Spinal claudication versus arterial claudication.
Ninety-three consecutive treadmill exercise stress test were performed for the assessment of peripheral vascular function. Thirty-one were for atypical claudication-like symptoms including pain on standing, relief on sitting and back pain. Pedal pulses were palpable in 24 patients. Twenty-five patients (81%) had a negative stress test, suggesting a non-vascular aetiology and this finding was subsequently confirmed in 24 of the 25. The final diagnoses were spinal stenosis 13, [CT = 3, myelogram = 5, neurosurgeon opinion = 4, MRI = 1], myositis 2, restless leg syndrome 2 and osteoarthritis 7. Four patients had symptoms due to a combination of peripheral occlusive arterial disease and spinal stenosis; the latter was considered the predominant disorder in all four. Of the original 31 patients with atypical symptoms, spinal stenosis was present in 13 (42%). Atypia- in the common syndrome of intermittent claudication should alert the surgeon to the possibility of spinal canal disorders. Further investigation may identify significant pathology spinal stenosis in particular.
Maher
M
M
Department of Surgery, University College, Cork, Ireland.
Hehir
D J
DJ
Neary
P
P
Hinchion
J
J
O'Donnell
J A
JA
D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005080:Exercise Test; D005260:Female; D006801:Humans; D007383:Intermittent Claudication / Q000175:diagnosis* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000175:diagnosis*; D013130:Spinal Stenosis / Q000150:complications / Q000175:diagnosis*