1. Phosphodiesterase 5 Inhibitor Use in Patients Undergoing Decompression Surgery for Lumbar Spinal Stenosis
- Author
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Thiru M. Annaswamy, Tri Pham, Adam Butler, and Rick A Weideman
- Subjects
medicine.medical_specialty ,Lumbar Vertebrae ,medicine.drug_mechanism_of_action ,Decompression ,business.industry ,Rehabilitation ,Prevalence ,Lumbar spinal stenosis ,Physical Therapy, Sports Therapy and Rehabilitation ,Phosphodiesterase 5 Inhibitors ,Decompression, Surgical ,medicine.disease ,Surgery ,Spinal Stenosis ,Treatment Outcome ,Lumbar ,medicine ,Humans ,In patient ,Prospective Studies ,Medical prescription ,Prospective cohort study ,business ,Phosphodiesterase 5 inhibitor - Abstract
Our objectives were to explore the association between phosphodiesterase 5 inhibitor use and lumbar decompression surgery by evaluating the prevalence of lumbar decompression surgery in a treatment group of patients with lumbar spinal stenosis compared with a control group.We performed database review and extracted data including lumbar decompression surgery prevalence, phosphodiesterase 5 inhibitor dosage, and fill dates. Treatment group was defined as those with phosphodiesterase 5 inhibitor fill dates of less than 30 days before surgery, and control group was defined as those with phosphodiesterase 5 inhibitor fill dates at any other time. Lumbar decompression surgery prevalence rates for both groups were calculated.Our study found 599 lumbar spinal stenosis patients who were prescribed phosphodiesterase 5 inhibitor. Three hundred thirty-eight underwent lumbar decompression surgery. Of these, 71 (21%) filled their prescription of less than 30 days before surgery, whereas 267 (79%) filled their prescription during a different period. The majority (94.6%) of surgical patients received decompression at two or more spinal levels.Prevalence of lumbar decompression surgery for lumbar spinal stenosis was significantly lower in patients in the treatment group on phosphodiesterase 5 inhibitor therapy compared with the control group. Among many potential explanations, the vasodilatory effect of phosphodiesterase 5 inhibitor may have contributed to a lower surgical rate. This is the first study to explore this novel association. Future prospective studies are necessary to better define the utility of phosphodiesterase 5 inhibitor in lumbar spinal stenosis.
- Published
- 2021