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    VAX-D: Treating Back Pain Without Surgery

    Experts discuss the effectiveness of a back pain treatment that offers an alternative to surgery.

    The Issue of Safety

    Is VAX-D safe? Apparently, that depends on whom you ask, and under what circumstances the treatment is performed.

    While the manufacturer touts VAX-D as safe, literature on VAX-D from Cedars-Sinai Medical Center in California lists the following risks: development of sharp, burning, or radiating pain during treatment; stress to the shoulder and rotator cuff muscles; and overstretching of the soft tissues of the back.

    As for the potential to experience pain, Dyer says: "The patient participates by holding hand grips. The patient can always let go, a natural reaction if pain is experienced."

    The clinician also plays an important role. "With good clinicians, patients do not experience shoulder pain," Dyer tells WebMD. "The practitioner needs to be a good clinical observer."

    Can patients suffer injuries during VAX-D treatment? Current literature from the VAX-D manufacturer states that "not one single injury has been sustained by a patient." A published report in a 2003 issue of Mayo Clinical Proceedings disputes that statement. The report describes a severe complication suffered by a patient during VAX-D treatment. The authors describe a "sudden, severe exacerbation of radicular pain" during a treatment session. Images of the subject's lumbar region showed significant enlargement of the disk protrusion after VAX-D, requiring emergency surgery. To date, this is the only published report of an adverse effect caused by VAX-D.

    How Effective Is It?

    Does VAX-D really work? To date, anecdotes such as that reported by Reiner and others offer the most persuasive evidence in favor of VAX-D's effectiveness. But what do studies tell us about VAX-D?

    "There are some studies suggesting that VAX-D is effective. Most people would say they're fairly flawed. The studies out there are not high quality," says Daniel J. Mazanec, MD, a spine specialist with the Cleveland Clinic. Lack of controls and the use of "sham treatments" (or placebo) for controls demonstrate poor quality of existing studies, he explains.

    For instance, a study on VAX-D published in a 1998 issue of Neurological Research reported a 71% success rate among the 778 subjects who underwent VAX-D treatment. While these results sound promising, the weakness of the study design dampens them. The study's glaring problem? It contained no control group. Investigators did not compare the effectiveness of VAX-D against subjects who received no treatment, placebo treatment, or some other type of treatment.

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