• Pain Pract · Jun 2018

    Limaprost or pregabalin: preoperative and postoperative medication for pain due to lumbar spinal stenosis.

    • Yuji Kasukawa, Naohisa Miyakoshi, Takashi Kobayashi, Kazuma Kikuchi, Kunio Ebata, Noriyuki Ishikawa, Tetsuya Suzuki, Hiroshi Sasaki, Yuji Hatakeyama, Michio Hongo, Yoshinori Ishikawa, Daisuke Kudo, Toshiki Abe, Koichiro Okuyama, Tadato Kido, Mitsuho Chiba, Toyohito Segawa, Masazumi Suzuki, Takashi Mizutani, Ryota Kimura, Yuichi Ono, Jumpei Iida, Eiji Abe, and Yoichi Shimada.
    • Department of Orthopedic Surgery, Akita University Graduate School of Medicine, Akita, Japan.
    • Pain Pract. 2018 Jun 1; 18 (5): 625-630.

    PurposeWe aimed to evaluate the incidence of (and risk factors for) postoperative pregabalin and/or limaprost to treat persistent numbness and/or pain of the lower extremities after lumbar spinal stenosis (LSS) surgery.MethodsMedical records of 329 patients (168 men, 161 women; average age 70 years) were retrospectively reviewed for data on the duration of LSS diagnosis; LSS disease; preoperative medication (limaprost, pregabalin, or combined limaprost/pregabalin; duration); symptoms; preoperative/postoperative intermittent claudication (IC); operation type; and postoperative medication and period.ResultsLimaprost, pregabalin, and combined limaprost/pregabalin were prescribed preoperatively for 43%, 7%, and 5% of patients, respectively. At an average of 21 months postoperatively, limaprost, pregabalin, and combined therapy were prescribed in 11%, 8%, 4% of patients, respectively. Medication requirement was significantly lower postoperatively than preoperatively (P < 0.0001). Significant risk factors for required postoperative medication were required preoperative medication (odds ratio [OR] 3.088, 95% confidence interval [CI] 1.679 to 5.681]; postoperative period (OR 1.063, 95% CI 1.031 to 1.096); and postoperative IC (OR 3.868, 95% CI 1.481 to 10.103). A negative impact from postoperative medication was seen in patients who had undergone decompression surgery (OR 0.589, 95% CI 0.377 to 0.918).ConclusionsOverall, 23% of LSS patients required medication for pain and/or numbness at 21 months postoperatively. Significant factors portending required postoperative medication were preoperative medication, longer postoperative period, and postoperative IC. A negative influence from postoperative medication was seen in patients who had undergone decompression surgery without fusion.© 2017 World Institute of Pain.

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