Imai Takaya, Nagai Sota, Michikawa Takehiro, Inagaki Risa, Kawabata Soya, Ito Kaori, Hachiya Kurenai, Takeda Hiroki, Ikeda Daiki, Yamada Shigeki, Fujita Nobuyuki, Kaneko Shinjiro
Department of Orthopaedic Surgery, School of Medicine, Fujita Health University, Toyoake 470-1192, Japan.
Department of Spine and Spinal Cord Surgery, Fujita Health University, Toyoake 470-1192, Japan.
J Clin Med. 2023 Mar 20;12(6):2385. doi: 10.3390/jcm12062385.
Treatment for lumbar spinal canal stenosis (LSCS) is mainly classified into conservative and surgical therapies. Among conservative therapies, pharmacological treatment is commonly prescribed for LSCS. Meanwhile, surgical treatment is the last option for LSCS. This study aimed to examine the impact of lumbar surgery on pharmacological treatment for patients with LSCS. Consecutive patients aged ≥ 40 years who underwent lumbar surgery for LSCS were identified. A total of 142 patients were retrospectively reviewed for preoperative and 6-month and 1-year postoperative LSCS medications. The results showed that the number of LSCS medications significantly decreased after lumbar surgery. The proportion of the patients taking non-steroidal anti-inflammatory drugs, pregabalin/mirogabalin, opioids, prostaglandin E1 analogs, and neurotropin was significantly decreased after lumbar surgery, but that of the patients taking mecobalamin, acetaminophen, and serotonin-noradrenalin reuptake inhibitors was not significantly changed. Additionally, around 15% of the participants showed an increase in LSCS medications even after lumbar surgery. Multivariable analysis revealed that individuals without improvements in walking ability (RR: 2.7, 95% CI: 1.3-5.9) or social life (RR: 2.3, 95% CI: 1.1-5.0) had a greater risk of a postoperative increase in LSCS medications. The study results may provide physicians with beneficial information on treatment for LSCS.
腰椎管狭窄症(LSCS)的治疗主要分为保守治疗和手术治疗。在保守治疗中,药物治疗是LSCS常用的治疗方法。同时,手术治疗是LSCS的最后选择。本研究旨在探讨腰椎手术对LSCS患者药物治疗的影响。确定了连续接受LSCS腰椎手术且年龄≥40岁的患者。对142例患者进行回顾性分析,观察其术前、术后6个月和1年的LSCS用药情况。结果显示,腰椎手术后LSCS用药数量显著减少。腰椎手术后,服用非甾体类抗炎药、普瑞巴林/米罗加巴林、阿片类药物、前列腺素E1类似物和神经妥乐平的患者比例显著下降,但服用甲钴胺、对乙酰氨基酚和5-羟色胺-去甲肾上腺素再摄取抑制剂的患者比例无显著变化。此外,约15%的参与者即使在腰椎手术后LSCS用药也有所增加。多变量分析显示,步行能力(RR:2.7,95%CI:1.3-5.9)或社交生活(RR:2.3,95%CI:1.1-5.0)没有改善的个体术后LSCS用药增加的风险更大。研究结果可能为医生提供有关LSCS治疗的有益信息。