Appleby David, Andersson Gunnar, Totta Michael
Smith & Nephew, Endoscopy, Biostatistics, Andover, Massachusetts, USA.
Pain Med. 2006 Jul-Aug;7(4):308-16. doi: 10.1111/j.1526-4637.2006.00172.x.
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.
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.
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.
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%.
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.
本研究的目的是确定椎间盘内电热疗法(IDET)在缓解疼痛、减少残疾和并发症风险方面的代表性结果。
采用随机效应模型进行荟萃分析。使用与IDET手术相关的检索词在Medline数据库中进行文献检索,检索词包括IDET、椎间盘内电热疗法、椎间盘和纤维环成形术。
分析的观察指标包括视觉模拟量表(VAS)疼痛评估、SF-36健康调查中的身体疼痛和身体功能分量表以及Oswestry残疾指数。
从1998年到2005年3月,共识别出62篇关于IDET手术的同行评审文章。排除45篇文章,本综述共纳入17篇独立发表的报告。通过VAS测量,疼痛强度的总体平均改善为2.9分。通过SF-36测量,身体功能的总体平均改善为21.1分。通过SF-36测量,身体疼痛的总体平均改善为18.0分。通过Oswestry残疾指数测量,残疾的总体平均改善为7.0分。并发症的总体发生率为0.8%。
尽管在IDET手术的各项研究中报告的结果存在差异,但已发表研究的汇总结果提供了令人信服的证据,证明了IDET手术的相对疗效和安全性。