Limaprost or Pregabalin: Preoperative and Postoperative Medication for Pain due to Lumbar Spinal Stenosis

Abstract Purpose We aimed to evaluate the incidence of (and risk factors for) postoperative pregabalin and/or limaprost to treat persistent numbness and/or pain of the lower extremities after lumbar spinal stenosis ( LSS ) surgery. Methods Medical records of 329 patients (168 men, 161 women; average age 70 years) were retrospectively reviewed for data on the duration of LSS diagnosis; LSS disease; preoperative medication (limaprost, pregabalin, or combined limaprost/pregabalin; duration); symptoms; preoperative/postoperative intermittent claudication ( IC ); operation type; and postoperative medication and period. Results Limaprost, pregabalin, and combined limaprost/pregabalin were prescribed preoperatively for 43%, 7%, and 5% of patients, respectively. At an average of 21 months postoperatively, limaprost, pregabalin, and combined therapy were prescribed in 11%, 8%, 4% of patients, respectively. Medication requirement was significantly lower postoperatively than preoperatively ( P < 0.0001). Significant risk factors for required postoperative medication were required preoperative medication (odds ratio [ OR ] 3.088, 95% confidence interval [ CI ] 1.679 to 5.681]; postoperative period ( OR 1.063, 95% CI 1.031 to 1.096); and postoperative IC ( OR 3.868, 95% CI 1.481 to 10.103). A negative impact from postoperative medication was seen in patients who had undergone decompression surgery ( OR 0.589, 95% CI 0.377 to 0.918). Conclusions Overall, 23% of LSS patients required medication for pain and/or numbness at 21 months postoperatively. Significant factors portending required postoperative medication were preoperative medication, longer postoperative period, and postoperative IC . A negative influence from postoperative medication was seen in patients who had undergone decompression surgery without fusion.