SpineCATH Intradiscal Electrothermal Therapy
This procedure is for patients diagnosed with a disc-related problem in your lower back. The thermal treatment with the Intradiscal Catheter is intended to treat the protein wall of your disc and reduce the volume of disc material that causes nerve irritation. Your physician feels this procedure could improve your symptoms. This is a minimally invasive procedure and you will go home the same day. The procedure involves a wire (the catheter) which is guided into your disc through a needle and is heated for about 15 minutes. Then the catheter and needle are removed completely and you will be sent back to recovery.
Pre-operative Preparation
Before scheduling the procedure, you must read and sign the informed consent to participate in the clinical study..
One week before the procedure
Stop all NSAID's, aspirin and aspirin-containing compounds.
Do NOT discontinue heart, blood pressure or diabetes medications, or other medications prescribed by a physician.
Be sure to tell your physician if
During the procedure
An I.V. will be placed in your arm and you will be given a light sedative. After you are in position on the table, x-ray equipment will identify the area affected. Your lower back skin and muscle tissue will then be numbed with local anesthetic.
Your physician will place a needle into your disc under x-ray guidance. Generally, you may experience mild discomfort during this part of the procedure. Once the needle is in the proper position, your physician may inject x-ray dye into the disc for diagnostic purposes. This is known as discography.
The next step is to insert the electrothermal treatment catheter through the needle. patients typically do not feel any discomfort during this step. However some patients have reported a mild discomfort in their back when the catheter moves through the disc. (See diagram of catheter placement on back page.)
When the catheter position is confirmed by x-ray, the heating element is activated. The hear is slowly increased and will last for 14 to 17 minutes. As the heat increases into the treatment range, you might experience your typical disc-related symptoms. Your physician will monitor your responses during the procedure to ensure that any pain you feel is well controlled.
At the end of the procedure, a small bandage will be placed on your back, and you will rest in a recovery area until you are ready to go home.
Post-operative Management: Immediate
In the first three days after your procedure (the immediate post-operative period), you may experience a moderate increase in your normal back pain. Rest, ice, pain medication and anti-inflammatories will minimize possible discomfort during this time. Non-steroidal anti-inflammatories are OK.
Any unusual or new symptoms (for example, fever, rash, numbness) should be reported to your physician immediately by telephone. Do not expect your usual pre-procedure symptoms to immediately disappear.
You should not exert yourself during this time, even if you experience a marked reduction in your usual pre-procedure pain, because exertion may negatively affect the overall outcome. No housework, lifting or bending should be done.
Short walks (15 to 20 minutes) are okay, but generally the first few days should be spent resting.
You should discuss with your physician your plan to return to work. If your work is sedentary, you can typically return 1 to 5 days after the procedure.
You will schedule follow-up visits with your physician for continuing assessment of your condition.
Post-operative Management: Mid Term
For the first month following the procedure, your disc continues to heal. You may begin to feel a reduction in pain. However, pain reduction may occur over 3 to 4 months.
During the first month, you must treat your back carefully;. Restrict bending, twisting or heavy lifting. No sports activities including running, biking, golf, tennis, skiing etc.
Limit your sitting time to tolerance levels and limit long car rider and plane nights to only what is absolutely necessary. You do not have to abstain from sexual activity with your usual partner, but be careful not to exert your back.
You may resume back exercises under your physician's guidance. Anti-inflammatory medications and/or pain medication may be prescribed if needed to control discomfort associated with your normal back pain. Icing 1- 2 times per day (10-15 minutes) is advisable to reduce any low back discomfort.
Rehabilitation Exercises
Your physician will guide you regarding rehabilitation exercises after your procedure. If you have been performing strenuous rehabilitation exercises before the procedure, you will not immediately return to that level of exercise, but to a more moderate level that will be gradually increased as you improve. Be sure to ask your physician for a post-operative exercise program.
Post-operative Management: Long Term
In the 2nd, 3rd and 4th months post-operatively continue to maintain good body mechanics and do not bend or lift improperly. Your physician and physical therapist will help you advance your exercise program to improve your strength and flexibility, if you plan to return to athletic pursuits, special advanced training will probably help you achieve this goal.
Your physician may allow you to resume sporting activity 3-4 months after the procedure and may allow you to resume traveling for work or pleasure during this time as well.
In the end...
Your physician has selected this procedure because it offers you a less invasive option for your condition. It may be a promising first step in trying to reduce your symptoms.