Background Lumbar canal stenosis mainly affects adults in the 5th decade of life and has a negative impact on quality of life. One of the most frequent complaints is claudication during gait.
Objectives Assess the effectiveness of orally administered systemic corticosteroids on gait in patients with narrow lumbar canal syndrome
Methods Sixty-one patients aged 50 to 75 years were randomized. The patients and examiner were blinded. The study received approval from the local ethics committee. Clinical diagnosis: lower limb complaints (pain, weakness, sensation of burning or tingling) that improved with the cessation of ambulation, with or without the presence of low back pain. The radiological diagnosis was based on stenosis of the lumbar canal with an area less than 100 mm2, One group took prednisone (corticosteroid) at an initial daily dose of 1mg per kg of weight, with weekly decreasing. The control group received a placebo in the morning. Evaluations were performed on the initial session and after three, six and twelve weeks.
Results Among the patients having taken the corticosteroid, the mean distance traveled on the walk text was 367 m (88-553 m) on the initial evaluation, 379 m (168-568 m) after three weeks, 346 m (176-498 m) after six weeks and 352 m (206-572 m) on the final evaluation. Among those who took the placebo, the mean distance traveled was 388 m (176-575 m) on the initial evaluation (p=0.3728), 391 m (178-581 m) after three weeks (p=0.6453), 389 m (181-607 m) after six weeks (p=0.0746) and 395 m (260-572 m) on the final evaluation (p=0.0496). Figure 1: Results regarding improvement (Likert scale): 1 = much worse; 2 = worse; 3 = unaltered; 4 = better; 5 = much betterThe patients submitted to the corticoid steroid exhibited a greater improvement between the first evaluation and second evaluation.
Conclusions The use of an oral corticoid steroid with a progressive reduction in dose over a three-week period proved effective in the initial phase of treatment, but no differences were found in relation to patients having taken a placebo over 12 weeks of follow up
Hamanishi C, Matukura N, Fujita M, Tomihara M, Tanaka S: Crosssectional area of the stenotic lumbar dural tube measured from the transverse views of MRI. J Spinal Dis 1994, 7:388-393.
Disclosure of Interest None Declared