62. 10 Common Decompression Mistakes

🎙 Episode 62 – 10 Common Decompression Mistakes In this episode of The Practice Builders Podcast, Dr. Kyle Pankonin breaks down 10 common decompression mistakes that can hurt patient selection, clinical outcomes, and case acceptance. From relying too heavily on MRI findings to pulling with more force than necessary, many of these issues come down to the same thing: matching the recommendation to the actual patient in front of you. History, exam findings, imaging, neurological status, inflammation, and severity all need to work together. Dr. Pankonin walks through the clinical and communication adjustments that can help doctors select better candidates, set realistic expectations, and use decompression more effectively across a wider range of spine conditions. Key topics include: Why imaging alone should never determine whether someone is a decompression candidate How realistic expectations, including the 50% improvement benchmark, can improve patient satisfaction When an MRI is truly necessary and when history, exam, and X-rays may provide enough information Why identifying the actual pain generator matters before recommending a decompression program Why large disc herniations shouldn’t automatically intimidate you The importance of addressing inflammation aggressively in stubborn cases Why more pulling force doesn’t necessarily produce better results How to match the number of visits to the severity of the patient’s condition instead of automatically recommending 24 visits Why decompression can apply beyond traditional disc cases, including facet problems, stenosis, and some spondylolisthesis presentations How better case selection and dosing can improve both the patient experience and clinical results The big takeaway: decompression works best when the protocol fits the patient, not when every patient gets the same protocol. Take the history, exam, imaging, severity, and goals together, then make the recommendation the individual case actually calls for. 🎧 Listen now on your favorite platform!