THERMAL ANNULOPLASTY is an FDA approved minimally invasive spine procedure to treat mid and lower back pain. THERMAL ANNULOPLASTY is for people who have moderate to severe back pain that interferes with their lives and which does not get enough better with physical therapy and medications.
As with all interventional procedures, this procedure is only for patients who havea good understanding of the various options available to them and the risksand benefits of each. Thermal annuloplasty is not a substitute for intensive multidisciplinary rehabilitation of the type offered through the Integrative Pain Center – in fact, in most cases this procedure is offered as an adjunct to our multidisciplinary program, when the patient’s back pain is severely limiting and psychosocial factors do not appear to be prominent; and provided the patient’s health insurance plan will support a multidisciplinary approach to pain treatment.
It is not for the leg pain (sciatica) that goes with a herniated or slipped disc, or with spinal stenosis. Thermal annuloplasty is therefore not an alternative to surgical procedures for leg pain/sciatica (including discectomy, foraminotomy,laminectomy, laser decompression, and others)
There are two variations of the thermal annuloplasty procedure. Allmost all of the research has studies the first generation procedure introduced in mid1990, yet at IPCA 80% of the thermal annuloplasty procedures are done using a very different generation II technique, introduced in about 2002. Both techniques involve heating the outer covering of a painful intervertebral disc, but they use different methods – and we think that this makes a big difference in results. The generation II technique includes taking actual temperature measurements in the outer disc, for example. At IPCA we continue to offer thermal annuloplasty because
- We see patients whose back pain is fairly debilitating yet they have not responded adequately to conservative care up to and including our multidisciplinary rehabilitation program – the back pain is often identified as interfering significantly with their progress in this program.
- We see patients whose persistent back pain seems likely to have an organic cause based on history, physical exam, and advanced testing.
- We are seeing good results about 70% of the time (good results means at least 50% pain reduction that lasts).
- We are not seeing complications at anywhere near the severity or frequency that we see with surgical procedures for back pain such as fusion or disc replacement.
- The procedure is far less costly (especially when done in the office) and has much shorter recovery time than the surgical procedures.
- If thermal annuloplasty works, a patient may avoid a bigger surgical procedure.
- If thermal annuloplasty does not work, the door is still open for a surgical procedure – but if a patient has a surgical procedure, the door is shut to thermal annuloplasty in the future.
Here is a typical patient report of the long term results of generation II thermal annuloplasty, this is typical of what the 70% who do well say, and is helpful in understanding what to expect:
From: Kathy Malone [
Sent: Wednesday, August 27, 2008 12:01 PM
Subject: IDET info
Just to give you an update on my condition, it’s now been 25 months since my procedure (July 2006) and I consider it very successful. Although I had to give up running for exercise (I had to give it up before the procedure – and the procedure did not get me back to running), I am able to walk several miles at a time at a fast pace, use an elliptical trainer several times a week, lift light weights and do core strengthening exercises without pain. My lower back muscles do get tight, but I’ve found that some massage and stretching make that manageable.
The biggest difference for me is that I can now sit for long periods of time without severe pain, which I was unable to do prior to the IDET. I am very pleased with the outcome of my IDET procedure and have absolutely no regrets (even though I had to pay for it myself and fly to AZ!) because it allowed me to avoid major surgery. J
If it is still possible to post comments on a website, please let me know. I would be happy to do so.
Kathy Malone, MA, ATC
Urban Outreach Coordinator
Methodist Sports Medicine / The Orthopedic Specialist