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[Neurogenic intermittent claudication in patients with degenerative lumbar stenosis]
1Evdokimov Moscow State University of Medicine and Dentistry, Moscow, Russia.
Objective:
To study the clinical manifestations of neurogenic intermittent claudication (NIC) in patients with degenerative lumbar stenosis (DLS).
Material And Methods:
The neurological status, intensity and nature of pain syndrome, and pain-free walking distance were evaluated in 83 NIC patients with DPS, who underwent surgical treatment.
Results:
The predominance of the clinical picture of sensorimotor pain (n=30; 36.1%) and isolated pain (n=31; 37.3%) forms of NIC was established. Isolated sensory (n=1; 1.2%), sensorimotor (n=3; 3.6%), and motor-pain (n=4; 4.8%) forms were significantly less common. In 6 (7.2%) patients, there was a pain-free form of NIC. In most patients, surgical treatment led to regression of neurological symptoms and an increase in the distance of pain-free walking. No relationship was found between the demographic and clinical characteristics of patients (gender, age, pain severity, pain-free walking distance), MRI results and the features of NIC clinical picture. In 4 patients, the phenomenon of pacing was revealed in the form of an increase in pain at the beginning of walking and a significant decrease or complete regression as walking continues.
Conclusion:
The clinical picture of NIC is polymorphic, its pain-free course is possible. The decision on the feasibility of surgical treatment of patients with PLS is possible taking into account the clinical picture of NIC and MRI results.
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