🎙 Episode 54 – Red Flags That Tell You a Patient Is Not a Good Candidate for Spinal Decompression

In this episode of The Practice Builders Podcast, Dr. Pankonin breaks down six major red flags doctors should watch for when selecting spinal decompression patients.

Successful decompression starts with proper patient selection. An MRI may show disc degeneration, bulges, or stenosis, but that does not automatically mean the patient is a good candidate. The MRI must match the patient’s symptoms, history, and exam findings.

He also discuss why doctors need to set realistic expectations, screen for psychological and compliance barriers, and look at the bigger picture when patients have significant comorbidities like obesity, smoking, poor conditioning, or lifestyle factors that may limit results.

Key topics include:

• Why the MRI must clinically correlate with the patient’s symptoms
• When severe multi-level central stenosis may limit decompression outcomes
• How fear-avoidance, disability mindset, anxiety, or depression can affect results
• Why “miracle seekers” often become disappointed patients
• How poor compliance can sabotage a 24-visit decompression plan
• Why comorbidities and lifestyle factors must be addressed before or during care

The big takeaway: not every patient with a bad MRI is a decompression candidate. The goal is to identify the right patients, set clear expectations, and create the best possible chance for a successful outcome.

Doctors should define success around meaningful improvement, such as at least 50% pain reduction and better function, rather than promising to “fix” or “cure” the condition.

🎧 Listen now on your favorite platform!