Neurogenic claudication

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Neurogenic claudication (NC) is a common "presentation", or one symptom of, spinal stenosis,^[1][2] or inflammation of the nerves emanating from the spinal cord. Neurogenic means that the problem originates with a problem at a nerve, and claudication, from the Latin for limp, means that the patients feels a painful cramping and/or weakness. NC should therefore be distinguished from vascular claudication, which is when the claudication stems from a circulatory problem, not a neural problem. NC can be bilateral or unilateral lateral calf, buttock, or thigh discomfort or pain and/or weakness. In some patients, it is precipitated by walking and prolonged standing. The pain is classically relieved by a change in position or flexion of the waist (anthropoid position) and not simply relieved by rest, as in vascular claudication. Therefore, patients with neurogenic intermittent claudication have less disability in climbing steps, pushing carts and cycling. In some patients with severe compression of the nerve roots, the NC is not intermittent but painfully persistent. The pathophysiology is thought to be ischemia of the lumbosacral nerve roots secondary to compression from surrounding structures, hypertrophied facets, ligamentum flavum, bone spurs, scar tissue, and bulging or herniated discs. In addition to vascular claudication, trochanteric bursitis should be considered in the differential.

See also

• Intermittent claudication
• Spinal stenosis

References

1. ^ Comer CM, Redmond AC, Bird HA, Conaghan PG (2009). "Assessment and management of neurogenic claudication associated with lumbar spinal stenosis in a UK primary care musculoskeletal service: a survey of current practice among physiotherapists". BMC Musculoskelet Disord 10: 121. doi:10.1186/1471-2474-10-121. PMID 19796387. PMC 2762954. http://www.biomedcentral.com/1471-2474/10/121. 
2. ^ Harrast MA (March 2008). "Epidural steroid injections for lumbar spinal stenosis". Curr Rev Musculoskelet Med 1 (1): 32–8. doi:10.1007/s12178-007-9003-2. PMID 19468896. PMC 2684150. http://dx.doi.org/10.1007/s12178-007-9003-2. 

• Greenberg MS, ed. Handbook of neurosurgery. 6th ed. Lakeland, FL: Greenberg Graphics, 2006:326.

External links

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