Intradiscal Heating Procedures

Intradiscal heating procedures are currently performed using two different methods. The original method was developed in the early 1990's by Dr. Sluijter of Holland. With this technique, a needle with 1.0 to 1.5 cm exposed tip is placed into the nucleus and annulus of the intervertebral disc. A radiofrequency generator is used to heat the surrounding tissue. Commonly several different locations are heated to temperatures between 65 and 80 degrees centigrade for a duration of one to five minutes. Our results using this technique are summarized in the first abstract (Intradiscal Thermal Modulation). Critiscm of this technique primarily centers around the ability of radiofrequency current to effectively reach therapeutic temperatures in the surrounding tissue. The effective heating radius is probably limited to 2 to 4 mm distance from the needle tip.

A newer technique was developed by Oratec. Rather than using radiofrequency, a catheter is used which is itself heated. Radiant heat then spreads into the surrounding tissue. Using this technique, one can achieve better spread of heat in the intervertebral disc. Our six-month followup using this newer technique is summarized in the second abstract (Intradiscal Electrothermal Annuloplasty, also known as Intradiscal Electrothermal Therapy or IDET).