“Bicycle test” of van Gelderen in diagnosis of intermittent cauda equina compression syndrome

Dyck, Peter; Doyle, John B.

doi:10.3171/jns.1977.46.5.0667

Cited by 58 publications

(23 citation statements)

References 13 publications

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“…In fact, this syndrome is manifested by radicular pain, often bilateral, that is exacerbated by standing, walking, and other positions that place the lumbar spine in extension, 22 while a flexed posture improves or relieves the symptoms. 23,24 The presented model, as every computational model of complex phenomena, includes some simplifications to build a manageable model of the real structure. Living tissues biomechanics is extremely complex and not comprehensively investigated yet.…”

Section: Discussionmentioning

confidence: 99%

Biomechanics of the Lumbar Spine After Dynamic Stabilization

Bellini¹,

Galbusera²,

Raimondi³

et al. 2007

Journal of Spinal Disorders &Amp; Techniques

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Target of the study was to predict the biomechanics of the instrumented and adjacent levels due to the insertion of the DIAM spinal stabilization system (Medtronic Ltd). For this purpose, a 3-dimensional finite element model of the intact L3/ S1 segment was developed and subjected to different loading conditions (flexion, extension, lateral bending, axial rotation). The model was then instrumented at the L4/L5 level and the same loading conditions were reapplied. Within the assumptions of our model, the simulation results suggested that the implant caused a reduction in range of motion of the instrumented level by 17% in flexion and by 43% in extension, whereas at the adjacent levels, no significant changes were predicted. Numerical results in terms of intradiscal pressure, relative to the intact condition, predicted that the intervertebral disc at the instrumented level was unloaded by 27% in flexion, by 51% in extension, and by 6% in axial rotation, while no variations in pressure were caused by the device in lateral bending. At the adjacent levels, a change of relative intradiscal pressure was predicted in extension, both at the L3/L4 level, which resulted unloaded by 26% and at the L5/S1 level, unloaded by 8%. Furthermore, a reduction in terms of principal compressive stress in the annulus fibrosus of the L4/L5 instrumented level was predicted, as compared with the intact condition. These numerical predictions have to be regarded as a theoretical representation of the behavior of the spine, because any finite element model represents only a simplification of the real structure.

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Section: Discussionmentioning

confidence: 99%

Biomechanics of the Lumbar Spine After Dynamic Stabilization

Bellini¹,

Galbusera²,

Raimondi³

et al. 2007

Journal of Spinal Disorders &Amp; Techniques

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“…VOLUME 84-A · NUMBER 11 · NOVEMBER 2002 A COMPREHENSIVE STUDY OF PATIENTS W ITH SURGICALLY TREATED LUMBAR SPINAL STENOSIS W ITH NEUROGENIC CLAUDICATION used for neurological assessment of patients with lumbar spinal stenosis. Functional status has been assessed with use of a bicycle [6][7][8][9] and a treadmill 8,10-12 . We are not aware of any study focusing on the relationship among objective functional measurements, subjective symptoms, and the degree of narrowing of the spinal canal in patients treated surgically for lumbar spinal stenosis.…”

mentioning

confidence: 99%

A Comprehensive Study of Patients With Surgically Treated Lumbar Spinal Stenosis With Neurogenic Claudication

Yukawa

Lenke

Tenhula

et al. 2002

The Journal of Bone and Joint Surgery-American Volume

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"A comprehensive study of patients with surgically treated lumbar spinal stenosis with neurogenic claudication." Journal of Bone and Joint Surgery.84,11. 1954-1959. (2002 Background: The relationship between objective measurements and subjective symptoms of patients with spinal stenosis and the degree of narrowing of the spinal canal is not clear. The purpose of this study was to evaluate patients undergoing surgery for lumbar spinal stenosis and intermittent neurogenic claudication with functional testing, quantitative imaging, and patient self-assessment.

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“…The 'bicycle test' has been suggested as a means of identification of lumbar versus vascular claudication. 18,31,32 While not performed in the classic fashion (cycle both flexed and extended comparing time to symptoms), 31 the fact that the patient was relatively asymptomatic during flexed, seated cycling rather than during a standing activity (stair climbing) could be considered to be clinically meaningful. It would be expected that LSS would demonstrate a position dependant mechanical behavior, while the neurologic deficits following CSM would show no symptomatic change, despite the mechanical change of position.…”

Section: Discussionmentioning

confidence: 99%

Tandem spinal stenosis: a case of stenotic cauda equina syndrome following cervical decompression and fusion for spondylotic cervical myelopathy

Swanson

2012

Journal of Manual & Manipulative Therapy

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Tandem spinal stenosis is a clinical phenomenon which may cause a functional loss related to neurologic compression in numerous areas of the spinal cord. In this phenomenon, the second area of symptomatic neurologic insult is not revealed until the primary symptomatic area has been treated. This case describes a 71-year-old male referred to physical therapy 4 weeks following a combined anterior/posterior C3/4 decompression and fusion for treatment of cervical spondylotic myelopathy. Approximately 8 weeks postoperatively (4 weeks after initiation of physical therapy), the patient began to complain of bilateral lower extremity weakness, primarily with climbing stairs. At 12 weeks post-operatively, the patient developed bowel incontinence and saddle paresthesia. Magnetic resonance imaging revealed multiple levels of critical stenosis of the lower thoracic and upper lumbar spine, which resulted in referral for surgical intervention. Following surgical decompression there was complete recovery of lower extremity strength, saddle area sensation and bowel function. This case highlights the need for the clinician to remain vigilant for concomitant pathology despite successful surgical intervention. A thorough knowledge of the presentation of various spinal disorders, as well as a thorough neurologic examination, is required to accurately recognize both candid and subtle red flags requiring immediate referral for surgical intervention.

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“Bicycle test” of van Gelderen in diagnosis of intermittent cauda equina compression syndrome

Cited by 58 publications

References 13 publications

Biomechanics of the Lumbar Spine After Dynamic Stabilization

Biomechanics of the Lumbar Spine After Dynamic Stabilization

A Comprehensive Study of Patients With Surgically Treated Lumbar Spinal Stenosis With Neurogenic Claudication

Tandem spinal stenosis: a case of stenotic cauda equina syndrome following cervical decompression and fusion for spondylotic cervical myelopathy

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