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The Efficiency of Gabapentin Therapy in Patients With Lumbar Spinal Stenosis

Yaksi, Ali MD*; Özgönenel, Levent MD*; Özgönenel, Bülent MD†

doi: 10.1097/01.brs.0000261029.29170.e6
Randomized Trial

Study Design. Randomized controlled study.

Objectives. To investigate the efficacy of treatment with gabapentin on the clinical symptoms and findings in patients with lumbar spinal stenosis (LSS).

Summary of Background Data. LSS is a syndrome resulting from the narrowing of the lumbar nerve root canal, spinal canal, and intervertebral foramen, causing compression of the spinal cord. The most significant clinical symptom in patients with LSS is neurologic intermittent claudication (NIC). Gabapentin, which has been used in the treatment of neuropathic pain, may be effective in the treatment of symptoms associated with LSS.

Methods. Fifty-five patients with LSS, who had NIC as the primary complaint, were randomized into 2 groups. All patients were treated with therapeutic exercises, lumbosacral corset with steel bracing, and nonsteroidal anti-inflammatory drugs. The treatment group received gabapentin orally in addition to the standard treatment.

Results. Gabapentin treatment resulted in an increase in the walking distance better than what was obtained with standard treatment (P = 0.001). Gabapentin-treated patients also showed improvements in pain scores (P = 0.006) and recovery of sensory deficit (P = 0.04), better than could be attained with the standard treatment.

Conclusion. Based on the results of our pilot study, extensive clinical studies are warranted to investigate the role of gabapentin in the management of symptomatic LSS.

Fifty-five patients with lumbar spinal stenosis were randomized to receive oral gabapentin or nothing along with the standard treatment. Patients receiving gabapentin showed superior reduction in pain scores and increased their walking distance when compared with control patients. Gabapentin should be considered in the treatment of lumbar spinal stenosis.

From the *Department of Physical Medicine & Rehabilitation, S.B. Istanbul Education and Research Hospital, Istanbul, Turkey; and †Department of Clinical Pathology, William Beaumont Hospital, Royal Oak, MI.

Acknowledgment date: May 18, 2006. First revision date: August 23, 2006. Second revision date: September 13, 2006. Acceptance date: September 14, 2006.

Presented orally at the 20th National Congress of Physical Medicine & Rehabilitation in Bodrum, Turkey, June 22–26, 2005.

The device(s)/drug(s) is/are FDA-approved or approved by corresponding national agency for this indication.

No funds were received in support of this work. No benefits in any form have been or will be received from a commercial party related directly or indirectly to the subject of this manuscript.

Address correspondence and reprint requests to Levent Özgönenel, Ağaçkakan sokak No. 21/2, 34290 Kocamustafapaşa, Istanbul, Turkey; E-mail: levento26@yahoo.com

© 2007 Lippincott Williams & Wilkins, Inc.