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Prostaglandin E 1 Treatment for Lumbar Spinal Canal Stenosis: Review of the Literature
Author(s) -
Yoshihara Hiroyuki
Publication year - 2016
Publication title -
pain practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.899
H-Index - 58
eISSN - 1533-2500
pISSN - 1530-7085
DOI - 10.1111/papr.12272
Subject(s) - medicine , lumbar spinal stenosis , prostaglandin e , lumbar , cauda equina , prostaglandin , visual analogue scale , surgery , intermittent claudication , spinal stenosis , anesthesia , spinal cord , vascular disease , arterial disease , psychiatry
Background The important pathophysiologic factor of neurogenic intermittent claudication (NIC) in lumbar spinal canal stenosis ( LSCS ) has been reported to be the reduction in intraneural blood flow and a state of relative ischemia in nerve tissues. Prostaglandin E1 ( PGE 1) presumably improves symptoms in patients with LSCS by improving the blood flow in the cauda equina and nerve roots through its vasodilation and antiplatelet aggregation effects. The purpose of the study was to summarize the results of previous studies regarding PGE 1 treatment for LSCS and to describe the details of PGE 1 treatment to all physicians who take care of patients with LSCS . Methods Review of the literature. Results There are 3 PGE 1‐related products that have been used clinically for the treatment of LSCS : PGE 1, lipo‐ PGE 1, and limaprost ( PGE 1 derivative). Experimental studies have been performed to verify the efficacy of PGE 1 treatment for LSCS . Many studies have reported clinical outcomes of PGE 1 treatment in patients with LSCS . Overall, previous studies examining PGE 1 treatment for LSCS demonstrate improvement in several clinical outcome measures such as the visual analog scale, Japanese Orthopaedic Association score, and NIC distance, although most of the studies have only short‐term follow‐up. Conclusions Based on the results of previous studies, PGE 1 treatment may be an option as a conservative treatment for LSCS . However, future studies with high‐quality and long‐term follow‐up are necessary. Future studies also should include refinement of indications, administration period, as well as comparisons between PGE 1 treatment and other conservative treatments such as epidural injection.