腰部脊柱管狭窄症の間欠跛行に対するlipoprostaglandin E1点滴治療の効果と限界

Efficacy and Limitations of Intravenous Lipoprostaglandin E1 Infusion against Neurogenic Intermittent Claudication in Patients with Lumbar Spinal Canal Stenosis

　経口prostaglandin E1(PGE1)製剤が無効であった腰部脊柱管狭窄症(lumbar spinal canal stenosis；LCS)37症例に対してlipoprostaglandin E1(lipo-PGE1)点滴治療(1日5μg×14日間)を行い，連続歩行可能距離の有意な改善が得られた．治療効果は馬尾型・混合型と比較して，神経根型で有意に優れていた．治療後平均17カ月の最終調査時，12例においてその効果は持続していた．一方，20例において本治療後に手術治療を要しており，その効果は限定的と思われた．

　We investigated the efficacy of intravenous infusion of lipoprostaglandin E1 (lipo-PGE1) against neurogenic intermittent claudication (NIC) in patients with lumbar spinal canal stenosis (LCS).　Lipo-PGE1 (5μg daily for 14 consecutive days) was administered by intravenous infusion to 37 patients who had not responded well to oral PGE1 therapy.　The patients' average maximum walking distance had significantly improved after treatment.　The patients with the radicular type of NIC had significantly better results than the patients with the cauda equina type or mixed type.　After an average follow-up period of 17 months therapeutic efficacy has continued in 12 patients, but the 20 other patients required surgery after treatment.　Intravenous lipo-PGE1 therapy appeared to provide limited efficacy against NIC in LCS patients.