Lumbar Neurogenic Claudication

Lumbar neurogenic claudication, sometimes referred to as pseudoclaudication, is the clinical syndrome of back pain radiating down one or both legs during ambulation. Classically, the symptoms abate with forward flexion of the lumbar spine and worsen with extension. The condition arises from lumbar spinal stenosis, which is common in the elderly population. Many asymptomatic individuals have lumbar spinal stenosis seen on magnetic resonance imaging (MRI), so this syndrome is a clinical diagnosis. The majority of patients have favorable responses with conservative treatment, which includes physical therapy, bracing, medications, and epidural steroid injections. Patients who do not improve may go on to have surgery. Spinal stenosis has become one of the most common reasons to undergo lumbar spinal surgery in patients older than 65 years of age.