title: Comparison of radicular symptoms caused by lumbar disc herniation and lumbar spinal stenosis in the elderly.
abstract: METHODS
  Comparative study using combined data from 2 prospective cohort studies.
  
  
  OBJECTIVE
  To expose the differences between the clinical characteristics of neurogenic claudication from magnetic resonance image-documented lumbar spinal stenosis (LSS) and lumbosacral radicular syndrome from acute, magnetic resonance image-documented, lumbar disc herniation (LDH).
  
  
  BACKGROUND
  LSS and LDH are the common lumbar disorders that produce lower extremity pain. Though known factors such as pain induced by walking for LSS and the rapid onset of symptoms for LDH are useful for differentiating these disorders, exploration of differences in other factors has received limited study.
  
  
  METHODS
  This study included participants aged 60 yr or older from 2 previous studies. One examined walking limitations caused by LSS and the second the natural history of LDH in elderly adults. The clinical features of both groups were compared by calculating means, medians, and standard deviations for continuous variables, and frequencies for categorical variables. χ test was used to explore differences between LSS and LDH for categorical variables, and Student t test or Mann-Whitney test for continuous variables.
  
  
  RESULTS
  Participants with LSS had more medical comorbidity, less intense leg pain, and less disability than those with LDH. Leg pain was more common in the anterior thigh, anterior knee and shin in LDH, and in the posterior knee in LSS. Trunk flexion was more impaired in LDH. Positive straight leg raising and femoral stretch signs were common in LDH, and rare in LSS. Abnormal Achilles reflexes were noted more frequently in LSS.
  
  
  CONCLUSIONS
  In addition to established factors, greater leg pain intensity, greater disability, and pain in the anterior leg are more common in the elderly with LDH than in the elderly with LSS. Normal trunk flexion, absence of nerve root tension signs and abnormal Achilles reflexes are more common in LSS.
  
  
  METHODS
  3.
authors: Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA 02120, USA. jrainvil@nebh.org
authors: James
authors: J
authors: Rainville
authors: Edrick
authors: E
authors: Lopez
mesh_terms: D000368:Aged; D001696:Biomechanical Phenomena; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000503:physiopathology*; D007866:Leg / Q000503:physiopathology; D008159:Lumbar Vertebrae / Q000473:pathology / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000503:physiopathology*; D011446:Prospective Studies; D011843:Radiculopathy / Q000209:etiology / Q000503:physiopathology*; D013130:Spinal Stenosis / Q000150:complications / Q000503:physiopathology*; D016138:Walking / Q000502:physiology