• Seiji Ohtori, Masaomi Yamashita, Yasuaki Murata, Yawara Eguchi, Yasuchika Aoki, Hiromi Ataka, Jiro Hirayama, Tomoyuki Ozawa, Tatsuo Morinaga, Hajime Arai, Masaya Mimura, Hiroto Kamoda, Sumihisa Orita, Masayuki Miyagi, Tomohiro Miyashita, Yuzuru Okamoto, Tetsuhiro Ishikawa, Hiroaki Sameda, Tomoaki Kinoshita, Eiji Hanaoka, Miyako Suzuki, Munetaka Suzuki, Takato Aihara, Toshinori Ito, Gen Inoue, Masatsune Yamagata, Tomoaki Toyone, Gou Kubota, Yoshihiro Sakuma, Yasuhiro Oikawa, Kazuhide Inage, Takeshi Sainoh, Jun Sato, Kazuyo Yamauchi, Kazuhisa Takahashi, and Chiba Low Back Pain Research Group.
• Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
• Yonsei Med. J. 2014 May 1; 55 (3): 779-84.

PurposeTo examine the effects of conservative and surgical treatments for nocturnal leg cramps in patients with lumbar spinal stenosis (LSS). Nocturnal leg cramps is frequently observed in patients with peripheral neuropathy. However, there have been few reports on the relationship between nocturnal leg cramps and LSS, and it remains unknown whether conservative or surgical intervention has an impact on leg cramps in patients with LSS.Materials And MethodsThe subjects were 130 LSS patients with low back and leg pain. Conservative treatment such as exercise, medication, and epidural block was used in 66 patients and surgical treatment such as decompression or decompression and fusion was performed in 64 patients. Pain scores and frequency of nocturnal leg cramps were evaluated based on self-reported questionnaires completed before and 3 months after treatment.ResultsThe severity of low back and leg pain was higher and the incidence of nocturnal leg cramps was significantly higher before treatment in the surgically treated group compared with the conservatively treated group. Pain scores improved in both groups after the intervention. The incidence of nocturnal leg cramps was significantly improved by surgical treatment (p=0.027), but not by conservative treatment (p=0.122).ConclusionThe findings of this prospective study indicate that the prevalence of nocturnal leg cramps is associated with LSS and severity of symptoms. Pain symptoms were improved by conservative or surgical treatment, but only surgery improved nocturnal leg cramps in patients with LSS. Thus, these results indicate that the prevalence of nocturnal leg cramps is associated with spinal nerve compression by LSS.

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