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Neurogenic claudication

MedGen UID:
663142
Concept ID:
C0580173
Finding
Synonyms: Intermittent spinal claudication; Pseudoclaudication; Spinal claudication
SNOMED CT: Spinal claudication (303081002); Intermittent spinal claudication (303081002); Pseudoclaudication (303081002); Neurogenic claudication (303081002)
 
HPO: HP:0031952

Definition

Lumbar spinal stenoses may induce symptoms following an individually typical latency on standing or when walking due to swelling of the cauda equina, which leads to compression. This is referred to as neurogenic claudication. The symptoms of lumbar spinal stenosis can be explained by an increase in lumbar lordosis and spinal canal stenosis in an upright position compared to the sitting position or if spondylolisthesis is present by a shift of the vertebrae while standing and walking. Following an individually characteristic distance, walking becomes associated with deep muscular pain and with neurological deficits, such as sensory deficits and paresis in the lower limbs, which resolve within minutes when the affected person sits or lies down. Activities performed in a flexed posture, such as cycling often cause less problems than walking. For the same reason, walking uphill may be tolerated better than walking downhill. Clinical neurological examination at rest may be entirely normal but there is usually pain on hyperextension of the lumbar spine. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVNeurogenic claudication

Professional guidelines

PubMed

Ammendolia C, Hofkirchner C, Plener J, Bussières A, Schneider MJ, Young JJ, Furlan AD, Stuber K, Ahmed A, Cancelliere C, Adeboyejo A, Ornelas J
BMJ Open 2022 Jan 19;12(1):e057724. doi: 10.1136/bmjopen-2021-057724. PMID: 35046008Free PMC Article
Bussières A, Cancelliere C, Ammendolia C, Comer CM, Zoubi FA, Châtillon CE, Chernish G, Cox JM, Gliedt JA, Haskett D, Jensen RK, Marchand AA, Tomkins-Lane C, O'Shaughnessy J, Passmore S, Schneider MJ, Shipka P, Stewart G, Stuber K, Yee A, Ornelas J
J Pain 2021 Sep;22(9):1015-1039. Epub 2021 Apr 12 doi: 10.1016/j.jpain.2021.03.147. PMID: 33857615
Boody BS, Savage JW
J Am Acad Orthop Surg 2016 Dec;24(12):829-842. doi: 10.5435/JAAOS-D-14-00461. PMID: 27792054

Recent clinical studies

Etiology

Akkawi I, Zmerly H
Acta Biomed 2022 Jan 19;92(6):e2021313. doi: 10.23750/abm.v92i6.10526. PMID: 35075090Free PMC Article
Ammendolia C, Hofkirchner C, Plener J, Bussières A, Schneider MJ, Young JJ, Furlan AD, Stuber K, Ahmed A, Cancelliere C, Adeboyejo A, Ornelas J
BMJ Open 2022 Jan 19;12(1):e057724. doi: 10.1136/bmjopen-2021-057724. PMID: 35046008Free PMC Article
Borenstein DG, Balagué F
Rheum Dis Clin North Am 2021 May;47(2):149-163. Epub 2021 Mar 12 doi: 10.1016/j.rdc.2020.12.001. PMID: 33781487
Schneider MJ, Ammendolia C, Murphy DR, Glick RM, Hile E, Tudorascu DL, Morton SC, Smith C, Patterson CG, Piva SR
JAMA Netw Open 2019 Jan 4;2(1):e186828. doi: 10.1001/jamanetworkopen.2018.6828. PMID: 30646197Free PMC Article
Melancia JL, Francisco AF, Antunes JL
Handb Clin Neurol 2014;119:541-9. doi: 10.1016/B978-0-7020-4086-3.00035-7. PMID: 24365318

Diagnosis

Akkawi I, Zmerly H
Acta Biomed 2022 Jan 19;92(6):e2021313. doi: 10.23750/abm.v92i6.10526. PMID: 35075090Free PMC Article
Borenstein DG, Balagué F
Rheum Dis Clin North Am 2021 May;47(2):149-163. Epub 2021 Mar 12 doi: 10.1016/j.rdc.2020.12.001. PMID: 33781487
García-Ramos CL, Valenzuela-González J, Baeza-Álvarez VB, Rosales-Olivarez LM, Alpizar-Aguirre A, Reyes-Sánchez A
Acta Ortop Mex 2020 Sep-Oct;34(5):324-328. PMID: 33634638
Deer T, Sayed D, Michels J, Josephson Y, Li S, Calodney AK
Pain Med 2019 Dec 1;20(Suppl 2):S32-S44. doi: 10.1093/pm/pnz161. PMID: 31808530Free PMC Article
Melancia JL, Francisco AF, Antunes JL
Handb Clin Neurol 2014;119:541-9. doi: 10.1016/B978-0-7020-4086-3.00035-7. PMID: 24365318

