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  #1  
Old 05-08-2007, 08:18 PM
Teresa Teresa is offline
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Join Date: May 2007
Posts: 12
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Hello All,
Thanks for the information provided on this site. My story is long beginning with an injury in 2004. The short version: Fell and landed on tailbone with "jam injury" to spine. I have had ongoing evaluation and treatment for cervical and lumbar injury. C5-6 and C6-7 discectomies in January of 2005 with ongoing pain in neck, traps, arms, headaches and numbness and tingling in hands. Continued low back pain and pain down legs, leg tremors and clumsy gait. Ongoing evaluation and conservative treatment of lumbar. I had a discogram in April 2007 which showed multiple levels of herniation from L2-S1. Multiple radial and annular tears at L3-S1. Doctor is recommending IDET at 2 levels as a conservative approach verses discetomy and fusion. Would you recommend the IDET prior to additional surgery? I continue to work full time in a sedentary position which requires 12-15 hour days at my desk. Since I do not feel the cervical fusion was effective, I am unwilling to have lumbar fusion. Can someone suggest a surgeon in Central Florida that would provide referral to Dr. Bertagnoli and care state side? My thought is that I would benefit from revision of the cervical fusion with ADR and also ADR on the lumbar. Has anyone had a cervical revision? Has anyone had ADR at the cervical and lumbar?
Thanks for any advice. I look forward to learning more as I read the forums.

Teresa
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Teresa
"I can be changed by what hapens to me. But, I refuse to be reduced by it." Author: Maya Angelou
Injury July 2004 neck and low back
Conservative Evaluation and Treatment to include PT, ESIs, etc for lumbar and cervical.
January 2005 C5-6 a
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  #2  
Old 05-08-2007, 09:03 PM
spotty14 spotty14 is offline
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Join Date: Dec 2004
Posts: 365
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Hi,
I would not recommend the IDET unless you have a minor disc problem. It didn't fix large tears or degeneration that I had and I still have leg (some) pain and lots of foot pain and numbness. It only helped me slightly for a short time. Whatever moisture was left in the discs is probably gone due to the heating process.
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7/05 EMG/Nerve Conduction Tests
8/04 Disqualified from ADR clinical trial due to severe osteoporosis -- getting treatment
3/04 updated MRI
11/2000 IDET L 3/4, L4/5
1/2000 Discogram
numerous epidural injections
physical therapy
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  #3  
Old 05-09-2007, 08:42 AM
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Harrison Harrison is offline
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Join Date: Oct 2004
Posts: 7,010
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Hi Teresa, welcome to our community. Many people within this community have had IDETS (and many had multiple level IDETS in the same proecure). I'd like to see some studies showing long-term efficacy; but many patients SEEM to eventually require surgical intervention after IDETS. There are many other procedures that may be better for you long-term; so you are wise to seek a highly experienced surgeon. There are many, many here in the states, but we can talk about this option too. Give me a buzz when you can.

In the meantime, here is one of many articles you can find on the subject.
______________________________


doi:10.1016/j.spinee.2003.07.010
Copyright © 2003 Elsevier Inc. All rights reserved.
Clinical study

Intradiscal electrothermal therapy (IDET) for chronic low back pain in active-duty soldiers: 2-year follow-up*1

abaabaBrett A. Freedman CPT, MC, , Steven P. Cohen LTC, MC, Timothy R. Kuklo LTC, MC, Ronald A. Lehman CPT, MC, Peter Larkin MAJ, MC and Jeffrey R. Giuliani 2LT, MC
aDepartment of Orthopaedic Surgery and Rehabilitation and bDepartment of General Surgery, Walter Reed Army Medical Center, Washington, DC 20307, USA
Received 3 February 2003; accepted 9 July 2003. Available online 4 November 2003.



Abstract

Background context

Intradiscal electrothermal therapy (IDET) is a new treatment option for chronic discogenic low back pain that is minimally invasive and has demonstrated success rates equal to or better than those for spinal fusion at short-term follow-up.

Purpose

To report our experience with IDET in the management of chronic discogenic low back pain in active-duty soldiers.

Study design/setting

Consecutive case series at a US Army medical center.

Outcome measures

The primary outcome measured was a reported 50% or greater reduction in pain at latest follow-up. Additional outcomes measured included analog pain scores, satisfaction, complications, duty status and subsequent spinal surgery.

Methods

Between 1999 and 2001, 41 active-duty soldiers (34 men, 7 women) underwent IDET for chronic discogenic low back pain unresponsive to nonoperative therapy. Data were collected through clinic chart review and follow-up questionnaires. Success was defined as a stated “50% decrease in pain” from baseline.

