Incidence of nocturnal leg cramps in patients with lumbar spinal stenosis before and after conservative and surgical treatment.
OBJECTIVE
To examine the effects of conservative and surgical treatments for nocturnal leg cramps in patients with lumbar spinal stenosis (LSS). Nocturnal leg cramps is frequently observed in patients with peripheral neuropathy. However, there have been few reports on the relationship between nocturnal leg cramps and LSS, and it remains unknown whether conservative or surgical intervention has an impact on leg cramps in patients with LSS.


METHODS
The subjects were 130 LSS patients with low back and leg pain. Conservative treatment such as exercise, medication, and epidural block was used in 66 patients and surgical treatment such as decompression or decompression and fusion was performed in 64 patients. Pain scores and frequency of nocturnal leg cramps were evaluated based on self-reported questionnaires completed before and 3 months after treatment.


RESULTS
The severity of low back and leg pain was higher and the incidence of nocturnal leg cramps was significantly higher before treatment in the surgically treated group compared with the conservatively treated group. Pain scores improved in both groups after the intervention. The incidence of nocturnal leg cramps was significantly improved by surgical treatment (p=0.027), but not by conservative treatment (p=0.122).


CONCLUSIONS
The findings of this prospective study indicate that the prevalence of nocturnal leg cramps is associated with LSS and severity of symptoms. Pain symptoms were improved by conservative or surgical treatment, but only surgery improved nocturnal leg cramps in patients with LSS. Thus, these results indicate that the prevalence of nocturnal leg cramps is associated with spinal nerve compression by LSS.
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Seiji
S
Ohtori
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Masaomi
M
Yamashita
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Yasuaki
Y
Murata
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Yawara
Y
Eguchi
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Yasuchika
Y
Aoki
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Hiromi
H
Ataka
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Jiro
J
Hirayama
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Tomoyuki
T
Ozawa
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Tatsuo
T
Morinaga
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Hajime
H
Arai
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Masaya
M
Mimura
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Hiroto
H
Kamoda
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Sumihisa
S
Orita
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Masayuki
M
Miyagi
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Tomohiro
T
Miyashita
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Yuzuru
Y
Okamoto
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Tetsuhiro
T
Ishikawa
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Hiroaki
H
Sameda
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Tomoaki
T
Kinoshita
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Eiji
E
Hanaoka
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Miyako
M
Suzuki
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Munetaka
M
Suzuki
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Takato
T
Aihara
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Toshinori
T
Ito
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Gen
G
Inoue
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Masatsune
M
Yamagata
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Tomoaki
T
Toyone
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Gou
G
Kubota
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Yoshihiro
Y
Sakuma
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Yasuhiro
Y
Oikawa
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Kazuhide
K
Inage
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Takeshi
T
Sainoh
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Jun
J
Sato
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Kazuyo
K
Yamauchi
Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, Chiba, Japan.
Kazuhisa
K
Takahashi
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D007866:Leg / Q000473:pathology*; D017116:Low Back Pain / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000453:epidemiology* / Q000209:etiology*; D011446:Prospective Studies; D013130:Spinal Stenosis / Q000150:complications* / Q000503:physiopathology* / Q000601:surgery; D011795:Surveys and Questionnaires
Nocturnal leg cramps; comparison; conservative treatment; decompression; fusion; lumbar spinal stenosis; outcome; pain; prospective study; severity; surgery