Not only is discogenic pain common; it is often debilitating and refractory to multiple types of care. Popular interventions for discogenic pain include intradiscal electrothermal therapy, spinal fusions, and artificial discs. In conservative pain medicine, our treatment options include exercise therapy, facet injections, radiofrequency ablations, pharmacotherapy, etc. However, at Care Medical Center, we offer the additional option of vertebral axial decompression. This non-invasive treatment offers high success rates, particularly in light of the fact that this treatment is often reserved for patients who have not achieved the desired result with surgery and/or other conservative care.
Despite high equipment costs and being a relatively new approach to discogenic pain, veterbral axial decompression (VAX-D) is perhaps the best researched “traction” technique.(1-7) However, it may not be entirely accurate to qualify VAX-D as a traction technique. Unlike traction in the traditional sense, VAX-D stands apart as the only non-invasive treatment proven to decompress only the disc.1 Dr. Allan Dyer, former Deputy Minister of Health from Ontario, Canada, and one of the developers of the external cardiac defibrillator, designed the vertebral axial decompression therapeutic table to apply distraction tension to the patient’s spine without eliciting reflex paravertebral muscle contractions. The VAX-D utilizes a split-table design and an electronic tensiometer harness that accomplishes maximum distraction with 25% of the traditional force. The hydraulic table establishes distraction tension that ranges from a baseline of 20-24lb with programmable increases in tension along a logarithmic time/force curve. The rationale for treatments include providing intradiscal negative pressure, reversal of herniations, improvement in nutrition, deposition of reparative collagen, and healing of annular tears.
The results demonstrated at the Department of Bioengineering, University of Illinois are consistent with our experience with VAX-D treatments.2 Their study published in the Journal of Neurological Research follows 778 patients with imaging-confirmed herniated disc, degenerative disc disease, or facet syndrome. Defining success as reducing pain to a 0 or 1 on a 0-5 scale, VAX-D achieves success in 71% of cases. Among patients who are unable to walk or who are capable of only limited ambulation, VAX-D achieves whole grade function increases in 78% of patients.
Candidates for VAX-D treatments include patients with discogenic low-back pain (with or without radiculopathy) who have failed conventional therapy, patients with neurological deficits, and patients with incomplete results from back surgery. Contraindications for VAX-D therapy include infection, neoplasm, osteoporosis, bilateral pars defect, unstable grade 2 spondylolisthesis, fractures, and surgical hardware in the spine.
References:
1. Ramos G, Martin W. Effects of vertebral axial decompression on intradiscal pressure. Journal of Neurosurgery. 1994; 81: 350-353.
2. Naguszewski W, Naguszewski R, Gose E. Dermatosomal somatosensory evoked potential demonstration of nerve root decompression after Vax-D therapy. Journal of Neurological Research. 2001; 23 (7): 706-714.
3. Beattie P, Nelson R, Michener L, et al. Outcomes after a prone lumbar traction protocol for patients with activity-limiting low back pain: A prospective case series study. Archives of Physical Medicine and Rehabilitation. 2008; 89 (2): 269-74.
4. Beattie P, Nelson R, Michener L, et al. Short and long-term outcomes following treatment with the Vax-D protocol for patients with chronic, activity limiting low back pain. Journal of Orthopaedic & Sports Physical Therapy. 2005; 35 (1).
5. Ramos G. Efficacy of vertebral axial decompression (Vax-D) on chronic low back pain: a study of dosage regimen. Journal of Neurological Research. 2004; 26 (3): 320-4.
6. Sherry E, Kitchener P, Smart R. A prospective randomized controlled study of Vax-D and TENS for the treatment of chronic low back pain. Journal of Neurological Research. 2001; 23 (7): 780-4.
7. Gose E, Naguszewski W, Naguszewski R. Vertebral axial decompression therapy for pain associated with herniated or degenerated discs or facet syndrome: an outcome study. Journal of Neurological Research. 1998; 20 (3): 186-190.
For Your Health,
Dr. Ryan Moorman
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