Use of Prostaglandin E1 for Lumbar Spinal Stenosis

One of the main symptoms of lumbar spinal stenosis (LSS) is intermittent claudication. Intermittent means the symptoms come and go. Claudication refers to limping caused by cramping pain or discomfort in the lower legs.

Increased pressure on the spinal cord or spinal nerve roots from a narrowed spinal canal is the main cause of this problem. It is usually a degenerative process that comes on as we age. A loss of circulation to the spinal area makes the problem even worse.

The results of this study may be of interest to patients who are looking for a conservative treatment plan to treat their stenosis. Only patients with intermittent claudication from nerve impairment who also had poor blood flow were included. They were given an intravenous (IV) infusion of prostaglandin E1 (PGE1) for two weeks. This was followed up with oral (by mouth) PGE1.

PGE1 dilates or opens up the blood vessels in the epidural space (inside the spinal canal. If symptoms aren't improved after PGE1 treatment, then sugery may be needed.

The results were measured before and after treatment. Measurements included distance walked before stopping because of pain, spinal stenosis rate, and function. Stenosis rate refers to the area of spinal canal opening seen on MRI and CT myelography testing. Function was assessed using a special survey of subjective symptoms and objective findings.

The authors report that PGE1 was helpful in alleviating painful walking. The treatment was safe. It did not appear to be linked with the patient's age, severity of stenosis, or claudication distance. Level of function did seem to make a difference. Patients with more severe symptoms had less response to the PGE1.

Researchers are hopeful that treatments like PEG1 can benefit patients with painful intermittent claudication from lumbar spinal stenosis. This would be good news for patients who either don't want or can't have surgery for any reason.

Kazo Nakanishi, MD, PhD, et al. Midterm Results of Prostaglandin E1 Treatment in Patients With Lumbar Spinal Canal Stenosis Accompanied by Intermittent Claudication. In Spine. June 1, 2008. Vol. 33. No. 13. Pp. 1465-1469.

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