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A comparative study of three conservative treatments in patients with lumbar spinal stenosis: lumbar spinal stenosis with acupuncture and physical therapy study (LAP study)

Lumbar spinal stenosis (LSS) is usually associated with neurological symptoms and intermittent claudication in the lower extremities due to narrowing of the intervertebral foramen and spinal canal. Because of these symptoms, LSS is an important risk factor for decreased quality of life, particularly in the elderly. With aging of the society, the number of patients with LSS is predicted to rapidly increase.

Background for this study:Lumbar Spinal Stenosis

Although the efficiency of conservative management for lumbar spinal stenosis (LSS) has been examined, different conservative management approaches have not been compared. This study performed the first comparative trial of three types of conservative management (medication with acetaminophen, exercise, and acupuncture) in Japanese patients with LSS.

Methods of this study:

Patients with L5 root radiculopathy associated with LSS who visited this study hospital for surgical treatment were enrolled between December 2011 and January 2014. In this open-label study, patients were assigned to three treatment groups (medication, exercise, acupuncture) according to the visit time.

Results of this study:

Thirty-eight, 40, and 41 patients were allocated to the medication, exercise, and acupuncture groups, respectively. No patient underwent surgical treatment during the study period. The symptom severity scores improved significantly after treatment in the medication, exercise and acupuncture groups. The physical function score improved significantly in the acupuncture group, but not in the medication and exercise groups. The mean reduction in the score for physical function was significantly greater for acupuncture than for exercise. The mean score for treatment satisfaction was significantly greater for acupuncture than for medication.

Conclusions

Acupuncture was significantly more effective than physical exercise according to the physical function score. Acupuncture was significantly more effective than medication according to the satisfaction score. The present study provides new important information that will aid decision making in LSS treatment.

Trial registration

This study was registered with the UMIN Clinical Trials Registry (UMIN000006957).

©  The Author(s). 2018

  • Hiroyuki Oka
  • Ko Matsudaira,
  • Yuichi Takano,
  • Daichi Kasuya,
  • Masaki Niiya,
  • Juichi Tonosu,
  • Masayoshi Fukushima,
  • Yasushi Oshima,
  • Tomoko Fujii,
  • Sakae Tanaka and
  • Hirohiko Inanami

BMC Complementary and Alternative MedicineBMC series – open, inclusive and trusted201818:19

https://doi.org/10.1186/s12906-018-2087-y

©  The Author(s). 2018

  • Received: 3 February 2017
  • Accepted: 14 January 2018
  • Published: 19 January 2018