Future of Spinal Decompression (Part 2)

Hey there and welcome back. I'm Dr. Vince Leone, executive producer and co-host of the Practice Builders Podcast. With my partner in crime, Dr. Kyle Pankinen, we deliver proven strategies to help you grow fast, specialize with confidence, and build profitable staff-run practices. Let's go ahead and dive into today's episode now. Hello and welcome to the Practice Builders Podcast. Happy to have you here. My name is Dr. Vince Leone.

And my name is Dr. Kyle Pankinen, and I also am happy to have you here. And, uh, this is going to be a part 2. This is going to be a little deeper dive into what we covered last time. Dr. Leone will introduce the topic, and I think you're going to like this one.

Oh, absolutely. And this is State of Spinal Decompression Part 2, Focus on Published Research. And Now, I was just talking to a doctor 2 days ago, and, you know, he's thinking about getting into decompression. You know, he's been practicing for 30 years and seeing the writing on the wall, which, you know, to be fair, we've been shouting from the rooftops for the last decade or so. Isn't that right, Dr. Kyle?

We've been there. We've been shouting loud. Let's get on board, everybody. Get on the bandwagon.

Yeah, I remember, you know, I started With decompression, well, actually, right when I graduated in '07 and then kind of went full tilt in 2012. But even when I started the consulting business as a side business in 2016, I was talking about, hey, insurance is dwindling, cash services is where it's at. So, we've been talking about this a long time. And now, I think it's starting to catch up. But as I had mentioned—

Right.

Prior, I was talking to this doctor, um, and he's like, does this actually work? And, you know, hey, that's a fair, fair question. Now, it may show a little naivete of not actually digging into all the published research, which is, hey, that's what you guys got us for. And that's what we're going to do today. We're going to dive into the published research because it absolutely works 100%. No, not 100% of the time, but it absolutely works. And, um, but when you have Confidence that it works and a protocol that works and the research that supports it, that's only going to help your enrollment rate with patients, right? Because they sense that confidence. So it is, you know, a valid question. And that's why we wanted to dig into this today so we can give you guys and gals, everyone listening to the podcast, some of the ammo that you need in your report of findings. So that, because patients are going to ask the same thing, especially left-brain kind of analytical types, they're going to want to know, hey, is this supported by research? So again, good news, it is. Let's go ahead and dive into that first research paper. Dr. Kyle, what do you got?

Yeah, so this is 2025, has been, uh, I follow the— I keep up with the literature that comes out year after year with this. 2025 has been one of the best years in recent memory as far as new and emerging and just volume of studies that are coming out. So it's pretty exciting. I mean, we have studies coming out of Japan, Korea, South Korea, Egypt, and also the United States. Egypt, yeah. Egypt is doing studies on spinal decompression.

Who knew? Not me.

Who knew?

It was right. Wow, interesting.

Yeah, so I'll go into some of the latest though. The most exciting thing is there's actually a University of Southern Florida in the United States, which is a major medical research, uh, university. They are really excited about spinal decompression and they're doing a lot of research. So what's that?

Who said again?

University of Southern Florida.

Oh, right, right. Yeah, yeah, absolutely.

So some of these studies that I'm gonna reference are from that. So the first one, the latest study out, there was 267 patients in it. And I'm not gonna go into great detail on these studies, but I wanna share a few bullet points. The study, the study they set, so it was a little bit larger study.

Yeah, that's a pretty good sample size.

Good sample size. So a lot of studies you'll see, it's like, oh, they do a little case series on 3 or 4 cases, but this is a larger one. I think the 2nd or 3rd largest one I've seen in spinal decompression research. And they found that the average, that 90.5% of the patients in the study saw a decrease, significant decrease pain. And the average was 62.5% reduction on average. And the dosage they used in this study was 20 total sessions. So research shows the optimal minimal dosage of spinal decompression is 20 to 24, depends on the study that you read. But if you're out there and you're thinking about doing decompression and you want to do it the right way for patients, what we can glean from research is You got to be in that range. You got to be in that 20 to 24. I like 24, and I know that's what you used in practice, Dr. Leone. That's what I use as the— I always tell patients that's the minimal clinical effective dosage. In other words, that's kind of the, the bare bones. We got to do at least that many. I know there might be cases that get better quicker, There might be cases that need some more than that, but that's kind of our baseline. And that's gleaned right from the research studies. You, of course, you, Dr. Leone, started way ahead of time back in 2007, like you said, all the way back then. When you started out, did you use that amount right from the get-go?

