Japanese Orthopaedic Association (JOA) clinical practice guidelines on the management of lumbar spinal stenosis, 2021 - Secondary publication

Kawakami, Mamoru; Takeshita, Katsushi; Inoue, Gen; Sekiguchi, Miho; Fujiwara, Yasushi; Hoshino, Minoru; Kaito, Takashi; Kawaguchi, Yoshiharu; Minetama, Masakazu; Orita, Sumihisa; Takahata, Masahiko; Tsuchiya, Kuniyoshi; Tsuji, Takashi; Yamada, Hiroshi; Watanabe, Kota

doi:10.1016/j.jos.2022.03.013

Cited by 21 publications

(26 citation statements)

References 319 publications

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“…Patients with LSCS develop numbness and pain in the lower extremities and intermittent claudication as distinctive clinical manifestations. Intermittent claudication due to LSCS is clinically classified into three types: the cauda equina type, nerve root type, and combined type [ 1 ]. Additionally, LSCS is divided into congenital and acquired etiologies.…”

Section: Introductionmentioning

confidence: 99%

“…LSCS treatment is mainly classified into conservative and surgical therapies [ 1 , 2 ]. Conservative therapy includes pharmacological treatment, physical therapy/exercise, spinal injection, manipulation, and ancillary treatments, such as bracing, traction, and electrical stimulation [ 1 , 2 ]. Among these treatments, pharmacological treatment is commonly prescribed for LSCS.…”

Section: Introductionmentioning

confidence: 99%

“…It includes many medication options: non-steroidal anti-inflammatory drugs (NSAIDs), opioids, serotonin-noradrenalin reuptake inhibitors (SNRIs), pregabalin/mirogabalin, prostaglandin E1 analogs (PGE1), acetaminophen, mecobalamin, and neurotropin [ 1 , 2 , 6 ]. Meanwhile, surgical treatment is the last option for patients with LSCS, considering that it is indicated for patients who are resistant to conservative treatments including pharmacological treatment [ 1 , 2 ]. Surgical treatment is mainly divided into decompression alone and decompression with lumbar fusion.…”

Section: Introductionmentioning

confidence: 99%

“…Surgical treatment is mainly divided into decompression alone and decompression with lumbar fusion. The former has favorable outcomes for patients without lumbar instability, and the latter has favorable outcomes for patients with lumbar instability [ 1 ]. Although patients who underwent lumbar surgery should be less dependent on conservative treatment, even patients after lumbar surgery occasionally show an increase in the intensity of conservative therapies.…”

Section: Introductionmentioning

confidence: 99%

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

Imai

Nagai

Michikawa

et al. 2023

JCM

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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.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Imai

Nagai

Michikawa

et al. 2023

JCM

View full text Add to dashboard Cite

show abstract

“…It has been suggested in various guidelines that the addition of lumbar fusion to decompression improves clinical outcomes. 20,21 However, these guidelines have not been updated to include results from recent well-evidenced controlled trials on this subject.…”

mentioning

confidence: 99%