[Possible conservative treatment methods for patients with spinal claudication].
The success of multimodal therapy for patients with symptoms of spinal canal stenosis lasting >6 months was investigated in a prospective study. Clinical (age, weight, height) and morphological data were collected for 36 patients (21 women and 15 men) with an average age of 67 years. The extent of narrowing in the spinal space (diameter of the dural sac <100 mm(2)) was measured by magnetic resonance imaging at segments L1-S1. Impairments in daily activities were assessed by questionnaire before a 3-week multimodal treatment regimen and 3 weeks and 6 months thereafter. In addition, depression status and walking distance on a treadmill were evaluated. Of the 180 segments examined, 124 evidenced a diameter of the dural sac of <100 mm(2). The average functional capacity improved with treatment from 46.7 to 53.5 (p<0.001) and the average depression status decreased from 13.5 to 11 (p>0.05). The average walking distance was 373 m before treatment and 565 m after treatment (p<0.001). Short-term improvement of the walking distance was achieved with the conservative treatment implemented. Medium- and long-term results remain unclear. Predictors for treatment success (age, sex, BMI, functional capacity, walking ability before treatment) could not be found. No scientific evidence can be gleaned from the literature in this regard so that further prospective studies should be performed.
Abteilung I, Orthopädische Universitätsklinik Heidelberg, Heidelberg. felix.zeifang@ok.uni-heidelberg.de
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D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D003000:Clonidine / Q000627:therapeutic use; D015928:Cognitive Behavioral Therapy / Q000379:methods; D003131:Combined Modality Therapy / Q000379:methods; D000529:Complementary Therapies / Q000379:methods*; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology / Q000628:therapy*; D008279:Magnetic Resonance Imaging; D008297:Male; D026741:Physical Therapy Modalities / Q000379:methods*; D011613:Psychotherapy / Q000379:methods*; D020127:Recovery of Function; D013130:Spinal Stenosis / Q000150:complications / Q000175:diagnosis* / Q000523:psychology / Q000628:therapy*; D016896:Treatment Outcome
D000700:Analgesics; D003000:Clonidine