An Investigation of drug therapy for lumbar spinal stenosis at our hospital -Did the rate of surgical treatment decrease after the start of antineuropathic pain drugs?-

<p>Introduction: The effects of antineuropathic pain drugs on lumbar spinal stenosis (LSS) in the midterm are unknown. Thus, the effects of antineuropathic pain drugs on LSS were retrospectively investigated.</p><p>Methods: Patients who could be followed for more than 6 months in the outpatient clinic and 533 matched patients were investigated. The patients were divided into two groups. One group (Group A, n=264) was treated before pregabalin, mirogabalin or opioids were started. The other group (Group P, n=269) was treated after they were started. Outcomes were classified into 5 categories: good, no change, deteriorated, surgical treatment, and unknown. The types and rates of each medicine or other treatments, and the outcomes of each group were obtained from the medical records.</p><p>Results: Pregabalin was used in 45.1%, mirogabalin in 19.5%, opiods in 20.5% and duloxetine in 8.5% in group P. Good results were obtained in 54.2%, no change was seen in 28.8%, deterioration was seen in 2.8%, surgical treatment was conducted in 12.9%, and the outcome was unknown in 1.5% in group A. Good results were obtained in 46.1%, no change was seen in 23.2%, deterioration was seen in 3.3%, surgical treatment was conducted in 26.2%, and the outcome was unknown in 1.1% in group P. There was no significant difference in the rate of good cases between them.</p><p>The rate of surgical treatment was higher in Group P than in Group A. However, the number of surgical treatments by one year was not different between them. Furthermore, group P was subdivided into two subgroups. One was the group treated by pregabalin or mirogabalin and the other was the group without them. There was no significant difference between them in the rate of good results and surgical treatment. The effect of antineuropathic pain drugs seemed better in mild or moderate cases. On the other hand, the rate of surgical treatment did not decrease after the start of antineuropathic pain drugs.</p><p>Conclusion: The midterm effect of antineuropathic pain drugs in the treatment of lumbar spinal stenosis was investigated.</p><p>Surgical treatment still needs to be considered for severe cases.</p>