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Limaprost Alfadex Improves Myelopathy Symptoms in Patients With Cervical Spinal Canal Stenosis

Sugawara, Taku MD, PhD; Hirano, Yoshitaka MD; Higashiyama, Naoki MD; Mizoi, Kazuo MD

doi: 10.1097/BRS.0b013e31819a84ec
Cervical Spine

Study Design. Myelopathy symptoms were prospectively studied in patients with cervical spinal canal stenosis (CSCS), using objective grading systems and stabilometry, to examine the effect of administration of prostaglandin E1 derivative limaprost alfadex (limaprost).

Objective. Myelopathy scores/grades and stabilometry parameters were evaluated before, and 1 and 3 months after starting the limaprost treatment.

Summary and Background Data. Limaprost is a potent vasodilator and antiplatelet agent and has been used to treat the symptoms of lumbar spinal canal stenosis. The action presumably involves increased blood flow in the compressed cauda equina. Limaprost can also increase blood flow in the compressed spinal cord, but effects on myelopathy symptoms in patients with CSCS have not been established.

Methods. This study examined 21 patients with mild spondylotic CSCS based on neurologic findings and compression of the cervical spinal cord on magnetic resonance imaging. Japanese Orthopedic Association score, grip and release test, and finger escape sign were measured, and stabilometry was performed by independent examiners, before, and 1 and 3 months after starting the oral limaprost treatment.

Results. Most patients experienced amelioration of the symptoms at 1 month after starting the treatment. Mean Japanese Orthopedic Association score and grip and release count were significantly improved and finger escape sign grade was higher in some patients. Stabilometry area with eyes closed and Romberg rate were also significantly improved. These improvements were maintained at 3 months.

Conclusion. The efficacy of oral limaprost administration for patients with CSCS was confirmed by objective scoring and quantitative data.

The efficacy of prostaglandin E1 derivative limaprost alfadex for patients with cervical spinal canal stenosis was evaluated by objective scoring/grading and stabilometry. The patients showed significant improvement of the symptoms and the effects were confirmed by objective data.

From the Department of Neurosurgery, Akita University School of Medicine, Akita, Japan.

Acknowledgment date: July 16, 2008. Revision date: September 13, 2008. Acceptance date: October 9, 2008.

The device(s)/drug(s) that is/are the subject of this manuscript is/are not FDA-approved for this indication and is/are not commercially available in the United States.

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 Taku Sugawara, MD, Department of Neurosurgery, Akita University School of Medicine, 1-1-1 Hondo, Akita 010-8543, Japan; E-mail: taku@nsg.med.akita-u.ac.jp.

© 2009 Lippincott Williams & Wilkins, Inc.