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Meta-Analysis of the Efficacy and Safety of Intradiscal Electrothermal Therapy (IDET)


David Appleby, MPH, Smith & Nephew, Endoscopy, Biostatistics, 150 Minuteman Road, Andover, Massachusetts, USA. Tel: 978-749-1570; Fax: 978-749-1443; E-mail:


Objective.  The objective of this study was to determine the representative outcomes of the intradiscal electrothermal therapy (IDET) procedure in terms of pain relief, reduction of disability, and risk of complications.

Design.  Meta-analysis, using a random-effects model. A Medline literature search was conducted using search terms associated with the IDET procedure including IDET, intradiscal electrothermal therapy, intervertebral disk, and annuloplasty.

Outcome Measures.  The outcomes analyzed were the visual analog scale (VAS) assessment of pain, the bodily pain, and physical functioning subscales of the SF-36 health survey, and the Oswestry disability index.

Results.  From 1998 to March 2005, 62 peer-reviewed articles were identified regarding the IDET procedure. Forty-five articles were excluded, leaving a total of 17 unique published reports included in this review. The overall mean improvement in pain intensity was 2.9 points as measured by the VAS. The overall mean improvement in physical function was 21.1 points as measured by the SF-36. The overall mean improvement in bodily pain was 18.0 points as measured by the SF-36. The overall mean improvement in disability was 7.0 points as measured by the Oswestry disability index. The overall incidence of complications was 0.8%.

Conclusion.  Although variation exists in the reported outcomes among the various studies of the IDET procedure, the pooled results of the published studies provide compelling evidence of the relative efficacy and safety of the IDET procedure.