IDET: Wire Goes In, Pain Goes Out

"If I sat in one place for more than 15 minutes, the pain became intense," she recalls. "I couldn't go to a movie, I couldn't sit in the stands to watch my son's baseball team, I couldn't even sit in a car for very long."

Back at work after three weeks' rest, Jeffers was assigned to a less physical job as a driver towing empty semi-trailers around the shipping dock. But the pain hung on, day after day, for the next three years.

In 1999, an exasperated Jeffers explored her medical alternatives. She consulted a local orthopaedic surgeon. An MRI (magnetic resonance imaging) and discogram (a procedure in which dye is injected into a spinal disc and tracked using X-ray movies) diagnosed her problem as three damaged discs in her lower spine. The orthopaedist recommended spinal fusion - a major operation.

Jeffers, an avid softball player before her accident, would have to live with restricted movement for the rest of her life if she chose spinal fusion. Her sister, an advanced practice nurse, suggested that she get a second opinion. That's when Jeffers made the decision that changed her life. She came to the Pain Management Center at the Cleveland Clinic. Under the leadership of Nagy Mekhail, M.D., Ph.D., the Pain Management Center specializes in the treatment of chronic pain. "We define chronic pain as pain that lasts for at least three months," says Dr. Mekhail, "and interferes with the habits and pleasures of everyday life."

Dr. Mekhail performed a second discogram on Jeffers, and concluded that because of her young age and relatively normal-sized disc space, she might benefit from minimally invasive intradiscal electrothermal therapy, or IDET, rather than major surgical fusion. In IDET, doctors carefully position a wire in the injured disc and send heat through the wire. The heat kills pain-transmitting nerve endings in the disc, and seals any pain causing cracks.

Jeffers wore a back brace for the first six weeks after the procedure to hold her spine steady while it healed. Two weeks after the brace was removed, she realized that her unwanted guest was gone. "There was a noticeable reduction in pain," she says. "We are very pleased with Ms. Jeffers' outcome," says Dr. Mekhail. "IDET is a valuable alternative to surgery for many patients who suffer from lower back pain secondary to degenerative disc disease."

Cleveland Clinic Foundation
Managing Pain, Volume One: Winter 2004
A Newsletter on Treating Chronic Pain from the Pain Management Department of the Cleveland Clinic