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June 5, 2003


Emory Studies Minimally Invasive Procedure to Reduce Pain and Size of Herniated Discs

ATLANTA- A minimally invasive procedure to alleviate the low back and severe leg pain often resulting from herniated disks is being studied at Emory University in a multi-center clinical trial. Called electrothermal disc decompression, or EDD, the procedure involves inserting a catheter into the disc and applying heat to shrink the disc and reduce the pain. The outpatient procedure takes 30 to 45 minutes, and patients can return to work within a few days.

"Surgery for herniated discs is the most common procedure for spine surgeons, but now we are looking into a treatment option that is less invasive than surgery," says Michael Schaufele, MD, assistant professor of physical medicine and rehabilitation, Emory University School of Medicine, and leader of this pilot study at the Emory Spine Center. "Patients who have failed non-surgical treatments such as physical therapy and epidurals for low back and intense leg pain, but who do not want to explore the option of surgery, are perfect candidates for this study."

A herniated disc develops when the soft area between the bones in the spine presses on the nerves around the backbone. The word herniate means to bulge or to stick out. It is sometimes called a ruptured disc. Herniated discs are most common in the lumbar spine, the part of the spine between the bottom of the ribs and the hips. As people age, the discs become flatter and less cushiony. When a disc becomes too weak, the outer part may tear, causing the inside of the disc to push through the tear and press on the nerves beside it. Herniated discs are most common in people in their 30s and 40s.

In the new minimally invasive procedure, under light sedation, a catheter is placed into the affected disc through a needle. The catheter is then attached to a generator for its heating source. Using fluoroscopy, a technique for obtaining "live" X-ray images, physicians insert the catheter into the affected disc and heat it to about 200 degrees Fahrenheit. The heat causes the disc herniation to shrink and, in turn, takes the pressure off the nerves to reduce pain. Only one treatment is needed to shrink the disc. Following EDD, patients are expected to have immediate leg pain relief. Back pain relief may follow. According to Dr. Schaufele, patients should receive the full benefits within weeks to months.

"This is a fairly new procedure for this indication, but a similar catheter has been around for awhile to treat certain patients with chronic low back pain," says Dr. Schaufele. The catheter, manufactured by Smith & Nephew Orthopaedics, is FDA approved. "If participants in the pilot study show improvement, we will likely go forward with a randomized, placebo-controlled study," Dr. Schaufele adds.

Participants are now being enrolled in the study. To qualify, participants must be between 18 and 50 years of age and have leg pain significantly greater than back pain for a minimum of eight weeks. Participants must also have had no success with conservative treatments, including anti-inflammatory medication, physical therapy and epidurals. Those who have had previous back surgery are not eligible for this research study.

For more information, please call Emory Health Connection at (404) 778-7777.

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