Impact of Lumbar Surgery on Pharmacological Treatment for Patients with Lumbar Spinal Canal Stenosis: A Single-Center Retrospective Study

Abstract

Treatment for lumbar spinal canal stenosis (LSCS) is mainly classified into conservative and surgical therapies. Among conservative therapies, pharmacological treatment is commonly prescribed for LSCS. Meanwhile, surgical treatment is the last option for LSCS. This study aimed to examine the impact of lumbar surgery on pharmacological treatment for patients with LSCS. Consecutive patients aged ≥ 40 years who underwent lumbar surgery for LSCS were identified. A total of 142 patients were retrospectively reviewed for preoperative and 6-month and 1-year postoperative LSCS medications. The results showed that the number of LSCS medications significantly decreased after lumbar surgery. The proportion of the patients taking non-steroidal anti-inflammatory drugs, pregabalin/mirogabalin, opioids, prostaglandin E1 analogs, and neurotropin was significantly decreased after lumbar surgery, but that of the patients taking mecobalamin, acetaminophen, and serotonin-noradrenalin reuptake inhibitors was not significantly changed. Additionally, around 15% of the participants showed an increase in LSCS medications even after lumbar surgery. Multivariable analysis revealed that individuals without improvements in walking ability (RR: 2.7, 95% CI: 1.3–5.9) or social life (RR: 2.3, 95% CI: 1.1–5.0) had a greater risk of a postoperative increase in LSCS medications. The study results may provide physicians with beneficial information on treatment for LSCS.

Effects of buccal acupuncture on postoperative analgesia in elderly patients undergoing laparoscopic radical gastrectomy: a randomized controlled trial

“…It contributes to pain relief through reducing the total number of μ receptors, decreasing the affinity of κ receptors and inhibiting the binding force between opioid and receptors ( 33 ). Characterized by the analgesic time-effect, the use of buccal acupuncture in rabbits increased the content of 5-HT and decreases the ratio of NE/5-HT in the hypothalamus ( 30 , 34 ).…”

What Types of Strategies Are Effective in Lumbar Spine Surgery? Considering the Etiology, Imaging Findings, and Risk of Complications

“…Conservative treatments for lumbar spinal disorders have thus far included pharmacological treatment, injections, rehabilitation, and surgical treatment using braces and are still being continued today. The proportion of the patients with LSS who underwent pharmacological treatment, such as the use of non-steroidal anti-inflammatory drugs, pregabalin/mirogabalin, opioids, prostaglandin E1 analogs, and neurotropin, significantly decreased after lumbar surgery [ 8 ]. People who do not show improvements in their walking abilities or social lives have higher risks of postoperative increases in the administration of the drugs mentioned above [ 8 ].…”

“…Finally, as a strategy for preventing complications, it is desirable to devise means of reducing the risk of bleeding due to hypotensive anesthesia [ 15 ], reduce psudoarthrosis [ 19 ], and reduce adjacent vertebral body fractures [ 20 ]. Appropriate prescriptions for relieving pain such as lower back and leg pain are also important for reducing postoperative complications [ 8 ]. Further research studies will progress in the future.…”