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Understanding the Risks of a New Treatment for Back Pain
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Posted on: 07/30/2003
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As promising new treatments begin to be used, it is important that doctors continue to study how well they work. Follow-up research helps doctors identify problems and determine which patients will benefit most from the new treatments.
These authors did follow-up research on intradiscal electrothermal therapy (IDET). IDET is a new treatment for back pain that is caused by the discs of the spine. Discs are like little cushions between the vertebrae. When discs rupture or bulge, they can cause pain. IDET involves inserting a probe into the disc and heating it for several minutes. It is thought that the heating causes a healing response in the disc.
The goals of this study were to find out what kinds of problems patients had after IDET and to help determine which patients were more likely to have poor outcomes. IDET was used on 79 patients. All had back pain for at least six months and had gotten little relief from nonsurgical treatments. All the patients also had discs that looked abnormal on MRI scans.
Key findings include:
IDET was fairly effective. Almost half of patients reported at least 50 percent pain relief at six months after treatment.
The complication rate was 10 percent. Most of the complications were easy to treat and went away with time. However, a few of the complications were serious. The authors note that doctors need to remember that IDET is not a risk-free procedure.
Obese patients were much less likely to have good outcomes. Only 10 percent of obese patients got good pain relief with IDET.
Obesity was the only risk factor found to be a predictor of poor outcomes. Factors such as age, smoking, leg pain, and diabetes did not seem to be linked to poor outcomes, at least in this small study.
The authors have stopped using IDET in obese patients based on the results of this study. The study didn't show why obese patients don't do well with IDET. The authors suggest a few theories. They think that extra weight may itself contribute to back pain, or that extra weight gets in the way of rehabilitation. They recommend further research with larger groups of patients.
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References:
Steven P. Cohen, MD, et al. Risk Factors for Failure and Complications of Intradiscal Electrothermal Therapy: A Pilot Study. In Spine. June 1, 2003. Vol. 28. No. 11. Pp. 1142-1147.
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