S Kikuchi1, E Watanabe, M Hasue. 1. Department of Orthopaedic Surgery, Fukushima Medical College, Japan.
Abstract
STUDY DESIGN: Neurogenic intermittent claudication can be caused by spinal cord compression. In this study, 20 patients with spinal intermittent claudication due to degenerative spine diseases were evaluated. OBJECTIVES: This study clarified the clinical features and pathomechanism of spinal intermittent claudication due to degenerative spine diseases. SUMMARY OF BACKGROUND DATA: Spinal intermittent claudication may either be produced by intrinsic or extrinsic lesions. Little is known about spinal intermittent claudication due to extrinsic lesions such as spinal cord compression. Twenty patients with spinal intermittent claudication, caused by cervical or thoracic lesions, who were given surgical treatment except for one, were studied. Their main subjective symptoms were tightness, weakness, and numbness in the lower limbs and a strangulated sensation in the trunk to lower limbs. The objective findings were occurrence and/or aggravation of spinothalamic signs. METHODS: The gait loading test was performed on these 20 patients. Selective spinal angiography was performed on the patients with thoracic myelopathy and its therapeutic effects were evaluated. A radiographic assessment was made in all patients. RESULTS: The subjective symptoms and objective findings were reproduced by the gait loading test. Selective spinal angiography temporarily relieved or improved the spinal intermittent claudication due to the thoracic myelopathy. Spinal intermittent claudication disappeared immediately after surgical treatment. CONCLUSIONS: Circulatory impairment of the spinal cord seems to be closely related to the etiology of spinal intermittent claudication. Besides providing diagnostic information, selective spinal angiography may also have a temporary therapeutic effect.
STUDY DESIGN: Neurogenic intermittent claudication can be caused by spinal cord compression. In this study, 20 patients with spinal intermittent claudication due to degenerative spine diseases were evaluated. OBJECTIVES: This study clarified the clinical features and pathomechanism of spinal intermittent claudication due to degenerative spine diseases. SUMMARY OF BACKGROUND DATA: Spinal intermittent claudication may either be produced by intrinsic or extrinsic lesions. Little is known about spinal intermittent claudication due to extrinsic lesions such as spinal cord compression. Twenty patients with spinal intermittent claudication, caused by cervical or thoracic lesions, who were given surgical treatment except for one, were studied. Their main subjective symptoms were tightness, weakness, and numbness in the lower limbs and a strangulated sensation in the trunk to lower limbs. The objective findings were occurrence and/or aggravation of spinothalamic signs. METHODS: The gait loading test was performed on these 20 patients. Selective spinal angiography was performed on the patients with thoracic myelopathy and its therapeutic effects were evaluated. A radiographic assessment was made in all patients. RESULTS: The subjective symptoms and objective findings were reproduced by the gait loading test. Selective spinal angiography temporarily relieved or improved the spinal intermittent claudication due to the thoracic myelopathy. Spinal intermittent claudication disappeared immediately after surgical treatment. CONCLUSIONS: Circulatory impairment of the spinal cord seems to be closely related to the etiology of spinal intermittent claudication. Besides providing diagnostic information, selective spinal angiography may also have a temporary therapeutic effect.