Yes. A disc extrusion can get smaller without surgery, and we now have peer-reviewed MRI evidence documenting it in the neck. Our second published study followed a 50-year-old man with a C5-6 extrusion pressing on his spinal cord, and follow-up imaging showed a 52% reduction in the extrusion with the cord compression resolved and no surgery performed.
Listen, I want to be careful with how I say this, because there is a lot of noise in my profession and I do not want to add to it. What I can tell you is what was measured, what was published, and what an independent board-certified radiologist confirmed. That is it. And in this case, what was measured is the kind of thing most people are told is impossible.
What is a cervical disc extrusion, and why does it usually mean surgery?
An extrusion is when disc material pushes all the way through the outer wall of the disc and out into the spinal canal. It is a more advanced injury than a bulge or a contained herniation. When that material presses on the spinal cord itself, the standard recommendation is almost always surgical.
Think of a jelly donut that has been stepped on. A bulge is the donut widening at the edges. A herniation is the jelly pushing against a weak spot in the wall. An extrusion is the jelly coming out. Once it is out, the common assumption is that it stays out and the only way to deal with it is to go in and take it out.
Add cord compression to that picture and the urgency goes up. Cervical myelopathy is what happens when the spinal cord itself gets squeezed in the neck. It can cause neck pain, numbness, weakness, and problems with coordination. Most surgeons look at that MRI and start talking about fusion or disc replacement, and honestly, sometimes they are right to. I am not anti-surgery. I am anti-surgery-as-the-only-conversation.
What did the new study actually find?
A 50-year-old man came in with persistent neck pain radiating through the shoulder blade, plus numbness and tremors in his fingers. Imaging showed a C5-6 disc extrusion with upward migration of the disc material, segmental instability, and cord compression. After a three-month program of non-surgical spinal decompression combined with conservative chiropractic care, his pain, function, and neurological symptoms all improved substantially.
The follow-up MRI is the part that matters. It showed a 52% reduction in the size of the extrusion, and it showed no remaining cord compression. There were no adverse effects reported during or after care. He did not have surgery.
The paper is Dudum J, Gatterman B, Buonopane S, published in the Journal of Contemporary Chiropractic, 2026, volume 9, issue 1, pages 240 to 247. You can see the published research for yourself rather than taking my word for any of it.
My co-author Dr. Bryan Gatterman is a board-certified chiropractic radiologist, DC, DACBR. He reads the images. I treat the patients. That separation is deliberate, and it is why these numbers mean something. When Bryan called me on a Sunday morning after reading one of these scans and asked me how I did that, I knew we had something worth writing up properly.
How does non-surgical spinal decompression reduce an extrusion?
Decompression uses a specialized table to create negative pressure inside the disc. That pressure change pulls disc material back toward the center and lets fluid and nutrients move back into a disc that has been starved of both. It is not traction. Traction pulls on the whole spine. Decompression targets a specific segment at a specific angle.
Here is the analogy I use with patients in the office. Imagine a sponge that has been sitting under a brick for ten years. It is flat, it is dry, and nothing is getting in or out of it. You cannot fix that sponge by pressing harder on it. You have to take the brick off and let it re-expand so it can absorb again. That is what we are doing to the disc, over and over, in a controlled way, for a set number of sessions.
The angle piece is the part almost nobody gets right. A C5-6 problem and an L5-S1 problem do not respond to the same setup. If you want the mechanics in more detail, here is how non-surgical spinal decompression works and what a session actually looks like.
Did the results hold up, or did the disc go back?
This is the question I get most, and it is the right question. The improvement was still there at follow-up more than a year later. Continued improvement was documented, not just maintenance of the original result.
A lot of conservative care produces a good six-week story and a bad one-year story. Pain drops, everyone celebrates, and then twelve months on the patient is back where they started because nothing about the underlying disc actually changed. That is why we image again instead of just asking people how they feel.
Feeling better and being better are two different things, and only one of them shows up on a scan.
Is this the first study, or is there more?
This is the second peer-reviewed paper. The first, published in 2024 in the same journal, documented four patients with lumbar disc herniations treated over eight weeks with decompression plus chiropractic care.
In that first study, post-treatment MRI showed disc reductions of 9%, 27%, 30%, and 78%. All four patients were 100% pain-free at the end of care. None of them had surgery. The reductions were confirmed by independent radiologists, not by me.
So one paper on the low back, one on the neck. Two papers total, both peer-reviewed, both with imaging attached. I would rather have two documented studies than a hundred testimonials.
Does this mean you can avoid neck surgery?
It means surgery is not automatically the only option, and that a second opinion before you schedule anything is worth your time. It does not mean every extrusion responds this way, and I will not tell you it does.
Some people genuinely need the operation. Progressive neurological loss, certain fracture patterns, certain instabilities. If I look at your imaging and think surgery is your best path, I will say so out loud, and I have said it plenty of times.
What I object to is the patient who is handed a surgical date at the first appointment without anyone ever mentioning that a documented non-surgical option exists. We see a lot of patients who came in already scheduled for surgery and simply wanted someone to look at the MRI one more time first.
Why does this research come out of a Walnut Creek chiropractic office?
Because of volume, and because of measurement. Our Walnut Creek center is one of the largest single-location spinal decompression centers in the United States, with 13 tables and more than 50,000 treatments performed.
When you do something 50,000 times you start noticing patterns that you cannot see doing it a hundred times. And because we take post-treatment imaging as a matter of routine rather than as an exception, we end up with cases that are documentable.
My own history is part of why I care about this. In April 2020, at 35 years old, I herniated my own L5-S1 disc, roughly 5 millimeters. I had been practicing for a decade and I tried everything I knew. Nothing touched it. I bought a decompression table out of pure desperation and I was pain-free in five to eight weeks. That is what started all of this.
Frequently asked questions
Can an extruded disc really shrink, or does it just stop hurting?
It can measurably shrink. In our published cervical case, follow-up MRI documented a 52% reduction in the extrusion with cord compression resolved. In our published lumbar case series, post-treatment MRI showed reductions of 9%, 27%, 30%, and 78%, confirmed by independent radiologists. Pain relief and structural change are separate things, and we measure both.
How long does a decompression program take?
The cervical case in our study ran three months. Most programs fall in that general range, though the exact number of sessions depends on the size and location of the injury, how long it has been going on, and what the imaging shows at intake. You should get a specific timeline at your consultation, not a vague one.
Is decompression painful?
No. Most patients find it comfortable, and a fair number fall asleep on the table. There is no recovery time and no downtime afterward.
Do I need an MRI before I come in?
Bring one if you have it. It makes the first conversation far more useful, because we can look at the actual pathology together instead of guessing from symptoms. If you do not have one, we will talk through whether you need imaging.
Where is the clinic and do people travel in for this?
We are at 1900 Olympic Blvd, Suite 100, Walnut Creek, CA 94596, in the East Bay. We see patients from across the Bay Area and Northern California, and we regularly treat people who fly in from out of state and out of the country specifically for this protocol.
Was this study independently reviewed?
Yes. Both papers were published in the Journal of Contemporary Chiropractic, a peer-reviewed journal, and the imaging in both was read by a board-certified radiologist who is a co-author, not by the treating doctor alone.
Come talk to us
If you have been told you need neck or back surgery, get a second set of eyes on your imaging before you schedule anything. Surgery is permanent. A conversation is not.
Contact us or call (925) 300-3302 and we will get you in.
Dr. JD