Lumbar Spinal Stenosis and Intermittent Neurogenic Claudication

Abstract

Lumbar spinal stenosis and intermittent neurogenic claudication is a disease that occurs frequently after the age of 55 and becomes complicated after the age of 65 in clinical, radiological and therapeutic aspects. In this review, acquired spinal stenosis secondary to degenerative osteoarthritis is evaluated. In this disease, lumbar and extremity pain and paresthesia are frequent; however, the most characteristic feature of the disease is the occurrence and worsening of these findings with erect posture and walking (intermittent neurogenic claudication). Even though the radiological findings of spinal stenosis are apparent, 1/4-1/5 of the patients may be asymptomatic. In order to support the clinical findings, neurophysiological tests have been used at rest and motion. Certain electrophysiological signs have been found to change after motion. The most helpful signs are the denervation of paravertebral and leg muscles, H-reflex abnormalities, and the findings obtained with the recently used radicular excitation methods. Electrophysiological methods have been found to be more compatible with the clinical findings. Lumbar surgical approach is considered in patients with impaired life quality and in those unresponsive to conservative treatment.