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Pregabalin for Refractory Radicular Leg Pain due to Lumbar Spinal Stenosis: A Preliminary Prospective Study


Affiliations
1 Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
2 Department of Orthopaedic Surgery, Japan Community Health Care Organization Funabashi Central Hospital, Funabashi 273-0021, Japan
3 Department of Orthopaedic Surgery, Shimoshizu National Hospital, Yotsukaido 284-0003, Japan
4 Department of Orthopaedic Surgery, Kitasato University, Sagamihara 252-0375, Japan
5 Department of Orthopaedic Surgery, Tsuga Saito Orthopaedic Clinic, Chiba 264-0025, Japan
6 Department of Orthopaedic Surgery, Showa University, Tokyo 142-8666, Japan
7 Department of Orthopaedic Surgery, Chiba Cancer Center, Chiba 260-0801, Japan
8 Department of Orthopaedic Surgery, Sanmu Medical Center, Sanmu 289-1326, Japan
9 Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane 283-8686, Japan
10 Department of Orthopaedic Surgery, Kumagaya General Hospital, Kumagaya 360-0013, Japan
11 Department of Orthopaedic Surgery, Japan Community Health Care Organization Chiba Hospital, Chiba 260-8710, Japan
12 Department of Orthopaedic Surgery, Chiba National Medical Center, Chiba 260-0042, Japan
13 Department of Orthopaedic Surgery, Funabashi Municipal Medical Center, Funabashi 273-8588, Japan
 

We investigated the efficacy of pregabalin (PGB) for neuropathic leg pain in lumbar spinal stenosis (LSS) patients with disturbed activities of daily living (ADL)/quality of life (QOL) in a prospective observational study. Subjects were a total of 104 LSS patients with neuropathic pain (NeP) in leg and neurological intermittent claudication (IMC) refractory to nonsteroidal anti-inflammatory drugs (NSAIDs) for at least a month. NeP was identified using screening tool, Pain DETECT questionnaire. Visual analog scale (VAS) scores and responses to the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were assessed before and 6 weeks after PGB treatment initiation. Changes in IMC distance and adverse events were also recorded. PGB significantly improved theirVAS scores for pain and sleep quality (P < 0.001).With respect to JOABPEQ, significant improvements were observed with regard to the following dimensions: pain-related disorders (P < 0.01), lumbar spine dysfunction (P = 0.031), gait disturbance (P = 0.028), and psychological disorders (P = 0.014). The IMC distance showed an improvement tendency after PGB treatment, albeit with no significance (P = 0.063).Minor adverse events such as dizziness were observed. PGB can be effective for neuropathic leg pain refractory to NSAIDs in LSS patients, resulting in not only pain control but also improving lower back pain-related ADL/QOL scores.
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  • Pregabalin for Refractory Radicular Leg Pain due to Lumbar Spinal Stenosis: A Preliminary Prospective Study

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Authors

Sumihisa Orita
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
Masaomi Yamashita
Department of Orthopaedic Surgery, Japan Community Health Care Organization Funabashi Central Hospital, Funabashi 273-0021, Japan
Yawara Eguchi
Department of Orthopaedic Surgery, Shimoshizu National Hospital, Yotsukaido 284-0003, Japan
Miyako Suzuki
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
Gen Inoue
Department of Orthopaedic Surgery, Kitasato University, Sagamihara 252-0375, Japan
Masayuki Miyagi
Department of Orthopaedic Surgery, Kitasato University, Sagamihara 252-0375, Japan
Tomoko Watanabe
Department of Orthopaedic Surgery, Tsuga Saito Orthopaedic Clinic, Chiba 264-0025, Japan
Tomoyuki Ozawa
Department of Orthopaedic Surgery, Showa University, Tokyo 142-8666, Japan
Hiroto Kamoda
Department of Orthopaedic Surgery, Chiba Cancer Center, Chiba 260-0801, Japan
Tetsuhiro Ishikawa
Department of Orthopaedic Surgery, Sanmu Medical Center, Sanmu 289-1326, Japan
Yasuchika Aoki
Department of Orthopaedic Surgery, Eastern Chiba Medical Center, Togane 283-8686, Japan
Toshinori Ito
Department of Orthopaedic Surgery, Kumagaya General Hospital, Kumagaya 360-0013, Japan
Go Kubota
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
Munetaka Suzuki
Department of Orthopaedic Surgery, Shimoshizu National Hospital, Yotsukaido 284-0003, Japan
Kazuyo Yamauchi
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
Eiji Hanaoka
Department of Orthopaedic Surgery, Japan Community Health Care Organization Chiba Hospital, Chiba 260-8710, Japan
Yoshihiro Sakuma
Department of Orthopaedic Surgery, Chiba National Medical Center, Chiba 260-0042, Japan
Jun Shimbo
Department of Orthopaedic Surgery, Funabashi Municipal Medical Center, Funabashi 273-8588, Japan
Yasuhiro Oikawa
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
Takane Suzuki
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
Kazuhisa Takahashi
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
Seiji Ohtori
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan

Abstract


We investigated the efficacy of pregabalin (PGB) for neuropathic leg pain in lumbar spinal stenosis (LSS) patients with disturbed activities of daily living (ADL)/quality of life (QOL) in a prospective observational study. Subjects were a total of 104 LSS patients with neuropathic pain (NeP) in leg and neurological intermittent claudication (IMC) refractory to nonsteroidal anti-inflammatory drugs (NSAIDs) for at least a month. NeP was identified using screening tool, Pain DETECT questionnaire. Visual analog scale (VAS) scores and responses to the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ) were assessed before and 6 weeks after PGB treatment initiation. Changes in IMC distance and adverse events were also recorded. PGB significantly improved theirVAS scores for pain and sleep quality (P < 0.001).With respect to JOABPEQ, significant improvements were observed with regard to the following dimensions: pain-related disorders (P < 0.01), lumbar spine dysfunction (P = 0.031), gait disturbance (P = 0.028), and psychological disorders (P = 0.014). The IMC distance showed an improvement tendency after PGB treatment, albeit with no significance (P = 0.063).Minor adverse events such as dizziness were observed. PGB can be effective for neuropathic leg pain refractory to NSAIDs in LSS patients, resulting in not only pain control but also improving lower back pain-related ADL/QOL scores.