We did. And 'cause we hired a coach, right?

Excuse me.

So we always did 24 visits. I don't know that we had the research back then to support that, but, you know, we had the DRX-9000 and we played with the treatment time a little bit. I, I can't remember what they were recommending, but we did 20 minutes and, you know, 16 minutes and 28 minutes. Like, we kind of jumped all around because we had a pretty good volume to see, and we ended up, you know, right about 25 minutes per treatment, 24 Treatments total. And I always tell doctors, you know, our protocol is 24 visits over 90 days, right? And we have some adjunct therapies that we throw in there that we won't kind of dive into here. But 24 visits, 90 days seems to be based on the research as well as anecdotally. We've been tracking this within specialized practice. Dr. Kyle's done an excellent job of that. Um, I would always prefer to be a little on the higher side You know, like in others it says 20 to 24. I would rather be on the higher side. And if for some reason they are 100% perfect after 22 visits or 21 visits, I mean, you could in theory just, you know, bank the remaining visits, put it into a maintenance plan once a month, that type of thing. No one's going to complain if they have got, you know, if they've gotten incredible results, they've gotten their life back, and they have a couple visits left over. Here's where they will complain is if you recommend too few And they get kind of there, almost there, but they're not quite there. And now they're, they're not so happy, right? Because now they have to shell out more money and you lose kind of that credence or that credibility because, you know, you weren't— you guessed wrong, right? You went on the low side. Now, the caveat to that even is if it's a super severe case, you know, we typically would say, hey, Published research, uh, 24 visits minimum effective dose. Because the severity of this, we may need an additional 4 to 6 on the back end, but let's see how you do. I mean, if you, if you follow the treatment protocol, uh, uh, very closely, you're compliant, you're not, um, doing things to exacerbate the condition, uh, away from the office, who knows, maybe you get done in 24 visits, but we'll revisit that at the end. So I think you wanna protect yourself and you wanna give the patient the best chance of success.

Yeah. And that leads into what they also found in the study. Remember I said it, it was about 62 point or 65.2% reduction on average. So that means that I always teach, we always teach our doctors in specialized practice, what are you telling these patients what they can expect from their results? I always teach doctors, That you're looking for helping the patient reduce their condition by at least a minimum of 50%. And if you can get them to 65.2, as this study did, or more, they think you did a heck of a job with them. And you have to realize, docs, that as you're treating, these are challenging cases.

Mm-hmm.

These are sometimes multilevel disc herniations, large disc herniations, spinal stenosis. You aren't always gonna get these 100% better and never ever tell a patient that you're going to do that because you're gonna overpromise. What you wanna do is underpromise and overdeliver.

I like that.

And I always tell docs, if you look at surgical outcomes, surgery is considered successful if the patient goes into surgery and they come out and in the subsequent days and weeks and months following, they can say, I'm 50% better, doctor. That's a surgical success. So thankfully, with decompression, as the research is showing, we usually can do better than that. Okay.

Well, and, and on top of that, Dr. Kyle, you know, we're adding some adjunct therapies that, you know, I feel accelerates and even gets that a little bit better because they're just doing spinal decompression. So, um, Great study. I love that. What I really like about that is the expanded sample size. When you're working with 5 to 7 patients, or even, you know, maybe 20 patients, it— while I think it helps, right, to, to get any data that you can, you know, 260-some-odd patients, um, now we're getting into the realm of really having some significant results.

