Percutaneous lumbar mechanical disc decompression utilizing Dekompressor®: an update of current evidence

Area of Science:

• Neurosurgery
• Orthopedics
• Minimally Invasive Procedures

Background:

• Traditional open discectomy for nerve root compression has limitations, especially for contained disc herniations.
• Minimally invasive techniques, including the Dekompressor, have emerged for lumbar disc decompression.
• Existing evidence for alternative techniques like Dekompressor is not yet convincing, with a lack of robust data.

Purpose of the Study:

• To systematically review and update the literature on the clinical effectiveness of the Dekompressor device.
• To evaluate the efficacy of mechanical lumbar disc decompression using the Dekompressor (high RPM device).

Main Methods:

• Systematic literature review focusing on mechanical disc decompression with the Dekompressor.
• Inclusion of randomized trials (Cochrane Musculoskeletal Review Group criteria) and observational studies (Newcastle-Ottawa Scale).
• Evidence quality assessed using USPSTF criteria; data sourced from PubMed, EMBASE (1966-2012), and manual bibliographical searches.

Main Results:

• Only 3 studies met the inclusion criteria out of 5 initially considered.
• The level of evidence for percutaneous disc decompression (PDD) with the Dekompressor was classified as limited according to USPSTF criteria.
• Primary outcome was pain relief; secondary outcomes included functional and psychological improvement, opioid use, and return to work.

Conclusions:

• A significant paucity of high-quality literature exists regarding PDD with the Dekompressor.
• The current systematic review indicates limited evidence supporting the effectiveness of PDD with the Dekompressor for lumbar disc issues.