The Center for Spine Care - www.centerforspinecare.com

1. Degenerative Disc Disease
2. Internal Disc Disruption
3. Contained Disc herniation
4. Multi-level Degenerative Disc Disease

1. Failure of aggressive conservative care to relieve pain.
2. Prefer a minimally invasive procedure over a major surgical intervention.
3. Willingness to participate in intense post op rehabilitation program.

1. Large or extruded disc herniation with or without redicular leg pain.
2. Neurologic deficit.
3. Severe degenerative disc disease (advanced loss of disc space that precludes intradiscal catheter navigation).
4. Previous disc surgery (e.g. discectomy).
5. Failed fusion surgery (pseudoarthrosis).
6. Deformity (e.g. scoliosis, spondylolisthesis, kyphosis).
7. Tumor.
8. Infection.
9. Inability to participate in an intensive rehabilitation program.

1. As the patient you are given a light sedative prior to the procedure, as well as a local anesthetic to numb your skin and muscle tissue, where the needle will be inserted.
2. A needle is inserted into the disc, using a flouroscope (real time x-ray), which allows me to see where the needle is going and position it properly.
3. After the needle is in " position", the electrothermal catheter is inserted through the needle.
4. The needle and catheter placement are confirmed by x-ray prior to heating up the probe.
5. The heat is gradually increased until it reaches the treatment temperature range.
6. The heat treatment generally lasts from 14 to 17 minutes and you will be asked to provide feedback on any discomfort you may experience. Generally a patient experiences no pain to only mild discomfort.
7. The entire procedure for one disc level will take approximately 30 minutes to one hour.

1. Refrain from driving a vehicle for 1-5 days. It is safe to travel by car or plane. However, limit sitting to 20 minutes.
2. Continue to rest, and use ice and medication, as necessary for discomfort. Typically, non-steriodal anti-inflammatories are prescribed.
3. For 3-5 days after the procedure do not over exert yourself. Avoid housework, lifting, and bending, even if your pain is decreased. You may take short 15-20 minute walks interspersed with rest.
4. Returning to work will be discussed based upon the physical demands of your job.

1. You can walk as much as you tolerate and perform gentle streching.
2. Continue to use proper body mechanics and restrict bending, twisting, and lifting to 10 pounds.
3. No sports activities.
4. Continue to limit sitting to 20 minutes.

1. Continue to observe good body mechanics.
2. At 6 weeks post procedure, formal and specific spine therapy is recommended.
3. Therapy and activity will be individualized depending on your diagnosis and clinical progress.

1. During the first 4-6 weeks the disc is in the process of healing and therefore do not expect a change in your pain.
2. At 6 weeks and even for 3-6 months after the procedure the disc is continuing to heal and reduction in pain occurs.
3. Your progress will be followed and you can expect returning to the clinic at the 6 week, 3 month and 6 month post procedure dates.
4. The first group of patients at 6 month follow up (18/25) - 72% reported good to excellent relief of chronic low back pain.
5. These results have remained the same in over 70 patients.

1. No complications have been recorded in the preliminary or clinical study.
2. Occasionally, an increase in the usual pre-procedure pain occurs. This has always been temporary.
3. Patients have also reported rare sensory symptoms (numbness) in their legs post procedure. This has also been temporary.
4. No patient has been made worse by the series.

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