Authors' objectives:

In commissioning this report, AHRQ, in consultation with CMS and ECRI, developed four key questions; 1: What are the patient inclusion and exclusion criteria used in studies of decompression therapy? 2: What are the efficacy or effectiveness outcomes measured in studies of decompression therapy? Are the efficacy/effectiveness outcome measured in studies of decompression therapy comparable to those used in studies of other non-surgical modalities for chronic low back pain due to a herniated disc or degenerative disc disease? 3: Is decompression therapy an effective treatment for chronic low back pain due to herniated disc or degenerative disc disease? 4: What complications, harms, and adverse events associated with decompression therapy have been reported?

Authors' recommendations: Patient inclusion criteria for studies of decompression therapy were chronic low back pain, with or without radicular symptoms, due to degenerative or herniated disc disease or due to facet arthritis. Product literature and the exclusion criteria in the examined studies suggest that this therapy should be avoided in patients with osteoporosis, tumor, infection, spinal instability, and surgical implants. The health outcome measures reported in studies of decompression therapy are also reported in literature on other non-surgical treatments for low back pain. However, a number of additional outcomes (absenteeism, return to work, overall health, analgesic consumption, low back painrelated disability rates, and quality of life) have been reported for other non-surgical treatments. Currently available evidence is too limited in quality and quantity to allow for the formulation of evidence-based conclusions regarding the efficacy of decompression therapy as a therapy for chronic back pain when compared with other non-surgical treatment options. Of the studies examined for assessment of efficacy, neither included patients over 65 years of age. Adverse event reporting for decompression therapy is infrequent. There was one case report of an enlargement of an existing disc protrusion, and other studies reported worsening of pain in some patients.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://www.cms.gov/mcd/viewtechassess.asp?where=search&tid=47

Year Published: 2007

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: United States

Organisation Name: Agency for Healthcare Research and Quality

Contact Address: Center for Outcomes and Evidence Technology Assessment Program, 540 Gaither Road, Rockville, MD 20850, USA. Tel: +1 301 427 1610; Fax: +1 301 427 1639;

Contact Name: martin.erlichman@ahrq.hhs.gov

Contact Email: martin.erlichman@ahrq.hhs.gov

Copyright: Agency for Healthcare Research and Quality (AHRQ)