The study of the intermittent claudication-the distinction between peripheral arterial occlusive disease and lumbar spinal canal stenosis

Abstract

We investigated a test method that could be useful for differentiating peripheral arterial occlusive disease (P) from lumbar spinal canal stenosis (S) in the patients whose major complaint is intermittent claudication. The results are reported in the following. The subjects of study were 136 patients who visited Jyoto Insurance Hospital with a major complaint of intermittent claudication. As the first step, the ankle brachial pressure index (ABPI) was determined and the subjects were classified into groups depending on the result. Subsequently, the palpation of dorsal artery of foot, loading test in standing position and the postural factor were investigated. According to the results, dorsal artery of foot was not tactile in 11 patients in P group and 23 patients in S group at the sensitivity of 61.1% and specificity of 80.5%; loading test in standing position was negative in 7 and 25 respectively at the sensitivity of 38.9% and specificity of 78.8%; postural factor was negative in 16 and 49 respectively at the sensitivity of 88.9% and specificity of 58.5%. The sensitivity and specificity of method investigated this time to differentiate P from S were not sufficiently high. Accordingly, we reached the conclusion that there is no method to replace the ABPI determination method.