Amen. That's a great— that's a great point. It is good to see a larger sample size, which will bring me to my next point here. They've done some studies recently, 'cause I get doctors that ask this all the time, that, well, they always ask me about protocol. What, how much pull force should I use? And thankfully research is starting to emerge that kind of guiding us. A lot of the standard thinking for a while is you wanna use like 50% of body weight. And actually, some of the newer studies that are coming out are suggesting maybe that much pull isn't necessary. So one of the studies I've read recently, they compared 10% of body weight force versus 50%. It was a very short duration study. They monitored— they did 2 weeks of treatment, and then at the end of 2 weeks, they saw how each group did, and statistically they were pretty close as far as Pain relief, function pretty close. No statistical difference, significant difference. But then what they did is they stopped the treatment at two weeks, and then they went another two weeks, and then they monitored them again. And they actually found that the high force group, the 50%, their progress kind of just stalled out. The 10% force group, though. Actually continued to improve.

Oh wow.

And so that doesn't prove conclusively that low force is necessarily better, or that 10% is the optimal dosage or weight or pull, but it does suggest this, that you don't necessarily need to pull hard in order to produce results that are changes in the right direction for these patients. So And then another study I'm going to reference, it was a cervical spine study, decompression. They did 5% of body weight, 10% of body weight, 15% of body weight, and 20%.

Now, are you saying they sequentially did that? So week 1 was 5, week 2 was 10? Like, are you saying that's— or they had 4 different groups of people? Okay, okay. So 4 different groups. This guy did— or this group did 5%, this group did 10%, etc., correct?

Correct.

Okay.

And what they found was 5% didn't do so hot, but neither did 20%. They found that at 20% of body weight for cervical spine, it actually produced iatrogenesis, meaning patients got sore, they got dizzy, they had increased neck pain, things like that. And what they found in the study is that 10% or 15% of body weight for cervical Was a more sweet spot. So what I'm teaching doctors that are doing decompression and coaching them through specialized practices is start with lighter pulls. Start with lighter pulls, and most patients, according to studies, are going to respond to lighter pulls. And only work up if you have to. In other words, you're not getting your, your 8 visits, your 10, your 12 visits in And there's not much change happening, okay, then you got to change some variables. And one of the things you can change is pull. If you start out with high pull, you might create iatrogenesis. You might flare that patient up, and it's hard to come down in a sense because you scared the patient in some ways.

Mm-hmm.

It's better to start low, have less chance of iatrogenesis, and then work your way on up. If you need to. But the studies show, hey, there's a likelihood you won't need to. You can stay at those lighter pulls. And that's what I'm finding in my own practice is 9 out of 10 times I don't need to go much higher than those lighter pulls. So I personally do about 10% of body weight for cervical and about 25% of body weight for lumbar.

You know, I like to cook ribs once in a while, Dr. Kyle. And I like to cook them low and slow, and that tends to make them very juicy and tender. So I think we can take that analogy to spinal decompression, you know, low and slow. We're not in a rush. We got 24 visits to do this, right? So if you are— and by the way, it's gonna be a lower pull, you know, just Logically thinking, it's going to be a more comfortable post-treatment experience for the patient versus a 50% body weight pull. And I think this is kind of where, you know, just like with chiropractic, we have the art and the science of chiropractic. There is an art and science of decompression, right? And so you start with the baseline, right? A really solid protocol that's, you know, and that's one reason why doctors join SP is because, hey, now I'm using a protocol that's already helped thousands of patients. But there is a It's an art and a science because every table is a little bit different. And I would probably say every— even if you have the same table as someone else, it may be a little bit different. So, I remember, I can't remember the name of the doctor, but he was the one that, you know, was kind of promoting the Arthrostim and the VibraCussor. He was kind of talking about, you know, these are the tools and, you know, and then the art comes in how you use them. And it's the kind of a similar thing with decompression. There is an art to it where you need to start to get a sense, an intuition. Yeah. Intuitive sense, and you'll get this the more patients you treat, of, you know, what have you seen, doctor, that gets the best results? And track your results. And, you know, okay, this was a female in their 50s and they were petite versus, you know, a male in their 60s and he was, you know, maybe not obese, but he was overweight, right? So I think you take all that into account. I think you start with a baseline. I like the lower pull weights, but I don't know that anything is 100% absolute. I think you need to be able to adjust. You need to have some things in your back pocket to adjust to, right, if they're not getting the results. Because here's the worst thing from a patient perspective: you just keep doing the same thing. If they're not getting results, they're going to lose confidence in that regard, right? So that's great stuff. I really like that. Now, One thing that doctors may be thinking is, well, what table did they do this research on? And if I have a different table, does it still apply? What would you say to that, Doc?

