Efficacy and Risks of Intradiscal Electrothermal Therapy (IDET) for Treatment of Low Back Pain: A Narrative Review.

purpose of reviewChronic low back pain, particularly discogenic pain, remains challenging to treat effectively due to complex underlying mechanisms and variability in patient response. Intradiscal Electrothermal Therapy (IDET) has emerged as a minimally invasive intervention to alleviate discogenic back pain through targeted thermal denaturation of nociceptive nerve fibers and collagen remodeling within the intervertebral disc. The present investigation critically examines existing literature to assess efficacy, safety profile, optimal patient selection criteria, and relative effectiveness compared to alternative minimally invasive treatments such as nucleoplasty and radiofrequency annuloplasty. RECENT

findingsWhile several randomized controlled trials and meta-analyses suggest IDET provides moderate short-term relief, some studies highlight significant placebo effects and question its long-term efficacy. Notably, careful patient selection, guided by clinical presentation and diagnostic imaging, emerges as a critical factor influencing outcomes. This review addresses potential complications, including rare but serious conditions like cauda equina syndrome and discitis. Emerging techniques such as biacuplasty and radiofrequency annuloplasty are also discussed, contextualizing IDET among other minimally invasive thermal procedures. Further research with rigorous methodological standards and consistent patient criteria is necessary to clarify the clinical utility of IDET and identify the patient populations most likely to benefit from this intervention.