Your personal guide to Intra Discal Electro Thermal Annulaplasty (IDETA)

 Surgery :: Microdiscectomy
Anterior Cervical Decompression Fusion :: Disc Replacement (Pro Disc)
Posterior Lumbar Interbody Fusion (PLIF)

Following your consultation with Dr Diwan it has been decided that due to your chronic lower back pain, a reasonable plan of action is for you to undergo IDETA.  This procedure requires sedation (a mild anaesthetic) and will take about 45 minutes to an hour to complete.  Under x-ray guidance a needle is passed through the skin on the back and inserted into the effected intervertebral disc.  To stabilise a painful modular segment, a coil that delivers thermal energy is passed down the needle and the annulus (wall of the intervertebral disc) is thermally modulated. A radio frequency generator controls the temperature along with temperature sensors located within the coil. IDETA is performed as a day only procedure.

Preoperative instructions     

• Smoking is prohibited for 2 weeks before your operation and 4 weeks after surgery.  Research suggests that smoking decreases new capillary growth which inturn slows the healing process.
• Try to limit alcohol intake 1 week before surgery. 
• It is important that you are properly fitted for a brace that will be worn following your procedure for 3 months.

1 week before

• Arrange support person to be with you for the first day at home.  If this is not possible, you will need to arrange transport home from the hospital following your procedure.
• Communicate with the hospital regarding your admission status for you stay, St lukes Hospital complex 02 93560200

2 days before

• Call hospital to confirm booking, fasting time and hospital costs.
• Call Dr Diwan’s office to confirm post procedure appointment.

·        Pack for hospital: include comfortable cloths that do not have a tight waist band, slip on shoes if possible, reading material to help pass the time before your procedure

1 day before

• Fast from the specified time given to you by the hospital
• Ensure you have all the relevant contact numbers

Day of surgery

• Remember to pack your brace and any X-Rays or CT scans that Dr Diwan does not already have.
• Do not eat anything until the completion of your procedure
• When you have a shower pay special attention to your back and groin area
• Take all your contact numbers
• Leave home in plenty of time
• Remember to take your Medicare card and your private insurance details if applicable.

What to expect following surgery

Pain- You may experience some discomfort in your back following IDETA.  Very few people experience instant relief from their pain. In fact the pain may intensify for a few days before it decreases over the next 4 weeks.  You should expect ongoing improvement over 12 weeks post procedure.  

Postoperative instructions

• As a brace has been advised for you, it must remain on at all times for the first 6 weeks.  It can be removed for bathing only.  

First 2 – 3 days

• Take thing very easy for the first few days.
• It essential that you maintain a straight back at all times ( lordotic posture )
• To help support your back it is also important to keep your stomach muscles tight “sucked in”

week 2

• Walking is encouraged daily after the first week.  You should begin slowly and gradually build up.  If this activity causes you pain, stop!
• Limit your time spent sitting to 30 – 45 minutes at a time for the first 3- 4 weeks, then increase as tolerated.
• Do not lift anything greater than 5 kg
• Ensure that you keep your appointment with Dr Diwan.

Following your appointment you will be given further instructions as to your rehabilitation

It is very important that you protect your spine from excessive loading for at least the first 3 months.

Commonly asked questions

 When do I see Dr Diwan after the IDETA?

You should make an appointment to see Dr Diwan in his rooms (Suite 7A Level 5 St George Private Hospital Ph 95889622) for 10 days following your procedure.

Do I have to wear a back brace?   

 Yes you do.  It should be worn all the time for the first 6 weeks except for bathing. After this period of time Dr Diwan will assess your back and explain how long the brace should be worn.

When can I drive a car?

After 3-4 days you can drive for up to 20 minutes (first month) after this time frame you can slowly increase your driving time as tolerated.

What type of exercise can I do?

You can begin walking for 20 minutes a day at the beginning of the 2nd week following your procedure, and increased to twice daily when tolerated. By the end of week 4 you should be walking for 1 hour per day.

Gentle leg stretches - Quad stretch, hamstring stretch and calf stretch.   

Continue static abdominal contractions. You are encouraged to improve your aerobic fitness (A stationary bike is recommended)

 When is it safe to Bend and twist?

Bending at the waist is to be avoided for all activities for 3 months.  It is very important to maintain good posture especially driving and sitting. When you need to bend ensure you bend at the knees and or /the hips only.

When can I go back to work?

You will be off work for at least 1 week.  When you return for the post operative consult, Dr Diwan will tell you when it is ok for you to return to work. This will depend on how strenuous or physical your job is.

When can I engage in sexual relations?

It is fine to resume sexual activity in the first week providing you are the less active partner.  Thereafter such activity has to be in keeping with the above guidelines.