Document Detail


New treatment of lumbar disc herniation involving 5-hydroxytryptamine2A receptor inhibitor: a randomized controlled trial.
MedLine Citation:
PMID:  15871484     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: Serotonin or 5-hydroxytryptamine (5-HT) is a chemical mediator associated with nucleus pulposus-induced radiculopathy. Inhibition of 5-HT receptors may potentially alleviate symptoms in patients with lumbar disc herniation. This prospective randomized controlled study was performed to evaluate the efficacy of the 5-HT2A receptor inhibitor in the treatment of symptomatic lumbar disc herniation. METHODS: Forty patients with sciatica due to L4-5 or L5-S1 disc herniation were randomly allocated to treatment with the 5-HT2A inhibitor (sarpogrelate 300 mg/day) or nonsteroidal antiinflammatory drugs (NSAIDs; diclofenac 75 mg/day). Low-back pain, leg pain, and numbness were evaluated using a visual analog scale (VAS) before and after a 2-week course of treatment. The patients received only allocated medicine during the 2-week regimen and were thereafter allowed to choose any treatment options depending on their residual symptoms. One-year clinical outcomes were assessed based on the rates of additional medical interventions. The mean VAS score improvements in the 5-HT2A and NSAID groups were 33 and 46% for low-back pain, 32 and 32% for leg pain, and 35 and 22% for leg numbness, respectively. After the 2-week regimen, no additional medical interventions were required in 50% of 5-HT2A-treated patients and 15% of those receiving NSAIDs. Epidural or nerve root block procedures were performed in 35% of the 5-HT2A group and 45% of the NSAID group. Surgery was required in 20% of the 5-HT2A group and 30% of the NSAID group patients. CONCLUSIONS: The current study provided evidence that the efficacy of the 5-HT2A inhibitor was comparable with that of NSAID therapy for lumbar disc herniation. The 5-HT2A inhibitor has the potential to alleviate symptoms in patients with lumbar disc herniation.
Authors:
Masahiro Kanayama; Tomoyuki Hashimoto; Keiichi Shigenobu; Fumihiro Oha; Shigeru Yamane
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Journal of neurosurgery. Spine     Volume:  2     ISSN:  1547-5654     ISO Abbreviation:  -     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-05-05     Completed Date:  2005-05-31     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101223545     Medline TA:  J Neurosurg Spine     Country:  United States    
Other Details:
Languages:  eng     Pagination:  441-6     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Hakodate Central General Hospital, Hakodate, Japan. mkanayama@aol.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Autonomic Nerve Block / methods
Diclofenac / therapeutic use
Epidural Space
Female
Humans
Intervertebral Disk Displacement / complications,  drug therapy*,  surgery
Low Back Pain / drug therapy,  etiology,  surgery
Lumbar Vertebrae*
Male
Pain Measurement
Prospective Studies
Receptor, Serotonin, 5-HT2A / antagonists & inhibitors*
Sciatica / drug therapy,  etiology,  surgery
Serotonin Antagonists / administration & dosage,  pharmacology*,  therapeutic use*
Succinates / administration & dosage,  pharmacology*,  therapeutic use*
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal; 0/Receptor, Serotonin, 5-HT2A; 0/Serotonin Antagonists; 0/Succinates; 15307-86-5/Diclofenac; 86819-20-7/sarpogrelate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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