1.Inhibition of Neurogenic Inflammatory Pathways Associated with the Reduction in Discogenic Back Pain
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
Asian Spine Journal 2023;17(6):1043-1050
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. Backeck pain decreased significantly (p <0.001) from 6.30 to 4.36 after starting CGRP inhibitor therapy for migraine control. As recorded in the spine follow-up notes, 25% of patients experienced a functional improvement in the activities of daily living, and 17.5% experienced mobility improvement while taking CGRP inhibitors. Change in back/ neck pain moderately correlated (ρ=−0.430) with functional improvement but was not correlated with mobility improvement (ρ=−0.052).
Conclusions
Patients taking CGRP inhibitors for chronic migraines with comorbid degenerative spinal conditions experienced significant off-target reduction of backeck pain.
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