The Added Value of Postoperative Neurotrophins/Peptide Mixture in Treating L5 Motor Weakness in Lumbar Disc Prolapse: A Preliminary Report of Multicenter Randomized Controlled 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 with placebo. Study design: A prospective randomized controlled study (preliminary report) was conducted. Patients and methods: In total, 15 patients (group I) with L5 weakness who received a postdiscectomy adjuvant neurotrophins/peptide mixture were compared with group II (15 postdiscectomy patients with L5 weakness) treated with a placebo. The whole patient population was followed up at 2 weeks, 1 month, 3 months, 6 months, and 1 year for assessment of motor recovery. Results: The mean postoperative Medical Research Council score was signi fi cantly improved in both groups; however, the improvement was faster in group I than in group II. The mean Medical Research Council score improvement was signi fi cantly higher in group I than that in group II at 2 weeks, 1 month, 3 months, and 6 months; however, it was statistically insigni fi cant at 1 year. At 1-year follow-up, 80% of cases in group I had improved motor power up to grade 5 compared with 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 ef fi cient 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).