Yeah, some of the newest research, like out of the University of Southern Florida, is on the DRX-9000. Some of the stuff coming out of Japan and Korea and Egypt, they're actually on some tables I've not even I don't even know who makes some of their tables there 'cause they're not brands I'm— I've seen 'em in the studies, the pictures of 'em, but they're not brands that I'm— they're not American-made tables, put it that way.

Mm-hmm.

And I don't know which company is actually doing them. But here's how I would say that. I would say if your table has actuators, sensors controlled by a computer, you can make adjustments to angles, You can make changes to the amount of pull and stuff. And where you—

it—

the table is giving feedback through sensors to the computer. In other words, it has the latest, most modern technology in it. I think that regardless of, you know, if this study was done on the DRX-9000, I think you can extrapolate that to other decompression tables for the most part. As long as you have a table that has some of that modern technology in it. And I use the Hill DT, for instance, and that has that technology in it. And I've been doing it for 10 years now, tracking results, and we consistently 85 to 93% success rate year in and year out. It's always in that range somewhere. And so I always say, if you, if you're not confident about your table or your protocol, Then you got to track your results. And I always tell doctors, if you're helping 80% of the people get at least 50% or greater results, you got a pretty good table and a pretty good protocol. If you can't hit those benchmarks on the 80% of your cases, then either your protocols— something's off, or maybe you need a better table.

Wise words. I think that makes total sense. I think I would lean towards the You know, optimizing your protocol first, uh, versus, you know, reinvesting in, uh, you know, a whole new table. Because obviously tables can be expensive. Um, you kind of don't want— if you have like a— if you have multiple tables, you kind of don't want it, you know, one of these and one of that. It's ideally you have the same table because that, you know, that creates some confusion on the patient side. And like, you know, I like that table and I want that table. And then, oh gosh, then your techs are screaming. So, um, but I think, yeah, optimize protocol if you're not getting those results, right? 80%, 50% better. Um, protocol first, then start looking at your table. And, you know, regardless, I, I'm not going to name names on the lower-end tables, but, um, look, when I started playing golf, you know, I had cheap, cheap clubs. And as I got better, I started investing in better clubs because my game got better. I would consider the same thing when it comes to decompression. If you're really going to make a run of it, why would you not want to invest in better technology and continue to differentiate yourself from everything else out there in the marketplace?

Yeah, I literally just consulted with a doctor before our podcast today, and he said he has what I We would call in our industry one of the little lower-end tables, but he's just kind of getting a foothold in the niche. I said, don't change the table. Let's work on your protocol first. Let's get some patient flow. Let's track your results for a while and see how you're doing. And you don't need to spend $60,000, $70,000 on a new table when his lower-end table probably is gonna do what he needs to have done.

Hey there, it's Dr. Vince. And if you're getting value from this episode, please make sure to hit that subscribe button so you never miss an episode. And if you know another doc who's ready to grow their practice, share this with them. It might be exactly what they need right now. Thank you in advance. And now back to the show. I think that's a great point. Um, yeah, start with what you got, right? And optimize that. Um, you know, we have clients doing very, very well with, uh, the, the shall-not-be-named lower-end tables. Anyway, point being, it's, it's typically the carpenter, not the tools, but sometimes we can improve our tools. Um, okay, do we have another research, uh, article that we want to go over? Several.

