calcitonin and Intervertebral-Disc-Displacement

Immobilization is associated with increased bone resorption and decreased bone formation. We evaluated in a double-blind trial the effect of intranasal administration of salmon calcitonin on biochemical parameters of bone turnover in 32 patients immobilized for a prolapsed intervertebral disk. Calcitonin in a dose of two times 200 IU/day partially inhibited the increase in the fasting 2 h urinary hydroxyproline/creatinine ratio (OHPr/Cr) and calcium/creatinine ratio (Ca/Cr). The increase in OHPr/Cr was 40% less in the calcitonin group compared to the placebo group (P = 0.01), and the increase in Ca/Cr was 80% less in the calcitonin group (P = 0.04). Calcitonin also partially inhibited the increase in serum cross-linked carboxyl-terminal telopeptide of collagen type I (P < 0.05). The decrease in serum 1,25-dihydroxyvitamin D after 10 days of immobilization was significantly less in the calcitonin-treated group than in the placebo group (14 versus 29%, respectively; P < 0.05). Intranasal calcitonin did not influence the pain scores as measured with a visual analog scale (VAS). The tolerability of the nasal calcitonin preparation was excellent. We conclude that nasal salmon calcitonin counteracts the early increase in bone resorption induced by immobilization.

Topics: Administration, Intranasal; Adult; Bed Rest; Bone and Bones; Bone Resorption; Calcitonin; Calcium; Collagen; Collagen Type I; Creatinine; Double-Blind Method; Female; Humans; Hydroxyproline; Immobilization; Intervertebral Disc Displacement; Male; Middle Aged; Pain Measurement; Peptides

The hormone calcitonin has proved itself for some years in the treatment of chronic pain syndromes. In addition to its known influence on calcium exchange it gives vise to an analgesic effect within the central nervous system and this follows systemic administration or after bolus intrathecal injection. Two patients with chronic non malignant pain are presented in whom continuous delivery pumps have been used for intrathecal Lachs-Calcitonin (Karil, Fa. Sandoz).

Topics: Brachial Plexus Neuritis; Calcitonin; Female; Humans; Infusion Pumps; Injections, Spinal; Intervertebral Disc Displacement; Lumbar Vertebrae; Male; Middle Aged; Pain, Postoperative; Sciatica; Spinal Nerve Roots