title: Measurement of lower limb blood flow in patients with neurogenic claudication using positron emission tomography.
abstract: METHODS
  Ten subjects (seven with neurogenic claudication and three control subjects) underwent examination of lower limb muscle blood flow before and after exercise using positron emission tomography.
  
  
  OBJECTIVE
  To investigate the hypothesis that lower limb muscle ischemia was the origin of symptoms in neurogenic claudication.
  
  
  BACKGROUND
  Patients with neurogenic claudication secondary to spinal stenosis experience lower limb discomfort after exercise similar to that of ischemic claudication. However, they do not have clinical evidence of peripheral vascular disease. The authors postulated that the lower limb discomfort in patients with neurogenic claudication may arise from muscle ischemia due to inadequate dilatation of arterioles in response to exercise, this itself arising secondary to sympathetic dysfunction due to spinal stenosis.
  
  
  METHODS
  Using O15-labeled water and positron emission tomography measured thigh and leg muscle blood flow response to exercise bilaterally in seven patients with unilateral neurogenic claudication and three control subjects were measured.
  
  
  RESULTS
  The average values obtained for mid-thigh and mid-calf muscle perfusion at rest were 2.57 ml/min/100 g tissue (2.23-3.90) and 2.39 ml/min/100 g tissue (2.03-3.46), respectively. The average values obtained from mid-thigh and mid-calf perfusion after exercise were 4.41 ml/min/100 g tissue (2.8-6.0) and 4.87 ml/min/100 g (2.2-11.7). We found no difference in muscle perfusion between symptomatic and asymptomatic limbs in this group of patients.
  
  
  CONCLUSIONS
  These studies suggest that muscle ischemia is not the origin of symptoms in most patients with neurogenic claudication.
authors.affiliation: Department of Orthopaedics, Aberdeen University Medical School, Scotland.
authors.forename: G F
authors.initials: GF
authors.lastname: Keenan
authors.forename: G P
authors.initials: GP
authors.lastname: Ashcroft
authors.forename: G H
authors.initials: GH
authors.lastname: Roditi
authors.forename: J D
authors.initials: JD
authors.lastname: Hutchison
authors.forename: N T
authors.initials: NT
authors.lastname: Evans
authors.forename: P
authors.initials: P
authors.lastname: Mikecz
authors.forename: F
authors.initials: F
authors.lastname: Chaloner
authors.forename: M
authors.initials: M
authors.lastname: Dodd
authors.forename: C
authors.initials: C
authors.lastname: Leonard
authors.forename: R W
authors.initials: RW
authors.lastname: Porter
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000098:blood supply / Q000000981:diagnostic imaging; D009422:Nervous System Diseases / Q000150:complications*; D010146:Pain / Q000209:etiology*; D005082:Physical Exertion; D012039:Regional Blood Flow; D014055:Tomography, Emission-Computed