Abstract
Lipo-prostaglandin E1 (lipo-PGE1) is reported to be effective in the treatment of intermittent neurogenic claudication associated with lumbar spinal stenosis. However, the underlying mechanisms by which lipo-PGE1 improves the neurological symptoms have not been fully clarified. We examined the effects of lipo-PGE1, on blood flow and oxygen pressure in the lumbar nerve roots in cats and in patients with lumbar spinal stenosis. In anesthetized cats, blood flow and oxygen pressure in the L7 nerve root were measured with a laser-Doppler flowmeter and a Polarographie oxygen monitor, respectively. Lipo-PGE1, (0.075 and 0.15 μg/kg, i.v.) significantly increased blood flow and oxygen pressure in the nerve roots, following transient decreases. When the dural tube was compressed by a balloon at the L6 level, lipo-PGE1 (0.15μg/kg) significantly increased blood flow and oxygen pressure in the nerve roots. Lipo-PGE1, also increased the intraoperative nerve-root blood flow in seven of ten patients with lumbar spinal stenosis. The results suggest that one of the favorable effects of lipo-PGE1, on neurogenic claudication is to increase nerve-root blood flow and oxygen pressure.
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