Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova · 2021
[Neurogenic intermittent claudication in patients with degenerative lumbar stenosis].
СтатьяНазвание и аннотация: Перевод в очереди
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Nikitin A S, Kamchatnov P R
Аннотация
OBJECTIVE: To study the clinical manifestations of neurogenic intermittent claudication (NIC) in patients with degenerative lumbar stenosis (DLS).
MATERIAL AND METHODS: The neurological status, intensity and nature of pain syndrome, and pain-free walking distance were evaluated in 83 NIC patients with DPS, who underwent surgical treatment.
RESULTS: The predominance of the clinical picture of sensorimotor pain (n=30; 36.1%) and isolated pain (n=31; 37.3%) forms of NIC was established. Isolated sensory (n=1; 1.2%), sensorimotor (n=3; 3.6%), and motor-pain (n=4; 4.8%) forms were significantly less common. In 6 (7.2%) patients, there was a pain-free form of NIC. In most patients, surgical treatment led to regression of neurological symptoms and an increase in the distance of pain-free walking. No relationship was found between the demographic and clinical characteristics of patients (gender, age, pain severity, pain-free walking distance), MRI results and the features of NIC clinical picture. In 4 patients, the phenomenon of pacing was revealed in the form of an increase in pain at the beginning of walking and a significant decrease or complete regression as walking continues.
CONCLUSION: The clinical picture of NIC is polymorphic, its pain-free course is possible. The decision on the feasibility of surgical treatment of patients with PLS is possible taking into account the clinical picture of NIC and MRI results.
MATERIAL AND METHODS: The neurological status, intensity and nature of pain syndrome, and pain-free walking distance were evaluated in 83 NIC patients with DPS, who underwent surgical treatment.
RESULTS: The predominance of the clinical picture of sensorimotor pain (n=30; 36.1%) and isolated pain (n=31; 37.3%) forms of NIC was established. Isolated sensory (n=1; 1.2%), sensorimotor (n=3; 3.6%), and motor-pain (n=4; 4.8%) forms were significantly less common. In 6 (7.2%) patients, there was a pain-free form of NIC. In most patients, surgical treatment led to regression of neurological symptoms and an increase in the distance of pain-free walking. No relationship was found between the demographic and clinical characteristics of patients (gender, age, pain severity, pain-free walking distance), MRI results and the features of NIC clinical picture. In 4 patients, the phenomenon of pacing was revealed in the form of an increase in pain at the beginning of walking and a significant decrease or complete regression as walking continues.
CONCLUSION: The clinical picture of NIC is polymorphic, its pain-free course is possible. The decision on the feasibility of surgical treatment of patients with PLS is possible taking into account the clinical picture of NIC and MRI results.