Results

During the study period, 36 of 41 patients underwent a single trial of IDET, and the remaining 5 underwent two trials of IDET. Only the results of the 36 patients who underwent one trial of IDET were used for statistical analysis. All 36 patients were available for follow-up at 6 months, whereas only 31 patients (86%) were reached for final follow-up (average, 29.7 months; range, 24 to 46). The success rate was 47% (17 of 36) at 6 months and 16% (5 of 31 patients) at latest follow-up. Although overall success rates were low, 20 of 31 soldiers (65%) had a persistent decrease in their analog pain score (average decrease of 2.5±1.6 on a 10-point scale), with 52% having 2-point or greater decrease. Nineteen of 31 soldiers (61%) were still on active duty at a minimum of 24 months after IDET. There were five transient complications (16%) from IDET, all reported within the first month. Seven of 31 soldiers (23%), all male, went on to spinal surgery within 24 months of failed IDET.

Conclusions

IDET is not a substitute for spinal fusion in the treatment of chronic discogenic low back pain in active-duty soldiers. Our reasonable early results diminished with time and up to 20% of patients report worsening of baseline symptoms at final follow-up. IDET will prove its role in the treatment of chronic discogenic low back pain as more outcome data are obtained, but for now we consider it, at best, an antecedent rather than alternative to spinal fusion.

Author Keywords: IDET; Intradiscal electrothermal therapy; Degenerative disc disease; Discogenic; Low back pain; Outcomes


Corresponding author. 4425 Rosedale Avenue, Bethesda, MD 20814, USA. Tel.: (301) 652-3932; fax: (202) 782-6845.

*1 FDA device/drug status: approved for this indication: Spine CATH Intradiscal Catheter and Thermal Regulating Unit.

Support in whole or in part was received from Walter Reed Army Department of Clinical Investigation under Grant 01-24005.

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the United States Army or the Department of Defense. The authors are employees of the United States government. This work was prepared as part of their official duties and, as such, there is no copyright to be transferred. The Department of Clinical Investigation at Walter Reed Army Medical Center has supported this protocol and manuscript.


The Spine Journal
Volume 3, Issue 6, November-December 2003, Pages 502-509
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"Harrison" - info (at) adrsupport.org
Fell on my ***winter 2003, Canceled fusion April 6 2004
Reborn June 25th, 2004, L5-S1 ADR Charite in Boston
Founder & moderator of ADRSupport - 2004
Founder Arthroplasty Patient Foundation a 501(c)(3) - 2006
Creator & producer, Why Am I Still Sick? - 2012
Donate www.arthropatient.org/about/donate
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  #4  
Old 05-10-2007, 12:06 PM
CHILLEE CHILLEE is offline
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Join Date: Apr 2007
Posts: 35
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Hello Teresa! Welcome to the board. I think you will find a plethora of info in the forums as well as the archives. My situation is slightly different, but if there is one piece of advice I could give you, it would be to have as little surgery as possible. The IDET would be like putting a Band-Aid on the inevitable. With your case being so complicated, as someone else mentioned, there are many a fine doctor here in the US who would be qualified to help you in your situation, rather than going overseas. Each surgery leaves it's own "unique" mark on you( and I am not talking about scar tissue)each time. The more you have the more complicated it becomes each time. I would look into finding a MD familiar with what you've been through, and where you are trying to go. You have alot to address, but with some tenacity and patience, I am sure you will find what you are looking for. Best Wishes!
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08/99 Herniation L5-S1
03/02-12/02-PT and 3 epidurals
01/04-11/04-PT, Chiro, 3 epidurals
03/30/05 ADR Charite at CINN, Dr. Noam Stadlan
04/24/05 Return to CINN inpatient for pain control issues
01/18/06 Hospitalized for pain spike, 5 day stay
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  #5  
Old 05-10-2007, 01:34 PM
Teresa Teresa is offline
Junior Member
 
Join Date: May 2007
Posts: 12
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Thank you each for your replies. I am a bit overwhelmed with information at the moment and will continue to research. My gut tells me to request the ADRs for the lumbar and then request revision of cervical fusion with insertion of ADRs. I need to find a surgeon who will evaluate me for both and consider state side post op care if I decide to go to Germany. As an alternative, trying to locate a surgeon in USA who will do multiple levels. I look forward to continued involvement on this forum.
__________________
Teresa
"I can be changed by what hapens to me. But, I refuse to be reduced by it." Author: Maya Angelou
Injury July 2004 neck and low back
Conservative Evaluation and Treatment to include PT, ESIs, etc for lumbar and cervical.
January 2005 C5-6 a
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