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Efficacy of epidural administration of anti-interleukin-6 receptor antibody onto spinal nerve for treatment of sciatica

European Spine Journal volume 21, pages 2079–2084 (2012)Cite this article

Abstract

Introduction

Interleukin-6 (IL-6) is thought to play a crucial role in the radicular pain caused by lumbar spinal stenosis. However, efficacy of inhibition of IL-6 for sciatica in patients with lumbar spinal stenosis has not been clarified. The purpose of the current study was to examine the effect of the anti-IL-6 receptor monoclonal antibody, tocilizumab, on radicular pain by its epidural administration onto spinal nerves in patients with lumbar spinal stenosis.

Methods

Sixty patients with low back and radicular leg pain caused by spinal stenosis were investigated. In 30 patients, we infiltrated 2.0 mL of lidocaine and 80 mg of tocilizumab onto the affected spinal nerve, and 2.0 mL of lidocaine and 3.3 mg of dexamethasone were used in 30 patients. Low back pain, leg pain, and leg numbness were evaluated during 1 month after spinal nerve infiltration.

Results

Infiltration of tocilizumab was more effective than dexamethasone for leg pain (3 days, 1, 2, and 4 weeks), low back pain (3 days, 1, 2 and 4 weeks), and leg numbness (3 days, 1 and 2 weeks). No adverse event was observed in either group.

Conclusion

Our results indicate that the epidural administration of an anti-IL-6 receptor monoclonal antibody, tocilizumab, onto the spinal nerve produced reduction of radicular leg pain, numbness, and low back pain without adverse event. IL-6 may be one of the inducers of pain caused by spinal stenosis in humans.

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Conflict of interest

The authors did not receive and will not receive any benefits or funding from any commercial party related directly or indirectly to the subject of this article.

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Affiliations

  1. Department of Orthopaedic Surgery, Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba, 260-8670, Japan

    Seiji Ohtori, Masayuki Miyagi, Yawara Eguchi, Gen Inoue, Sumihisa Orita, Nobuyasu Ochiai, Shunji Kishida, Kazuki Kuniyoshi, Junichi Nakamura, Yasuchika Aoki, Tetsuhiro Ishikawa, Gen Arai, Hiroto Kamoda, Miyako Suzuki, Masashi Takaso, Takeo Furuya, Gou Kubota, Yoshihiro Sakuma, Yasuhiro Oikawa, Tomoaki Toyone & Kazuhisa Takahashi

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  1. Seiji Ohtori
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  2. Masayuki Miyagi
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  3. Yawara Eguchi
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  4. Gen Inoue
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  5. Sumihisa Orita
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  6. Nobuyasu Ochiai
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  8. Kazuki Kuniyoshi
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  9. Junichi Nakamura
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  11. Tetsuhiro Ishikawa
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  12. Gen Arai
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  13. Hiroto Kamoda
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  14. Miyako Suzuki
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  15. Masashi Takaso
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  16. Takeo Furuya
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  17. Gou Kubota
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  18. Yoshihiro Sakuma
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  19. Yasuhiro Oikawa
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  20. Tomoaki Toyone
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  21. Kazuhisa Takahashi
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Correspondence to Seiji Ohtori.

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Ohtori, S., Miyagi, M., Eguchi, Y. et al. Efficacy of epidural administration of anti-interleukin-6 receptor antibody onto spinal nerve for treatment of sciatica. Eur Spine J 21, 2079–2084 (2012). https://doi.org/10.1007/s00586-012-2183-5

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  • DOI: https://doi.org/10.1007/s00586-012-2183-5

Keywords

  • Anti-interleukin-6 receptor monoclonal antibody
  • Sciatica
  • Lumbar spinal stenosis
  • Pain
  • Tocilizumab