title: The effect of a prostaglandin E1 derivative on the symptoms and quality of life of patients with lumbar spinal stenosis.
abstract: BACKGROUND
  Quality of life (QOL) is a concern for patients with lumbar spinal stenosis (LSS). In this study, QOL was examined using the 5-item EuroQol (EQ-5D).
  
  
  METHODS
  QOL and activities of daily living (ADL) were surveyed for 91 patients who visited 18 medical institutions in our prefecture and were diagnosed with LSS-associated intermittent claudication. A second survey was performed after ≥6 weeks for 79 of the subjects to evaluate therapy with limaprost (an oral prostaglandin E1 derivative) or etodolac (an NSAID). Symptoms, maximum walking time, QOL, ADL items, and relationships among these variables were investigated for all 91 patients. Leg pain, leg numbness, and low back pain while walking were surveyed by use of VAS scores (0-100).
  
  
  RESULTS
  Leg pain, leg numbness, and low back pain while walking (VAS ≥25) were present in 83.5, 62.6, and 54.9 % of the patients in the first survey, and approximately half of the patients had a maximum walking time <15 min. The mean EQ-5D utility value for QOL was 0.59 ± 0.12. This value was significantly associated with maximum walking time (p = 0.030) based on classification of patients into groups with walking times <7.5, 7.5-15, 15-30, and >30 min, showing that maximum walking time affected health-related QOL. Of the 79 patients who completed the second survey, 56 had taken limaprost and 23 (control group) had received etodolac. Limaprost improved possible walking time, reduced ADL interference, and significantly increased the EQ-5D utility score, whereas no significant changes occurred in the control group. Maximum walking time was prolonged by ≥10 min and the EQ-5D utility value was improved by ≥0.1 points in significantly more patients in the limaprost group than in the control group.
  
  
  CONCLUSIONS
  According to the findings of this survey, at an average of 8 weeks after administration limaprost improved symptoms, QOL, and ADL in LSS patients whereas treatment with an NSAID reduced pain but did not have any other effects.
authors.affiliation: Department of Orthopaedic Surgery, Shinshu University, School of Medicine, Matsumoto Asahi 3-1-1, Nagano 390-8621, Japan. jtaka@shinshu-u.ac.jp
authors.forename: Jun
authors.initials: J
authors.lastname: Takahashi
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kobayashi
authors.forename: Shinji
authors.initials: S
authors.lastname: Wakabayashi
authors.forename: Masao
authors.initials: M
authors.lastname: Deguchi
authors.forename: Hidehiro
authors.initials: H
authors.lastname: Ito
authors.forename: Yuji
authors.initials: Y
authors.lastname: Mogami
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tanikawa
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Hideki
authors.initials: H
authors.lastname: Moriya
authors.forename: Ryohei
authors.initials: R
authors.lastname: Ashizawa
authors.forename: Kenji
authors.initials: K
authors.lastname: Takahara
authors.forename: Hisatoshi
authors.initials: H
authors.lastname: Kinoshita
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Tateiwa
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Misawa
authors.forename: Takahiro
authors.initials: T
authors.lastname: Tsutsumimoto
authors.forename: Taku
authors.initials: T
authors.lastname: Nakakohji
authors.forename: Yohei
authors.initials: Y
authors.lastname: Yuzawa
authors.forename: Akihito
authors.initials: A
authors.lastname: Sawaumi
authors.forename: Yohei
authors.initials: Y
authors.lastname: Hidai
authors.forename: Satoshi
authors.initials: S
authors.lastname: Matsuda
authors.forename: Isao
authors.initials: I
authors.lastname: Nakamura
authors.forename: Shigeyuki
authors.initials: S
authors.lastname: Toba
authors.forename: Mikio
authors.initials: M
authors.lastname: Kamimura
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nakane
authors.forename: Hiroki
authors.initials: H
authors.lastname: Hirabayashi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hashidate
authors.forename: Nobuhide
authors.initials: N
authors.lastname: Ogihara
authors.forename: Keijiro
authors.initials: K
authors.lastname: Mukaiyama
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
authors.forename: Kuniyoshi
authors.initials: K
authors.lastname: Ohtsuka
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000527:Alprostadil / Q000031:analogs & derivatives* / Q000627:therapeutic use; D016009:Chi-Square Distribution; D052246:Cyclooxygenase 2 Inhibitors / Q000627:therapeutic use*; D004185:Disability Evaluation; D017308:Etodolac / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000188:drug therapy; D017116:Low Back Pain / Q000188:drug therapy*; D008159:Lumbar Vertebrae; D008297:Male; D010147:Pain Measurement; D011788:Quality of Life; D013130:Spinal Stenosis / Q000188:drug therapy*; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014665:Vasodilator Agents / Q000627:therapeutic use*; D016138:Walking
chemical_list: D052246:Cyclooxygenase 2 Inhibitors; D014665:Vasodilator Agents; D017308:Etodolac; D000527:Alprostadil; C059238:limaprost