It seems that the major issue which affects the success of IDET is patient selection. Recent analysis and review suggested that such variability in patient selection criteria and use of different heating techniques from one study to another could contribute to differences in achieved clinical results (Appleby et al., 2006). The average pain score improvements in 13 studies analyzed were from 1.5 to 5 points. Functional capacity, measured by SF-36 physical function (PF) scores, improved from about 15 to 30 points in four studies.
It appears that the use of additional patient selection criteria may improve overall results of IDET. Pauza and colleagues in their sham-controlled [where some patients think they are getting the full treatment but are actually getting a placebo], prospective IDET study introduced a few additional patient selection criteria and achieved at least 50% improvement in 50% of the patients (Pauza et al., 2004). In another prospective, matched study, patients with any signs of disc degeneration at more than 2 lumbar levels (as seen on an MRI scan) had significantly less improvement in functional capacity and pain relief following the IDET (Kapural et al., 2004). Therefore, it seems that those who are not likely to benefit from IDET include patients with advanced multi-level degenerative disc disease (Kapural et al., 2004) and overweight patients (Cohen et al., 2004).
