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Combined Vascular and Neurogenic Claudication

JOHANSSON, J E, MD, FRCS(C)*; BARRINGTON, T W, MD, FRCS(C); AMELI, M, MD, FRCS(C)

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Eight patients with combined vascular and neurogenic claudication were presented. In the adult with coexistent neurospinal and vascular disease, a careful history and examination often suggested the pathology more productive of symptomatology. Among patients presenting with predominately vascular claudication, six of six patients had calf pain as part of the pain pattern, and in three of six patients the pain was crampy. Five of six patients had a consistent exercise tolerance pain pattern and obtained relief of symptoms by resting the leg. Among patients presenting with mainly neurogenic claudication, only four of eight patients had associated calf pain, and none experienced crampy pain. Five of eight patients had a variable exercise tolerance pain pattern and obtained complete relief of symptoms only by assuming the recumbent position. Doppler testing was very helpful as the initial step in the evaluation of the significance of an arterial lesion and in the follow-up assessment of these patients after vascular surgery. Lumbosacral-spine, cardiovascular, and neurologic examination was similar in the two groups of patients.

*From Queen Elizabeth Hospital, Division of Orthopaedics, Montreal, Quebec, Canada, Toronto East General and Orthopaedic Hospital, Inc.

†From Divisions of Orthopaedics, Toronto, Ontario, Canada

‡From Divisions of Vascular Surgery, Toronto, Ontario, Canada

© Lippincott-Raven Publishers.