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A new functional test in the diagnostic evaluation of neurogenic intermittent claudication

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Summary

A new functional test using downhill walking is described and evaluated in relation to the myelographical examination in 23 consecutive patients with neurogenic intermittent claudication. Discomfort and changes of the neurological status, emerging during the walk, were accepted as test results. They were noted in a decision matrix and the positive and the negative predictive values (PPV and NPV, respectively) calculated. The PPV of any symptom or any deterioration of the neurological status, resulting from this test as signs of a myelographical abnormality, was calculated to be 86 and 89 per cent, respectively, the corresponding NPV's being 50 and 40 per cent, respectively. The NPV of these parameters as signs of a myelographically verified lumbar spinal stenosis was calculated to be 100 per cent, the corresponding PPV's being 38 and 44 per cent, respectively. The development of “symptommarch” or of bilateral neurological signs during the walk was found to be of approximately the same diagnostical value. We conclude, that this function test may serve as a screening procedure in patients complaining of neurogenic intermittent claudication.

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References

  1. Van Gelderen, C. Ein orthotisches (lordotisches) kaudasyndrom. Acta Psyciatr Scand 1948, 23, 57–63 (In German).

    Google Scholar 

  2. Dyck, P., Doyle, J.B. “Bicycle test” of van Gelderen in diagnosis of intermittent cauda equina compression syndrome. J Neurosurg 1977, 46, 667–70.

    PubMed  Google Scholar 

  3. Lossius, A-M., Weber, H. Hvilken diagnostisk betydning har van Gelderens sykkeltest ved vertebrogen claudicatio ? Fysiotherapeuten 1983, 50, 335–6 (In Norwegian).

    Google Scholar 

  4. Surin, V. Syndrom av trång lumbal spinalkanal. Läkartidningen 1979, 76, 4802–6 (In Swedish).

    Google Scholar 

  5. Dahllöf, A-G., Irstam, L., Nachemson, A., Nordwall, A., Suurküla, M. Lumbal spinal stenos: Försummad differentialdiagnos vid claudicatio. Läkartidningen 1979, 76, 4807–10 (In Swedish).

    Google Scholar 

  6. Lie, H., Helgerud, E. Lumbai spinal stenose: Bruk av tredemølle i det diagnostiske arbeid. Tidsskr Nor Laegefor 1984, 104, 1729–32 (in Norwegian).

    Google Scholar 

  7. Johnson, K-E., Willner, S., Petterson, H. Analysis of operated cases with lumbar spinal stenosis. Acta Orthop Scand 1981, 52, 427–33.

    PubMed  Google Scholar 

  8. Johansson, J.E., Barrington, T.W., Ameli, M. Combined vascular and neurogenic claudication. Spine 1982, 7, 150–8.

    PubMed  Google Scholar 

  9. Jellinger, K., Neumayer, E. Claudication of the spinal cord and cauda equina. In: Handbook of Clinical Neurology, Eds: P.J. Vinken, G.W. Bruyen, North Holland, Amsterdam 1972, 507–47.

    Google Scholar 

  10. Verbiest, H. Pathomorphologic aspects of developmental lumbar stenosis. Orthop Clin N Am 1975, 6, 177–96.

    Google Scholar 

  11. Sortland, O., Magnaes, B., Hauge, T. Functional myelography with metrizamide in the diagnosis of lumbar spinal stenosis. Acta Radiol 1977, suppl 355, 43–54.

    Google Scholar 

  12. Medical Research Council. Aids to the investigation of peripheral nerve injuries. War Memorandum No. 7. Revised second edition. London, Her Majesty's Stationary Office, 1943.

    Google Scholar 

  13. Jensen, O.H. The medial hamstring reflex in the level-diagnosis of a lumbar disc herniation. Clin Rheumatol 1987, 6, 570–4.

    PubMed  Google Scholar 

  14. Hansen, E.B., Praestholm, J., Fahrenkrug, A., Bjerrum, J. A clinical trial of Amipaque in lumbar myelography. Br J Radiol 1976, 49, 34–8.

    PubMed  Google Scholar 

  15. Ciric, I., Mikhael, M.A., Tarkington, J.A., Vick, N.A. The lateral recess syndrome. J Neurosurg 1980, 53, 433–43.

    PubMed  Google Scholar 

  16. Dyck, P., Pheasant, H.C., Doyle, J.B., Rieder, J.J. Intermittent cauda equina compression syndrome: Its recognition and treatment. Spine 1977, 2, 75–81.

    Google Scholar 

  17. Kirkaldy-Willis, W.H., Paine, K.W.E., Cauchoix, J., MvIvor, G. Lumbar spinal stenosis. Clin Orthop 1974, 99, 30–50.

    PubMed  Google Scholar 

  18. Søgaard, I., Madsen, F.F. Neurogenic intermittent claudication. Acta Neurochirurgica 1983, 69, 195–203.

    PubMed  Google Scholar 

  19. Wilson, C.B., Ehni, G., Grollmus, J. Neurogenic intermittent claudication. Clin Neurosurg 1971, 18, 62–85.

    PubMed  Google Scholar 

  20. Ullrich, C.G., Binet, E.F., Sanecki, M.G., Kieffer, S.A. Quantitative assessment of the lumbar spinal canal by computed tomography. Radiology 1980, 134, 137–143.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Rheumatology, Hjørring Sygehus, DK-9800, Hjørring, Denmark

    O. H. Jensen & S. Schmidt-Olsen

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  1. O. H. Jensen
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  2. S. Schmidt-Olsen
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Jensen, O.H., Schmidt-Olsen, S. A new functional test in the diagnostic evaluation of neurogenic intermittent claudication. Clin Rheumatol 8, 363–367 (1989). https://doi.org/10.1007/BF02030349

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  • DOI: https://doi.org/10.1007/BF02030349

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