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MINERVA ORTOPEDICA E TRAUMATOLOGICA
A Journal on Orthopedics and Traumatology
Minerva Ortopedica e Traumatologica 2004 February;55(1):15-22
Gabapentin in the conservative treatment of radiculopathy
Blonna D. 1, Calvi V. 2, Collo G. 1, Marmotti A. 1, Castoldi F. 1
1 Divisione Universitaria di Ortopedia e Traumatologia Ospedale Mauriziano Umberto I, Torino
2 Servizio di Anestesia e Rianimazione Ospedale Mauriziano Umberto I, Torino
Aim. Radiculopathy is a medical disorder that is difficult to manage and slow to resolve. To improve conservative treatment of the disorder, we tested the efficacy of Gabapentin associated with the epidural administration of steroids.
Materials and methods. In this prospective, randomized study, patients received 3 epidural injections of steroids according to the regimen: 4 mg of b-methasone in 3 ml of 0.2% ropivacaine on days 1, 7, and 14. As an adjuvant, oral Gabapentin was given during the 2 months of the study according to the regimen: 100 mg of Gabapentin tid for 2 days, 200 mg tid for 2 days, and 300 mg tid for 56 days. Follow-up visits were conducted at days 7, 14 and 60.
Results. On days 7 and 14, all patients showed improvement in pain symptoms and paresthesia, without a significant difference between subjects and controls. The degree of hypoesthesia on day 7 was significantly less in the subjects. On examination at 60 days, the subjects with vertebral stenosis showed a greater reduction in pain symptoms than the controls. Comparison between base-line values and those measured after 60 days of treatment showed a significant reduction in the percentage of the degree of paresthesia.
Conclusion. The association of Gabapentin and epidural steroid injection should be recommended in the treatment of radiculopathy resistant to standard conservative treatment in patients with vertebral canal stenosis and in all other forms of radiculopathy when paresthetic and hypesthetic symptoms predominate.