Question: Implant Surgery or VAX-D Therapy?
I have 2 ruptured and degenerated discs (L4-L5 and L5-S1) with recurrent low back pain (debilitating) at least once a year, and more recently every six months. I have researched some alternatives to surgery, and have found the VAX-D therapy to be the most comprehensive. I am 35 years old and fairly active (when able). The VAX-D therapy consists of 30 sessions at 200 dollars each, and insurance will not cover it.
Am I better off opting for implant surgery (which would be my preference to fusion), or should I try the VAX-D therapy? What is your opinion of VAX-D, and is the PRODISC (or any comparable artificial disc) implant an available alternative yet?
Doctor’s Response: Manage the Pain Instead of Shooting for a "Cure."
My understanding is that there basically is no scientific evidence that VAX-D changes the natural history of low back pain. It is expensive and not covered by insurance because it is unproven. That is not to say that it does not work on some people, but it can be a lot of money for little benefit.
The PRODISC artificial disc is not commercially available as of yet, and the Charité artificial disc, which is FDA-approved for use in the U.S., is not approved for two-level artificial disc replacement surgeries. [Editorial note: The PRODISC-L was approved by the U.S. FDA on August 14, 2006 for use at a single vertebral level.]
A two-level fusion procedure in a young healthy adult is a big undertaking and should only be considered as a salvage procedure if you cannot function well.
The best alternative is to try to manage the pain with an active exercise program focused on stretching, strengthening, and conditioning. If your pain is only intermittent, any type of surgical intervention (either artificial disc or fusion surgery) is probably a bit aggressive.
It is probably better to manage your bouts of pain rather than shoot for a "cure."
- Nonsurgical Treatments for a Lumbar Herniated Disc
- Lumbar Artificial Disc Surgery for Chronic Back Pain
In Spine-health’s Doctor Advice section, physicians respond to frequently asked questions about back pain issues. These responses represent the opinion of one physician, and do not necessarily reflect the views of the broader medical community. The advice presented has not been peer reviewed by Spine-health’s medical advisory board.