Limthongkul Worawat, Puttasean Kritsada, Tanayavong Maruay, Singhatanadgige Weerasak, Yingsakmongkol Wicharn, Kerr Stephen J, Kotheeranurak Vit
Department of Orthopaedics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Center of Excellence in Biomechanics and Innovative Spine Surgery, Chulalongkorn University, Bangkok, Thailand.
Global Spine J. 2025 Apr 19:21925682251335253. doi: 10.1177/21925682251335253.
Study DesignA Randomized, Double-Blind, Controlled Trial.ObjectivePostoperative residual leg numbness is a common complication following decompressive and fusion lumbar spine surgery. Prostaglandin E1 derivatives, such as limaprost, have demonstrated efficacy in reducing leg numbness in non-surgical populations. However, evidence regarding the efficacy of limaprost in post-surgical patients remains limited. This randomized controlled trial aimed to compare patient-reported outcomes between postoperative limaprost and placebo treatment.MethodsSixty patients diagnosed with degenerative lumbar spine disease and undergoing one or two levels of decompressive and fusion lumbar spine surgery were randomized to receive either postoperative limaprost or placebo for 6 months. Primary outcome evaluation was leg numbness severity, as assessed using the Visual Analog Scale (VAS). Secondary outcomes included tingling sensation, back pain, leg pain, the Oswestry Disability Index (ODI), and the EuroQol-5D (EQ-5D).ResultsBaseline demographic characteristics and patient-reported outcomes were comparable between the two groups. Both groups exhibited significant reductions in leg numbness at all postoperative time points ( < 0.001). However, no significant difference in leg numbness scores was observed between limaprost and placebo groups ( = 0.5). Notably, patients in limaprost group exhibited significantly greater reductions in back pain compared to the placebo group over the entire follow-up period ( < 0.001). No clinically significant differences were observed between groups for other patient-reported outcomes.ConclusionPostoperative limaprost did not result in a significant reduction in leg numbness compared to placebo. Nevertheless, limaprost may offer potential benefits in alleviating back pain following decompressive and fusion lumbar spine surgery.
研究设计
一项随机、双盲、对照试验。
目的
术后残留腿部麻木是腰椎减压融合手术后常见的并发症。前列腺素E1衍生物,如利马前列素,已证明在非手术人群中可有效减轻腿部麻木。然而,关于利马前列素在术后患者中疗效的证据仍然有限。这项随机对照试验旨在比较术后使用利马前列素与安慰剂治疗后患者报告的结果。
方法
60例被诊断为退行性腰椎疾病并接受一或两个节段腰椎减压融合手术的患者被随机分为术后接受利马前列素或安慰剂治疗6个月。主要结局评估是使用视觉模拟量表(VAS)评估的腿部麻木严重程度。次要结局包括刺痛感、背痛、腿痛、Oswestry功能障碍指数(ODI)和欧洲五维健康量表(EQ-5D)。
结果
两组的基线人口统计学特征和患者报告的结果具有可比性。两组在所有术后时间点腿部麻木均显著减轻(<0.001)。然而,利马前列素组和安慰剂组之间的腿部麻木评分未观察到显著差异(=0.5)。值得注意的是,在整个随访期间,利马前列素组患者的背痛减轻程度明显大于安慰剂组(<0.001)。其他患者报告的结局在两组之间未观察到临床显著差异。
结论
与安慰剂相比,术后使用利马前列素并未导致腿部麻木显著减轻。尽管如此,利马前列素在减轻腰椎减压融合手术后的背痛方面可能具有潜在益处。