Limaprost alfadex improves myelopathy symptoms in patients with cervical spinal canal stenosis.
METHODS
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.


BACKGROUND
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.


CONCLUSIONS
The efficacy of oral limaprost administration for patients with CSCS was confirmed by objective scoring and quantitative data.
Sugawara
Taku
T
Department of Neurosurgery, Akita University School of Medicine, Akita, Japan. taku@nsg.med.akitau.ac.jp
Hirano
Yoshitaka
Y
Higashiyama
Naoki
N
Mizoi
Kazuo
K
D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000527:Alprostadil / Q000008:administration & dosage / Q000031:analogs & derivatives*; D002574:Cervical Vertebrae; D004244:Dizziness / Q000188:drug therapy / Q000209:etiology / Q000473:pathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009048:Motor Skills / Q000187:drug effects; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D004856:Postural Balance / Q000187:drug effects; D011446:Prospective Studies; D013130:Spinal Stenosis / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D055009:Spondylosis / Q000150:complications* / Q000473:pathology; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000008:administration & dosage*
D010975:Platelet Aggregation Inhibitors; D014665:Vasodilator Agents; D000527:Alprostadil; C059238:limaprost