Couple more. We don't have to go through the whole list, but we used to think— and when we see MRI results, doctors— I get doctors send me reports all the time. What do you think about this herniation, doctor? Is this one a decompression candidate? And what usually their concern is, boy, that is a big disc, isn't it, doctor? They'll measure it on MRI and it's a centimeter of extrusion and it's way out, it's far lateral or something like that. And sometimes we think, oh, imaging that looks bad, I think this is a surgical case. So they did a study on people that had large disc herniations exceeding—

Can we talk about large? Like, this is what drove me nuts. with MRI facilities, they didn't measure the darn thing. And so I—

Yeah.

And I wanted in millimeters, not obviously, you know, centimeters is tough to— anyways, is it 3 millimeters? Is it 7 millimeters? Is it 14 millimeters? Like, give me the number. And then they got really good at it, right? And they started measuring everything. And so I would encourage all doctors on your MRIs, like, if you have a facility that you are working with on a regular basis, have them start measuring it in millimeters so that you have a very good understanding of mild, medium, or severe disc bulge. Anyway, sorry, didn't mean to interrupt, but, um, I think that's important to reference.

No, you're right. You know, a mild one is probably going to be, you know, 1 to 3 or 4 millimeters. You know, 5 to 9 is probably a medium. And so this study, they were 10 millimeters or greater. They were big ones. And, you know, some doctors get intimidated by that. They think, well, that's too big, that we can't reduce that, send them to the neurosurgeon. In this study, they found they were able to reduce the majority of these, even these bigger ones that, you know, previously was thought it's a surgical case. So I always tell doctors, what you would glean from this is you never base how you're going to— if you're going to accept a case or not— based strictly off of imaging. You got to go with history, you got to do a detailed exam, and then you got to correlate that with your imaging findings and go with conditions on the ground. How is the patient functioning? Where is their pain level? What are their neurological status? Things of that nature. And then make a reasoned decision based upon all that information. Don't rely on just the imaging, and don't think that just because it's a big disc that it can't get better. This study showed these people got better by and large, even though they had what we, we would consider large disc herniations. The other study I was going to reference is—

I want to— can I pop in on that real quick? Yeah. So I want to reiterate that just in a sense of don't underestimate the power of the healing ability of the body, right?

Yeah.

When it is given the proper, you know, support, just like, you know, the amazing results you see with chiropractic. Well, hey, if, you know, you're— if you're— if you have the tools, the proper tools and protocols, don't underestimate what you can accomplish for the patient. Now, obviously, there are There are contraindications, and there are, you know, if you're seeing severe neurological presentations, yeah, then it, it may lean towards a surgical consult. But if not, um, I mean, to me it's like, again, let's exhaust all non-surgical options first. So I really like that study because I think that especially doctors newer to decompression would be more apt to refer out. And our job is to save people from surgery, not send more people their way. So, you know, and that comes from clinical confidence. And that's why Dr. Kyle does his world-class exam training for our doctors so that they can have more confidence in recommending care. So anyways, that's right. It's my 2 cents. I'm gonna step off my soapbox now.

That was, that was a silver dollar at least. That was more than 2 cents. That was good. Silver dollar.

I haven't seen one of those in a while.

No, we're not gonna see cents either much longer either. Sounds like they're quitting making pennies. That's what I hear.

My 2 cents are going out the door.

Next study is disc height. So, you know, doctors think, well, can we increase disc height? Can we regenerate Discs. Is it possible to regenerate discs? Newest study out showed the average disc height increase, uh, went from about 1.4 to 1.6 millimeters. I can reference a study done several years ago where it increased 1.3 millimeters. We also— this study, same study, showed that they were able to reduce herniation size by up to 70%. 7% in some cases. And so you can, you can tell a patient when they have degenerated discs, we can increase that height. Now, can you make it like new again? No. But can you increase the height and improve it? Yes. You also can reduce the herniation size. And some doctors think, well, I didn't draw that herniation all the way back in, that it failed. It's especially if they have a pre or post MRI. Most of the time you're not going to get the herniation to reduce 100%, and most of the time you don't need to. You just need to reduce it enough, whatever that is, to alleviate the nerve root compression. And that might be as little as a couple of millimeters of reduction sometimes can make the difference between a patient that has a lot of pain and a little or No pain.

