Article

OBJECTIVES: To evaluate the clinical effectiveness of botulinum toxin (BTX)
injection into the gastrocnemius muscles in patients with lumbar spinal stenosis
(LSS) who have frequent nocturnal calf cramps (NCCs). DESIGN: Prospective,
randomized clinical trial. SETTING: Outpatient department for interventional pain
management. PARTICIPANTS: Patients (N=50) with LSS who have NCCs at least once
per week were enrolled. INTERVENTION: Patients were randomly allocated to receive
either conservative treatments plus gabapentin (group GPN) or BTX injection
(group BTX). MAIN OUTCOME MEASURES: We assessed back/leg pain intensity, the
frequency and severity of NCCs, insomnia severity, and functional disability at
baseline and after 2 weeks, 1 month, and 3 months. Additionally, Patient Global
Impression of Change was assessed. RESULTS: Forty-five patients completed all
assessments (group GPN, n=21; group BTX, n=24). Compared with group GPN, leg pain
intensity, cramp frequency, and cramp severity were significantly decreased in
group BTX at all follow-up visits (all, P<.01). Also, insomnia significantly
improved in group BTX at the 2-week (P=.018) and 1-month follow-up (P=.037).
Functional disability significantly improved in group BTX at 2 weeks' follow-up
(P=.041). At the 3-month follow-up, patients in group BTX reported a higher
impression of improvement for NCC symptoms than did those in group GPN (P<.001).
A mean dose of 642.8mg of gabapentin was given daily in group GPN, but 7 patients
(33.3%) reported systemic side effects. There were no serious complications
related to BTX use. CONCLUSIONS: BTX treatment appears to be effective and safe
for NCCs in symptomatic LSS patients receiving conservative care.
CI - Copyright (c) 2017 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS