title: Percutaneous mechanical disc decompression using Dekompressor device: an appraisal of the current literature.
abstract: OBJECTIVE
  The objective of this study was to determine if the available literature answers the following questions: does percutaneous disc decompression using Dekompressor device relieve radicular pain caused by a small disc herniation? Is the duration of response stable and clinically worthwhile? Is relief of pain corroborated by improvements in physical and social function? Does relief of pain result in reduction in the use of other health care? Is there a risk of serious side effects or complications? DESIGN/SETTINGS: The study was designed as a narrative review and description of the available evidence, drawn from the databases of PubMed, EMBASE, and the Cochrane Library. Innovatively, the concept of the "context of the patient" was introduced in the assessment. It required the assessors to consider the alternatives the patients and their treating practitioners faced.
  
  
  RESULTS
  The literature search identified three nonrandomized clinical trials, and a single case series. All studies were reasonably rigorous in reporting relief of pain and the use of analgesics. Evidence with respect to physical functioning was scarce. Although investigators reported on the relief of pain, they lacked rigor when reporting associated outcome measures such as use of other health care and physical functioning.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Anesthesiology, Pain Medicine Division, Penn State Milton S. Hershey Medical Center, Penn State College of Medicine, Hershey, Pennsylvania 17033, USA. yvorobeychik@psu.edu
authors.forename: Yakov
authors.initials: Y
authors.lastname: Vorobeychik
authors.forename: Vitaly
authors.initials: V
authors.lastname: Gordin
authors.forename: Dmitriy
authors.initials: D
authors.lastname: Fuzaylov
authors.forename: Marek
authors.initials: M
authors.lastname: Kurowski
mesh_terms: D000700:Analgesics / Q000627:therapeutic use; D019299:Decompression, Surgical / Q000295:instrumentation* / Q000379:methods; D017587:Diskectomy, Percutaneous / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007403:Intervertebral Disc / Q000503:physiopathology / Q000601:surgery*; D008159:Lumbar Vertebrae / Q000503:physiopathology / Q000601:surgery*; D017063:Outcome Assessment, Health Care / Q000379:methods; D010146:Pain / Q000209:etiology; D012196:Review Literature as Topic; D016896:Treatment Outcome
chemical_list: D000700:Analgesics