Right. By the way, wasn't there like— I just remember from chiropractic school, they're like, the weight of a dime on a nerve can cause dysfunction, pain, numbness, tingling, etc. So if we are able to reduce, you know, the pressure from the disc by the weight of a dime, we're not fixing that disc perfectly, but we're taking that pressure off the nerve. So I think that That, you know, we have to be cognizant of how it may not sound like a lot, but even increasing disc height by 2, 3, 4 millimeters, that can have a massive change.

Yes, and that's what the studies are really showing. Just a couple other things. There was— they did a study on people that had multi-level disc herniations. So one of the ones they referenced, one had an L4 4-5 left medial and an L5-S1 left lateral.

Hmm, interesting.

And so a little more complex than just a, a single-level herniation. And they showed in the study that, you know what, even multi-level herniations with more than one level of nerve root involvement could be significantly improved. Well, then the final study I want to go into just a little tiny bit of detail. Everybody always asks the question, well, isn't decompression just traction therapy?

Hmm.

And I talked about this at the summit. It is a big one. And now, are decompression— a decompression table and a traction table trying to do the same thing? Yeah, they're trying to pull you apart, create separation. But they're now— they're now done a couple of head-to-head studies. The latest one was decompression versus conventional therapy or traction, and this is what they found: that the people in the decompression group saw an average of 62% reduction of their pain, while in conventional therapy or traction they saw 28%. They also showed the decompression group had an improvement of function of 45%, and conventional traction, 21%.

Wow.

So what does that mean in English?

It's double.

Old school traction don't work so well.

Well, well, 100%. I mean, it works okay, but the, the, you know, why would you stick with an old school technology? It's like doing a TENS unit, right? So, um, I always tell doctors, because patients are going to ask, right? Well, hey, I can go do traction at the PT and it's covered by insurance.

Well, hold on.

Yes, you can, right? We, you know, you can choose what you want to do, but let's go into it with more knowledge so you can make the best, well-educated decision about your health. Wouldn't that sound good? Yes, it would. Okay. So here's the 2 key differences between traction and decompression. Traction is nonspecific and static. In other words, it's not able to target a very specific disc. It's going to do the whole lumbar spine or the whole cervical spine. And it's static. In other words, it's going to pull and hold. Whereas decompression is specific to the disc level and it's dynamic. It's going to pull and release multiple times. That's what creates the pumping motion. That's what creates the negative pressure in the middle of the disc. And that's what allows the disc to absorb water. So don't let your patients off the hook and just say, oh, okay, you know, no, educate them. And that's what we always lean into is education, right? But educate them about You know, what the differences are. And so that, look, at least if they do decide to go the cheap route, they are going into it with eyes wide open. But by and large, if patients are, you know, if they, if they are truly committed to improving their condition, they have, you know, the means financially, they're going to go with the better option. I mean, it's just logical at this point, right?

That is correct. You mentioned a word, the pressure. Intradiscal pressure reduces. That's what separates ultimately a decompression table from a traction table. They find in the studies that traction can reduce intradiscal pressure, but it doesn't take it to a negative level. With our modern decompression tables, reduces intradiscal pressure and actually achieves Negative pressure. Usually it's somewhere between negative 100 to 150 millimeters of mercury, and that's when the better effects happen. Final thing, patients always ask, well, how long is it going to take before I start feeling better, doctor? And the latest studies out show that on average, you— it's going to be somewhere in the 3 to 6-week range. That's when the physiological effects of enough sessions of decompression start taking hold. Now, some start feeling better after the first visit, but on average, the studies are showing 3 to 6 weeks is where— in that time range is when most patients are going to really start to see some significant changes. And that's born right out of the research, and that's what you want to tell patients. Mrs. Jones, I expect in somewhere in that 3 to 6 week range you're going to start feeling some nice relief.

