Inhibition of Neurogenic Inflammatory Pathways Associated with the Reduction in Discogenic Back Pain

Autor: Jose A. Canseco, Hannah A. Levy, Brian A. Karamian, Olivia Blaber, Michael Chang, Neil Patel, John Curran, Alan S. Hilibrand, Gregory D. Schroeder, Alexander R. Vaccaro, Dessislava Z. Markova, David E. Surrey, Christopher K. Kepler
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Asian Spine Journal, Vol 17, Iss 6, Pp 1043-1050 (2023)
Druh dokumentu: article
ISSN: 1976-1902
1976-7846
DOI: 10.31616/asj.2023.0121
Popis: Study Design Retrospective cohort study. Purpose This study aimed to determine whether the initiation of anti-calcitonin gene-related peptide (CGRP inhibitor) medication therapy for migraines was also associated with improvements in back/neck pain, mobility, and function in a patient population with comorbid degenerative spinal disease and migraine. Overview of Literature CGRP upregulates pro-inflammatory cytokines such as tumor necrosis factor-α, interleukin-6, brain-derived neurotrophic factor, and nerve growth factor in spinal spondylotic disease, which results in disc degeneration and sensitization of nociceptive neurons. Although CGRP inhibitors can quell neurogenic inflammation in migraines, their off-site efficacy as a therapeutic target for discogenic back/neck pain conditions remains unknown. Methods All adult patients diagnosed with spinal spondylosis and migraine treated with CGRP inhibitors at a single academic institution between 2017 and 2020 were retrospectively identified. Patient demographic and medical data, follow-up duration, migraine severity and frequency, spinal pain, functional status, and mobility before and after the administration of CGRP inhibitors were collected. Paired univariate analysis was conducted to determine significant changes in spinal pain, headache severity, and headache frequency before and after the administration of CGRP inhibitors. The correlation between changes in the spinal pain score and functional or mobility improvement was assessed with Spearman’s rho. Results In total, 56 patients were included. The mean follow-up time after the administration of CGRP inhibitors was 123 days for spinal pain visits and 129 days for migraine visits. Back/neck pain decreased significantly (p
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