Decompression for IDD?

[lovebailey2001]

Is there any evidence for mechanical decompression useful for IDD! please share ur thoughts/experiences..

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[SSdoc33]

No

 

[PinchandBurn]

No

interesting. I had a similar discussion with someone at a recent conference. He opines that now, for patients with refractory radicular symptoms,etc (s/p 2 ESIs or 3 or whatever) we send to a surgeon for mechanical decompression. We now know the failure rate of surgery. HE opined, why not do SCS first. If that fails then and only then send to surgery. He stated SCS is pretty reversible and always can be removed, surgery cant be...

of course ,I dont practice this way, but.....

 

[lobelsteve]

Is there any evidence for mechanical decompression useful for IDD! please share ur thoughts/experiences..

Depends on what you mean?

http://www.chirobase.org/06DD/vaxd/vaxd.html

Refutes chiro or other guys doing Acuspine/Vax-d etc.

 

[101N]

no

1+

 

[ampaphb]

Even in Paducah, Lax can only call this Level III evidence

Comprehensive evidence-based guidelines for interventional techniques in the management of chronic spinal pain.
Pain Physician. 2009 Jul-Aug;12(4):699-802.​

He bases this on:

Alò KM, Wright RE, Sutcliffe J, Brandt SA
Percutaneous lumbar discectomy: clinical response in an initial cohort of fifty consecutive patients with chronic radicular pain.
Pain Pract. 2004 Mar;4(1):19-29.

Alò KM, Wright RE, Sutcliffe J, Brandt SA.
Percutaneous lumbar discectomy: one-year follow-up in an initial cohort of fifty consecutive patients with chronic radicular pain.
Pain Pract. 2005 Jun;5(2):116-24.

Lierz P, Alo KM, Felleiter P.
Percutaneous lumbar discectomy using the Dekompressor system under CT-control.
Pain Pract. 2009 May-Jun;9(3):216-20.

Amoretti N, David P, Grimaud A, Flory P, Hovorka I, Roux C, Chevallier P, Bruneton JN.
Clinical follow-up of 50 patients treated by percutaneous lumbar discectomy.
Clin Imaging. 2006 Jul-Aug;30(4):242-4.​

Vorobeychik et al at Hershey (Percutaneous mechanical disc decompression using Dekompressor device: an appraisal of the current literature. Pain Med. 2012 May;13(5):640-6) looked at the same 4 studies, and concluded

Unfortunately, the context of a patient with persistent radicular pain caused by a small disc herniation is the lack of good alternatives to Dekompressor procedure. The moral question is whether Dekompressor is any less valid an option than perpetual opioids or discectomy. This question would be much easier to answer if the literature on Dekompressor was more rigorous and more compelling in its evidence.​

 

[lovebailey2001]

Sorry for ambigous question! Actualy I was referring to 'Discogenic Pain' without radicular pain and herniation and by mechanical decompression I meant Percutaneous nucleotomy, Nucleoplasty and Dekompressor (Stryker) etc.. Recently I met somebody who claims that these devices are useful for discogenic low back pain without radicular pain! Though he cudn't explain the mechanism of relief...coz pain is coming out of sensitized annulus radial fissures mainly....

 

[lobelsteve]

Sorry for ambigous question! Actualy I was referring to 'Discogenic Pain' without radicular pain and herniation and by mechanical decompression I meant Percutaneous nucleotomy, Nucleoplasty and Dekompressor (Stryker) etc.. Recently I met somebody who claims that these devices are useful for discogenic low back pain without radicular pain! Though he cudn't explain the mechanism of relief...coz pain is coming out of sensitized annulus radial fissures mainly....

I believe most of the literature is from the inventor of the device, Kenny Alo. And it ain't pretty.

 

[SSdoc33]

Sorry for ambigous question! Actualy I was referring to 'Discogenic Pain' without radicular pain and herniation and by mechanical decompression I meant Percutaneous nucleotomy, Nucleoplasty and Dekompressor (Stryker) etc.. Recently I met somebody who claims that these devices are useful for discogenic low back pain without radicular pain! Though he cudn't explain the mechanism of relief...coz pain is coming out of sensitized annulus radial fissures mainly....

oh, i see. in that case...... No