And I— how that's so important, right? Because in a patient's mind, because they are, um, they've kind of been conditioned by the medical industry to take a pill and they're going to immediately feel a difference, right? So if they sign up for care and you don't pre-frame them about what results look like and the timelines associated with it, they're going to think, well, I, I mean, shoot, I started care, I should start getting better right away, right? No, no, no, no. Um, you have to pre-educate them, pre-frame them about what is normal, right? What is typical? Because now in week 2, If they haven't started getting significant results, you remember, Mrs. Jones, remember when we talked about at the beginning, talk about 3 to 6 weeks is when you're gonna start getting significant changes, okay? Please just be patient, give your body a chance, right? Then they're like, oh yeah, I remember that. Versus if you didn't say anything, oh well, no, no, most patients don't start responding until 3 to 6 weeks. What? Why are you telling me this now?

Yeah.

That would have been nice to know Back 3 weeks ago, you know what I'm saying? So, the more the patient knows, the more they are part of the relationship in terms of the care. It has to be patient and doctor on the same page. That's when you're not going to get patients that are upset. You're not going to get refunds. You're not going to get patients that drop out of care, God forbid, right? Because then they're never going to get the results, right? So, education and communication, like, Improving your communication skill sets, like, that is the next level of the doctors that really go to the next level. Uh, you know, being able to communicate, you know, throughout the care plan, but especially right at the beginning of what to expect, you know, and we talked about earlier the 50% rule. Um, not promising the moon, underpromising, overdelivering, all of these things go into having a happy Yeah, I always like to tell doctors—

final thing I would just say is that if you're going to be the expert, you need one of— one element of that is keeping up to date on the research in your relevant, relevant field of expertise. And if you keep up with the literature and you're a decompression doc, you're going to be able to answer patient questions better. You're going to be able to pre-educate them. As we've talked about better, and, uh, it's just gonna make you all around a better decompression doc. So one of the things we do at Specialized Practices is on our weekly clinical Q&As at the end of every month, the final Tuesday of every month, I literally update all of our doctors on the latest in spine research, decompression research, laser, shockwave. things of that nature, and to keep our doctors on the cutting edge of what's going on and happening in the field. And it distinguishes doctors and it makes them— it takes them to a higher level of expertise. That's the bottom line. So with that said, I'm all out of talk.

Well, I want to thank you for putting together those research papers for this podcast because I think that's Extremely helpful. And, uh, yeah, I mean, that's obviously a huge benefit of, you know, being a member, um, at SP is to be able to have access to this on a regular basis. And, um, and you're absolutely right, you know, if you're going to be an expert, um, keeping up on the relevant research is— I mean, it really should just be par for the course, right? So especially when you're treating these tough conditions. So Hope this was helpful for all those doctors out there treating spinal decompression. I keep seeing myself freeze, so I don't know if the weather is going crazy or what, but hopefully everyone hears is hearing me what I'm saying right now. But I want to thank everyone for listening. Thank you, Dr. Kyle. That was an excellent update. So that state of spinal decompression. First impression part 2, focus on research. Are we gonna do a part 3, Kyle?

Yes, we are gonna do a part 3, and I got a couple ideas for it. We gotta, we gotta keep the conversation going because it's so much fun.

It's so good. It's so good. We'll probably have to dive into some marketing stuff at some point because I know doctors are, you know, they're always like, well, I need more new patients. So we can, we can talk about that at some point in one of the the, uh, part 3 or 4 or something of that nature. But gonna have to wait for that one, docs. And hope you all enjoyed this episode of the Practice Builders Podcast. For Dr. Kyle Pinkerton, I'm Dr. Vince Leone. Thanks for listening, and we will see you on the next episode. Hey, it's Dr. Vince again, and hope you enjoyed that episode. And if you're ready to grow your practice fast with high-value decompression patients then the Decompression Accelerator could be a phenomenal option for you. This is our 90-day sprint to help you scale with proven systems, staff-driven protocols, and full marketing support, and it's all guaranteed. Spots are limited. Head to www.decompressionaccelerator.com to learn more.