Decompression quackery

Dr. Hall has done a service in exposing the quackery inherent in much of the chiropractic claim of effectiveness for "decompression therapy" ("Fix Your Ruptured Disk without Surgery?" SI, September/October 2007).

As a neurosurgeon with thirty-seven years' experience dealing in large measure with spinal disease in middle- and older-aged people, I see daily the waste of time and money with "methods" such as this. Claims that "decompression therapy" will be successful 86 percent of the time are utter nonsense.

I have two corrective comments, perhaps niggling: There is no reason to limit the straight-leg raising test significance to angles between 30 and 60 degrees--age and disc levels are more relevant to this test, as is the degree of irritation of the nerve root; and while it is true that discs that are bulging and not frankly ruptured will settle down for the majority of patients, much less commonly symptoms caused by disc fragments that are extruded into the extradural space will do so permanently.

A. Loren Amacher, MD

Lewisburg, Pennsylvania

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