Therapy

Resnick DK, Schmidt BT
Neurol Clin 2022 May;40(2):261-268. Epub 2022 Mar 31 doi: 10.1016/j.ncl.2021.11.005. PMID: 35465873
Ammendolia C, Hofkirchner C, Plener J, Bussières A, Schneider MJ, Young JJ, Furlan AD, Stuber K, Ahmed A, Cancelliere C, Adeboyejo A, Ornelas J
BMJ Open 2022 Jan 19;12(1):e057724. doi: 10.1136/bmjopen-2021-057724. PMID: 35046008Free PMC Article
Bussières A, Cancelliere C, Ammendolia C, Comer CM, Zoubi FA, Châtillon CE, Chernish G, Cox JM, Gliedt JA, Haskett D, Jensen RK, Marchand AA, Tomkins-Lane C, O'Shaughnessy J, Passmore S, Schneider MJ, Shipka P, Stewart G, Stuber K, Yee A, Ornelas J
J Pain 2021 Sep;22(9):1015-1039. Epub 2021 Apr 12 doi: 10.1016/j.jpain.2021.03.147. PMID: 33857615
Minetama M, Kawakami M, Teraguchi M, Kagotani R, Mera Y, Sumiya T, Nakagawa M, Yamamoto Y, Matsuo S, Koike Y, Sakon N, Nakatani T, Kitano T, Nakagawa Y
Spine J 2019 Aug;19(8):1310-1318. Epub 2019 Apr 12 doi: 10.1016/j.spinee.2019.04.009. PMID: 30986577
Schneider MJ, Ammendolia C, Murphy DR, Glick RM, Hile E, Tudorascu DL, Morton SC, Smith C, Patterson CG, Piva SR
JAMA Netw Open 2019 Jan 4;2(1):e186828. doi: 10.1001/jamanetworkopen.2018.6828. PMID: 30646197Free PMC Article

Prognosis

Kim HJ, Kim H, Kim YT, Sohn CH, Kim K, Kim DJ
PLoS One 2021;16(5):e0250742. Epub 2021 May 12 doi: 10.1371/journal.pone.0250742. PMID: 33979373Free PMC Article
Moojen WA, Schenck CD, Lycklama À Nijeholt GJ, Jacobs WCH, Van der Kallen BF, Arts MP, Peul WC, Vleggeert-Lankamp CLAM; Leiden-The Hague Spine Intervention Prognostic Study Group (SIPS)
Spine (Phila Pa 1976) 2018 Mar 1;43(5):348-355. doi: 10.1097/BRS.0000000000001301. PMID: 26630416
Trigg SD, Devilbiss Z
FP Essent 2017 Oct;461:21-25. PMID: 29019641
Metzger R, Chaney S
J Am Assoc Nurse Pract 2014 Jan;26(1):5-12. Epub 2013 Oct 1 doi: 10.1002/2327-6924.12083. PMID: 24170707
Borg A, Nurboja B, Timothy J, Choi D
Br J Neurosurg 2012 Aug;26(4):445-9. Epub 2012 May 15 doi: 10.3109/02688697.2012.680630. PMID: 22582741

Clinical prediction guides

Griffiths F, Srikesavan C, Ward L, Boniface G, Williamson E, Lamb SE
BMJ Open 2022 Sep 14;12(9):e060128. doi: 10.1136/bmjopen-2021-060128. PMID: 36104131Free PMC Article
Minetama M, Kawakami M, Teraguchi M, Kagotani R, Mera Y, Sumiya T, Nakagawa M, Yamamoto Y, Matsuo S, Koike Y, Sakon N, Nakatani T, Kitano T, Nakagawa Y
Spine J 2019 Aug;19(8):1310-1318. Epub 2019 Apr 12 doi: 10.1016/j.spinee.2019.04.009. PMID: 30986577
Schneider MJ, Ammendolia C, Murphy DR, Glick RM, Hile E, Tudorascu DL, Morton SC, Smith C, Patterson CG, Piva SR
JAMA Netw Open 2019 Jan 4;2(1):e186828. doi: 10.1001/jamanetworkopen.2018.6828. PMID: 30646197Free PMC Article
Genevay S, Courvoisier DS, Konstantinou K, Kovacs FM, Marty M, Rainville J, Norberg M, Kaux JF, Cha TD, Katz JN, Atlas SJ
Spine J 2018 Jun;18(6):941-947. Epub 2017 Oct 12 doi: 10.1016/j.spinee.2017.10.003. PMID: 29031994
Moojen WA, Arts MP, Bartels RH, Jacobs WC, Peul WC
Eur Spine J 2011 Oct;20(10):1596-606. Epub 2011 Jun 11 doi: 10.1007/s00586-011-1873-8. PMID: 21667130Free PMC Article

Recent systematic reviews

Comer C, Williamson E, McIlroy S, Srikesavan C, Dalton S, Melendez-Torres GJ, Lamb SE
Clin Rehabil 2024 Mar;38(3):361-374. Epub 2023 Sep 16 doi: 10.1177/02692155231201048. PMID: 37715644Free PMC Article
Ammendolia C, Hofkirchner C, Plener J, Bussières A, Schneider MJ, Young JJ, Furlan AD, Stuber K, Ahmed A, Cancelliere C, Adeboyejo A, Ornelas J
BMJ Open 2022 Jan 19;12(1):e057724. doi: 10.1136/bmjopen-2021-057724. PMID: 35046008Free PMC Article
Shamji MF, Mroz T, Hsu W, Chutkan N
Neurosurgery 2015 Oct;77 Suppl 4:S68-74. doi: 10.1227/NEU.0000000000000943. PMID: 26378360
Ammendolia C, Stuber K, de Bruin LK, Furlan AD, Kennedy CA, Rampersaud YR, Steenstra IA, Pennick V
Spine (Phila Pa 1976) 2012 May 1;37(10):E609-16. doi: 10.1097/BRS.0b013e318240d57d. PMID: 22158059
Moojen WA, Arts MP, Bartels RH, Jacobs WC, Peul WC
Eur Spine J 2011 Oct;20(10):1596-606. Epub 2011 Jun 11 doi: 10.1007/s00586-011-1873-8. PMID: 21667130Free PMC Article

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