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IDET Back Surgery

Dawn MacFarlane was hit by a car 6 years ago, which damaged a disc in her lower back.

She is among 80% of Americans who the American Medical Association says will experience low back pain at some point during their lifetimes.

"When you're in pain, it's a total drag," says Dawn MacFarlane, 37, a dental hygienist and mother of two. "It affects you physically and mentally. You're always tired."

After four epidural blocks for pain failed to provide relief, MacFarlane underwent a new type of back surgery for patients with degenerative disc diseases that uses the concept of heating the body from within. The procedure could mean a lot less pain without undergoing major surgery.

Dr. Frank Cammisa, director of the Spine Care Institute at Manhattan's Hospital for Special Surgery, performed the relatively new, minimally invasive surgery known as intradiscal electrothermal therapy, or IDET.

Under local anesthesia, a needle is inserted directly into the degenerated disc. A catheter with a heated tip then follows. The heat stabilizes collagen in the disc and deadens pain fibers.

IDET is considered a welcome alternative to more invasive spinal fusion surgery, which 200,000 Americans undergo annually. Fusion surgery requires a large incision, several days at the hospital, and weeks or months of recovery. It can also permanently limit flexibility.

IDET is done on an outpatient basis and patients can move about the next day.

"If it doesn't work, they can always have the fusion," Cammisa says. "They have not lost anything. So we think it's a reasonable alternative to the appropriately selected patient."

About 11,000 IDET procedures have been performed over the past several years. A multicenter trial shows a success rate of about 70% after 1 year.

Because the surgery is so new, there are no long-term studies, so it is too soon to tell if its effects are permanent.

"Our sense is that over time, the degenerative process may continue but we would be able to give patients a period of time where they were would be pain free," Cammisa says.

It can take anywhere from 2 weeks to 2 years to see the final result from this surgery. It costs about $8,000, compared with $30,000 to $40,000 dollars for spinal fusion.

MacFarlane is still sore from her surgery.
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