Intermittent claudication of the cauda equina - A study of flexion-extension myelography.:a study of flexion-extension myelography

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The purpose of this paper is to describe the relation of cauda eqina claudication to shape of the dural sac in spinal movement. Measurements were performed on 27 lateral lumbar myelograms in flexion and extension. Of the 27 patients studyied, 16 were lumbar canal stenosis and 11 were lumbar disc herniation. The patients with lumbar canal stenosis were divided into 4 groups; no mild, moderate and severe intermittent cludications. The patients with lumbar disc herniation were diveded into 2 groups; none or a little pain on walking and severe pain on walking.Each group was investigated and compared in the relation of cauda eqina claudication to shape of the dural sac in spinal movement.The main results found in this study were as follows;1) Generally, there proved to be an anterior displacement of the lumbar dural sac in lumbar extension and posterior displacement in lumbar flexion.2) In no or mild intermittent claudication cases, the lumbar dural sac has little anterior and posterior displacement in lumbar extension and flexion.3) In severe intermittent cludication cases, the lumbar dural sac has remarkable anterior and posterior displacement in lumbar extension and flexion. Especially in lumbar extension, the anterior dural surface was indented at the L4-5 interspaces by posterior bulging of the disc and displaced forward markedly behind the L4 and L5 vertebral bodies.
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