Electrothermal Coagulation

  I have 3 level DDD from L3 to S1 with a particiularly bad disc between L5 & S1. A fusion at that level is not practical due to the upper degenerative discs.
  I suffer bilateral lower extremity foot and leg discomfort and and right sided sciatica and wonder how effective is Intradiscal Electrothermal Coagulation using the catheter technique?
  I had a very bad reaction to a discogram 3 years ago and am concerned about any procedure making me worse off.
  I'd appreciate any info on electrotherapy for DDD.
  
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Dear Bob,
Degenerative disc disease (DDD) occurs commonly in the aging population.  It is generally referred to as 'arthritis' in the spine and, though this isn't completely correct, is due to normal wear and tear on the spine over the years.  All the pounding over the years can cause a disc to degenerate and have a characteristic black appearance on an MRI.  Patients may present with chronic back pain.  Spine surgeons can do fusion procedures in this patient population, though not all patients are improved after the fusion.
The natural history of degenerative disease is that it will continue to degenerate and the vertebral bodies will eventually fuse on their own, but this will take time.  
With regard to intradiscal electrothermic coagulation, we do not do this procedure and would therefore have little to add on the subject.  The benefit to such procedures is unclear and not a mainstay of management of degenerative disease in the spine.  
Good luck.