was performed routinely; hence there was a bias risk in favor of the procedure (this limitation was acknowledged by the authors). These investigators evaluated the current evidence for 3 such treatments: In a prospective, randomized, cross-over, multi-center trial , Desai et al (2016) compared the effectiveness of IDB versus conventional medical management (CMM) in the treatment of lumbar discogenic pain. These findings need to be validated by well-designed studies with larger sample size and longer follow-up duration. Between group differences were not significant for any outcomes. Magalhaes FN, Dotta L, Sasse A, et al. Patients with positive diagnostic MBN blocks (greater than 75 % relief) were randomized to MBN C-RFA or T-RFA. Ogbonnaya S, Kaliaperumal C, Qassim A, O'Sullivan M. Outcome of nucleoplasty in patients with radicular pain due to lumbar intervertebral disc herniation. These researchers observed no procedure or stem cell-related AEs or SAEs during the 1-year follow-up period; VAS, ODI, and SF-36 scores significantly improved in both groups receiving both low (cases 2, 4, and 5) and high (cases 7, 8, and 9) cell doses, and did not differ significantly between the 2 groups. They noted that further follow-up evaluation is underway to determine the durability of QOL improvement after Nucleoplasty. Interventional techniques: Evidence-based practice guidelines in the management of chronic spinal pain. In a review on IDET for the treatment of chronic discogenic low back pain, Wetzel et al (2002) stated that the studies published so far suggest that the pain resulting from lumbar disc disease may be diminished by intradiscal electrothermal annuloplasty. The level of evidence is lacking with Level III. 2001;82(9):1230-1237. 702 - Section 8 & 15-Accepted And Acknowledged. Group B appeared to be more effective, with a statistically significant difference, compared with group A regarding the secondary objectives of the study. The authors concluded that fluoroscopy-guided infiltrations of intervertebral discs and facet joints with PRGF in patients with chronic LBP resulted in significant pain reduction assessed by VAS. ol.numberedList LI { Accessed January 15, 2002. Case Rep Orthop. 2010;13(2):117-132. Mean post-treatment pain scores at months 1 and 6 were significantly lower (p < 0.01) in both groups, and between-group differences were not significant. Washington State Department of Labor, Industries. Management of non-radicular neck pain in adults. These researchers discussed good to fair evidence from RCTs that injection therapy, PIRFT, IDET, and prolotherapy are not effective. At 2, and 3 months after intradiscal PRF, the pain was scored as NRS 2. # color: white; The authors concluded, "Nonspecific factors associated with the procedure account for a proportion of the apparent efficacy of IDET, but its efficacy cannot be attributed wholly to a placebo effect. Medicina (Kaunas). In fact, an independent study found that IntraDiscNutrsosis patients have a greater than 90% success rate. In a recent review, Barndes et al (2002) commented: "IDET is an innovative tool for the treatment of discogenic back pain. They stated that future studies with larger sample size are needed to perform a better review of ozone effects on disk LBP. Rev. Nucleoplasty did not produce obvious changes at least on the early post-operative MRI examination. Pain Physician. 2019;160(4):945-953. font-size: 18px; The authors concluded that patients were pleased with the treatment results. The studies out there are not high quality," says Daniel J. Mazanec, MD, a spine specialist with the Cleveland Clinic. Results from 2 randomized controlled trials showed no differences between PIRFT and placebo, and between different PIRFT techniques. Available at: http://www.nucleoplasty.com/dph/information/brian_blue_case_study.pdf. Despite its use at various centers around the country, there are few published clinical studies that assess the efficacy of this procedure. Subjects were then monitored for adverse events (AE), range of motion (ROM), VAS, present pain intensity (PPI), ODI, BDI, Dallas Pain Questionnaire (DPQ) and SF-12 scores over a 6-month period; safety events were followed for 12 months. Combination of ultra-purified stem cells with an in situ-forming bioresorbable gel enhances intervertebral disc regeneration. Acta Neurochir Suppl. This is the first I, or my family member, has heard of this place and seems like a better choice rather than surgery. It is 100% non-invasive. A randomized, double-blind, controlled trial intradiscal electrothermal therapy versus placebo for the treatment of chronic discogenic low back pain. display: none; IntraDiscNutrosis has a success rate of over 90%, backed by an independent, randomized medical research study. Chicago, IL: BCBSA; 2002;17(11). 2019;49(6):1634-1639. The authors concluded that Nucleoplasty-based percutaneous disc decompression in patients with symptomatic contained disc herniations is safe and improves QOL as measured by the SF-36, EQ5D, and VAS for pain,3 generic QOL outcome instruments. .strikeThrough { Moreover, they stated that a randomized controlled trial (RCT) is needed to address the effectiveness of the procedure. Spine. As a result, bulging or herniated disks may retract, taking pressure off nerves and other structures in your spine. 2019;32(2):113-119. These researchers observed no procedural complications or AEs; predictors for success were Pfirrmann grading of 2 or less and higher QOL mental component scores. Standard treatment is microsurgical sequestrectomy with direct visualization of the spinal canal; while treatment innovations include minimally invasive intradiscal interventions (e.g., chemonucleolysis, manual and automated disc decompression, laser disc decompression, nucleoplasty and thermal anular RF techniques with posterolateral access to the intervertebral disc). Ultra-purified stem cells with an in situ-forming bioresorbable gel for enhancement of intervertebral disc regeneration.