title: Percutaneous lumbar mechanical disc decompression utilizing Dekompressor®: an update of current evidence.
abstract: BACKGROUND
  The primary goal of the surgical treatment of nerve root compression from a disc protrusion continues to be the relief of compression by removing the herniated nuclear material with open discectomy. However, poor results have been reported for contained disc herniations with open surgical interventions. In recent years, a number of minimally invasive nuclear decompression techniques for lumbar disc prolapse, protrusion, and/or herniation have been introduced, including the Dekompressor®. The efficacy of several alternative techniques, including the Dekompressor, automated percutaneous discectomy, and laser discectomy, has been described, but is not convincing. There is a continued paucity of evidence for all decompression techniques.
  
  
  OBJECTIVE
  The objective of this systematic review is to evaluate and update the literature describing the clinical effectiveness of Dekompressor, a high rotation per minute (RPM) device used in mechanical lumbar disc decompression.
  
  
  METHODS
  A systematic review of the literature focusing on mechanical disc decompression with Dekompressor.
  
  
  METHODS
  The available literature on the use of percutaneous disc decompression (PDD) with Dekompressor to manage chronic low back and lower extremity pain was reviewed using the Cochrane Musculoskeletal Review Group criteria for randomized trials and the Newcastle-Ottawa Scale criteria for observational studies.The level of evidence was classified as good, fair, and limited or poor based on the US Preventive Services Task Force (USPSTF) system for grading the quality of evidence.Data sources included relevant literature identified through PubMed and EMBASE from 1966 through September 2012, and manual searches of the bibliographies of known primary and review articles.
  
  
  METHODS
  Pain relief was the primary outcome measure. Secondary outcome measures were functional improvement, improvement of psychological status, opioid intake, and return to work. Short-term effectiveness was defined as one year or less. Long-term effectiveness was defined as greater than one year.
  
  
  RESULTS
  Only 5 studies were considered for inclusion. Of those, only 3 of them met inclusion criteria. Based on USPSTF criteria, the level of evidence for PDD with Dekompressor is limited.
  
  
  CONCLUSIONS
  Paucity of high quality literature.
  
  
  CONCLUSIONS
  This systematic review found limited evidence for PDD with Dekompressor.
authors.affiliation: Pain Management Center of Paducah, Paducah, KY, USA. drlm@thepainmd.com
authors.forename: Laxmaiah
authors.initials: L
authors.lastname: Manchikanti
authors.forename: Vijay
authors.initials: V
authors.lastname: Singh
authors.forename: Aaron K
authors.initials: AK
authors.lastname: Calodney
authors.forename: Standiford
authors.initials: S
authors.lastname: Helm
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Deer
authors.forename: Ramsin M
authors.initials: RM
authors.lastname: Benyamin
authors.forename: Frank J E
authors.initials: FJ
authors.lastname: Falco
authors.forename: Joshua A
authors.initials: JA
authors.lastname: Hirsch
mesh_terms: D059350:Chronic Pain / Q000601:surgery*; D019299:Decompression, Surgical / Q000379:methods; D017587:Diskectomy, Percutaneous / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D016896:Treatment Outcome