Intermittent claudication due to spinal stenosis in a vascular surgical practice

Intermittent claudication can be due to spinal canal stenosis. In order to define the frequency with which this condition presents to a vascular surgeon a review of 271 patients referred with claudication was carried out. Twenty-one (8%) were ultimately diagnosed as having spinal stenosis. There were no significant differences with regard to age or sex between these patients and those with true vascular claudication. There was, however, a significantly lower number of smokers in the spinal stenosis group. When the presenting features of the spinal stenosis group were analysed 62% (13/21) reported sensory symptoms such as numbness or parasthesiae, 38% (8/21) back pain and 67% (14/21) true pain in the legs on walking. In 71% (15/21), symptoms were reported as being bilateral and 29% (6/21) had reduced Doppler pressures. It is stressed that vascular surgeons need to maintain a high index of suspicion for spinal stenosis especially as the condition may coexist with vascular disease, making diagnosis difficult.