Volume : 6, Issue : 12, December - 2017

CONSERVATIVE MANAGEMENT OF "LUMBAR CANAL STENOSIS" : A PROSPECTIVE COMPERATIVE TRIAL

Dr. Sanyal Kumar, Dr . V. P. Sharma, Dr. A. K. Gupta, Dr. Dileep Kumar, Dr. Sudhir Mishra, Dr. Ganesh Yadav

Abstract :

<p>&nbsp;<b style="text-align: justify;"><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&#10;&quot;Camia&quot;,&quot;serif&quot;;mso-ascii-theme-font:major-latin;mso-hansi-theme-font:major-latin;&#10;mso-bidi-font-family:&quot;Times New Roman&quot;">Introduction:&nbsp; </span></b><span lang="EN-IN" style="text-align: justify; font-size: 12pt; line-height: 200%; font-family: Camia, serif;">Lumbar canal stenosis has various primary or secondary causes but secondary degenerative changes affect the global burden in the disability.</span></p> <p class="MsoListParagraphCxSpLast" style="margin-bottom:0in;margin-bottom:.0001pt;&#10;mso-add-space:auto;text-align:justify;line-height:200%"><b><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&#10;&quot;Camia&quot;,&quot;serif&quot;;mso-ascii-theme-font:major-latin;mso-hansi-theme-font:major-latin;&#10;mso-bidi-font-family:&quot;Times New Roman&quot;">Objective &amp; Aim</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Camia&quot;,&quot;serif&quot;;&#10;mso-ascii-theme-font:major-latin;mso-hansi-theme-font:major-latin;mso-bidi-font-family:&#10;&quot;Times New Roman&quot;">: To compare outcome of physical therapy alone (PT) and physical therapy with Drug therapy (PT+DT) in nonsurgical management of subjects with lumber canal stenosis.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-left:.5in;text-align:justify;line-height:200%"><b><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Camia&quot;,&quot;serif&quot;;mso-ascii-theme-font:major-latin;&#10;mso-hansi-theme-font:major-latin;mso-bidi-font-family:&quot;Times New Roman&quot;">Methodology</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Camia&quot;,&quot;serif&quot;;&#10;mso-ascii-theme-font:major-latin;mso-hansi-theme-font:major-latin;mso-bidi-font-family:&#10;&quot;Times New Roman&quot;">: This prospective randomised comperative study was performed in a tertiary care teaching institution of North India. Age and sex matched, subjects with Lumbar canal stenosis with neurogenic claudication were enrolled in this study. Subjects were assessed for pain by Numerical pain rating scale (NPRS), severity of disease by Claudication Distance (by Treadmill walking), Oswestry Disability Index (ODI) and Roland Morris Diability Index (RMDI) at 3weeks, 6 weeks and 3 months interval.<o:p></o:p></span></p> <p class="MsoNormal" style="margin-left:.5in;text-align:justify;line-height:200%"><b><span lang="EN-IN" style="font-size:12.0pt;&#10;line-height:200%;font-family:&quot;Camia&quot;,&quot;serif&quot;;mso-ascii-theme-font:major-latin;&#10;mso-hansi-theme-font:major-latin;mso-bidi-font-family:&quot;Times New Roman&quot;">Results</span></b><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;font-family:&quot;Camia&quot;,&quot;serif&quot;;&#10;mso-ascii-theme-font:major-latin;mso-hansi-theme-font:major-latin;mso-bidi-font-family:&#10;&quot;Times New Roman&quot;">: A total of 68 subjects were enrolled. The age of PT(30 subjects) and PT+DT (38 subjects) groups ranged from 45-72 yrs and 48-70 yrs respectively with mean (&plusmn; SD) 54.00 &plusmn; 9.55 yrs and 58.21 &plusmn; 10.24 yrs respectively, and median 50 yrs and 52 yrs respectively. &nbsp;Mean Claudication Distance, NPRS, ODI and RMDI scores were 565.50 &plusmn; 322.387.29 &plusmn; 1.47, 47.76 &plusmn; 12.48 and 47.63 &plusmn; 12.21 respectively at initial evaluation which improved to 1340.79 &plusmn; 541.50, 1.63 &plusmn; 1.22, 15.39 &plusmn; 9.27and 18.37 &plusmn; 11.48 respectively at 12 weeks in PT+DT group which was significantly improved(p&lt;0.001) as compared to PT alone group. <o:p></o:p></span></p> <p class="MsoNormal" style="margin-left:35.45pt;text-align:justify;line-height:&#10;200%"><b><span lang="EN-IN" style="font-size: 12pt; line-height: 200%; font-family: Camia, serif;">Conclusion</span></b><span lang="EN-IN" style="font-size: 12pt; line-height: 200%; font-family: Camia, serif;">: This study demonstrates significant improvement in evaluated parameters</span><span lang="EN-IN" style="font-size:12.0pt;line-height:200%;&#10;font-family:&quot;Camia&quot;,&quot;serif&quot;;mso-ascii-theme-font:major-latin;mso-hansi-theme-font:&#10;major-latin;mso-bidi-font-family:&quot;Times New Roman&quot;"> in PT + DT group as compared to PT group. Physical therapy in combined with drug therapy has greater impact than physical therapy alone.<o:p></o:p></span></p>