ABSTRACT
Treating axial and referred extremity pain is challenging, and the only microinvasive treatments were nuclear decompressions using injected chymopapain or disc decompressions through small bore needles to remove or vaporize disc tissue. Thermocoagulation of the medial branches of the dorsal spinal nerve had long been an accepted method for treating zygapophyseal joint pain. The therapeutic efficacy of intradiscal heating probably depends on the transfer of heat through the nucleus, annulus or both. Studies show that intradiscal heating causes thermal necrosis of tissue, and injury of the normal annulus caused by the long-heating elements could be a cause of prolonged flare-ups and unsatisfied outcome. Intradiscal electrothermal treatment was one of the first micro-invasive devices designed specifically for treating discogenic low back pain. Intradiscal infection remains a concern; however, the use of preoperative IV antibiotics and postoperative prophylactic injections of antibiotics into the disc significantly reduce the risk of infection to less than 1/3000 cases.
