Review
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World J Orthop. Apr 18, 2014; 5(2): 134-145
Published online Apr 18, 2014. doi: 10.5312/wjo.v5.i2.134
Pathophysiology, diagnosis and treatment of intermittent claudication in patients with lumbar canal stenosis
Shigeru Kobayashi
Shigeru Kobayashi, Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, and the Research and Education Program for Life Science, the University of Fukui, Fukui 910-1193, Japan
Author contributions: Kobayashi S solely contributed to this paper.
Supported by Grant-in Aid from the Ministry of Education, Science and Culture of Japan, No, 25460719
Correspondence to: Shigeru Kobayashi, MD, PhD, Department of Orthopaedics and Rehabilitation Medicine, Faculty of Medical Sciences, and the Research and Education Program for Life Science, the University of Fukui, Shimoaizuki 23, Fukui 910-1193, Japan. kshigeru@u-fukui.ac.jp
Telephone: +81-776-618383 Fax: +81-776-618125
Received: October 30, 2013
Revised: December 17, 2013
Accepted: March 3, 2014
Published online: April 18, 2014
Core Tip

Core tip: The radicular symptoms associated with degenerative disease of the lumbar spine are reported to be attributable to a combination of mechanical nerve root compression and resultant circulatory disturbance. Disturbance of blood flow in the cauda equina and nerve roots is reported to play an important role in the mechanism of intermittent claudication in patients with lumbar canal stenosis. Prostaglandin E1 (PGE1) is a potent vasodilator as well as an inhibitor of platelet aggregation and has therefore attracted interest as a therapeutic drug for lumbar canal stenosis with intermittent claudication. However, investigations in the clinical setting have shown that lipo-PGE1 is effective in some patients but not in others, although the reason for this is unclear.