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Corresponding Author

Ahmad FA Allam

Subject Area

Degenerative, Lumbosacral spine

Article Type

Original Study

Abstract

Background Data: Neurotrophins/peptide mixture is a porcine brain-derived peptide preparation with pharmacodynamic properties similar to those of endogenous neurotrophic factors. No study has evaluated the postoperative role of neurotrophins/peptide mixture in the recovery of postdiscectomy motor weakness. Purpose: This study aims to evaluate the effect of postoperative neurotrophins/peptide mixture treatment on the recovery of L5 motor weakness after lumbar discectomy compared to placebo. Study Design: Prospective randomized controlled study (preliminary report). Patients and Methods: In total, 15 patients (group I) with L5 weakness who received a postdiscectomy adjuvant neurotrophins/peptide mixture were compared to group II (15 postdiscectomy patients with L5 weakness) treated with a placebo. The whole patient population was followed up at 2 weeks, 1, 3, and 6 months, and 1 year for assessment of motor recovery. Results: The mean postoperative MRC score was significantly improved in both groups; however, the improvement was faster in group I than in group II. The mean MRC score improvement was significantly higher in group I than that in group II at 2 weeks and 1, 3, and 6 months; however, it was statistically insignificant at 1 year. At 1-year follow-up, 80 % of cases in group I had improved motor power up to grade 5 compared to 40 % of cases in group II. The rest of the patients reached grade 4 in both groups. There was no motor deterioration after improvement in either group. There were no reported drug-related adverse effects in group I. Conclusion: Neurotrophins/peptide mixture may be an efficient and safe adjunctive postoperative treatment for discogenic L5 motor weakness. It may accelerate recovery of nerve injury in an acute setting, which may be a result of accelerating nerve regeneration; however, the overall improvement was comparable to placebo. (2022ESJ2601)

Keywords

Cerebrolysin, lumbar disc, motor weakness, neurotrophins, peptide mixture.

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