Neurological function following early versus delayed decompression surgery for drop foot caused by lumbar degenerative diseases

Nakashima, Hiroaki; Ishikawa, Yoshimoto; Kanemura, Tokumi; Kato, Fumihiko; Satake, Kotaro; Ito, Keigo; Ito, Kenyu; Ando, Kei; Kobayashi, Kazuyoshi; Ishiguro, Naoki

doi:10.1016/j.jocn.2020.01.039

Cited by 10 publications

(4 citation statements)

References 27 publications

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“…Over time, lumbar degenerative diseases, such as lumbar spinal stenosis and lumbar disc herniation, can occur which lead to lumbar radiculopathies including foot drops. Previous research has shown that drop foot occurs in 0.6%-7.7% of cases that involve lumbar degenerative diseases [7]. More specifically, the L5 nerve root has been found to be the most common region of lumbar radiculopathy in cases involving foot drops [5].…”

Section: Discussionmentioning

confidence: 99%

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Successful Osteopathic Manipulative Treatment of Foot Drop

Tafler¹,

Katz²,

Kolesnikov³

et al. 2022

Cureus

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Section: Discussionmentioning

confidence: 99%

“…The most common causes of this condition are L5 radiculopathies and peroneal peripheral neuropathy [3][4][5]. Other causes include anterior horn disease, spinal cord lesions, brain disorders, sciatic nerve compression, lumbar plexopathies, and radiculopathies secondary to herniated nucleus pulposus or foraminal stenosis [4][5][6][7][8].…”

Section: Introductionmentioning

confidence: 99%

Successful Osteopathic Manipulative Treatment of Foot Drop

Tafler¹,

Katz²,

Kolesnikov³

et al. 2022

Cureus

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“…Of note, five of the seven patients (two in primary care and three in the emergency department) needed to attend more than once before any onward referral for investigation was made. This may reflect some uncertainty amongst nonspecialist colleagues on the frontline, which may be arising from a lack of clarity within the specialist (i.e., neurosurgical/ spinal) community itself, where the timing of surgery for acute discogenic foot drop remains a point of discussion [23,29]. We hope that the series presented will help in timely suspicion and investigation of acute lumbar spine aetiology.…”

Section: Discussionmentioning

confidence: 99%

Acute bilateral foot drop with or without cauda equina syndrome—a case series

et al. 2021

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Introduction Isolated acute bilateral foot drop due to degenerative spine disease is an extremely rare neurosurgical presentation, whilst the literature is rich with accounts of chronic bilateral foot drop occurring as a sequela of systemic illnesses. We present, to our knowledge, the largest case series of acute bilateral foot drop, with trauma and relevant systemic illness excluded. Methods Data from three different centres had been collected at the time of historic treatment, and records were subsequently reviewed retrospectively, documenting the clinical presentation, radiological level of compression, timing of surgery, and degree of neurological recovery. Results Seven patients are presented. The mean age at presentation was 52.1 years (range 41–66). All patients but one were male. All had a painful radiculopathic presentation. Relevant discopathy was observed from L2/3 to L5/S1, the commonest level being L3/4. Five were treated within 24 h of presentation, and two within 48 h. Three had concomitant cauda equina syndrome; of these, the first two made a full motor recovery, one by 6 weeks follow-up and the second on the same-day post-op evaluation. Overall, five out of seven cases had full resolution of their ankle dorsiflexion pareses. One patient with 1/5 power has not improved. Another with 1/5 weakness improved to normal on the one side and to 3/5 on the other. Conclusion When bilateral foot drop occurs acutely, we encourage the consideration of degenerative spinal disease. Relevant discopathy was observed from L2/3 to L5/S1; aberrant innervation may be at play. Cauda equina syndrome is not necessarily associated with acute bilateral foot drop. The prognosis seems to be pretty good with respect to recovery of the foot drop, especially if partial at presentation and if treated within 48 h.

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“…However, the L4 and S1 roots also innervate tibialis anterior and hallucis longus muscles based on electrical stimulation examination [ 2 ]. Two years postoperative follow-up of drop foot patients showed significantly better outcomes on early (79.1 + 21.2%) than delayed decompression groups (68.6 + 18.6%) [ 4 ]. Analgesics medication is still prescribed routinely in common cases of CLBP patients for relieving the neuropathic pain syndrome by neurotransmitter modulation at presynaptic receptors of afferent fibers [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Percutaneous Discectomy Followed by CESI Might Improve Neurological Disorder of Drop Foot Patients Due to Chronic LDH

Budisulistyo

Atmaja²

2020

Brain Sciences

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(1) Introduction: Epiconus and conus medullary syndromes that consisted of drop foot, pain, numbness, bladder or bowel dysfunction are serious problems might be caused by lumbar disc(s) herniation (LDH) compression. (2) Objective: To evaluate percutaneous discectomy effectivity for decompressing LDH lesions. (3) Case Report: Three patients suffered from drop feet, numbness, and bowel and bladder problems due to LDH compression. Patient #1 is a male (35 years old, basal metabolism index (BMI) = 23.9), point 1 on manual muscle test (MMT), with protrusion on L3 to S1 discs; Patient #2 is a female (62 years old, BMI = 22.4), point 3 on MMT, with protrusion on L2-4 and L5-S1 discs; Patient #3 is a female (43 years old, BMI = 26.6), point 4 on MMT, with extrusion on T12-L1 and L1-2 and L3-4 protruded discs. Six months follow-up showed of stand and walkability improvement with Patient #1 and #2. Patient #3 showed improvement in bowel and bladder problems within 10 weeks, without suffering of postoperative pain syndromes. (4) Discussion: Patient #1 and #2 showed better outcomes than Patient #3 who affected epiconus and cauda equina syndromes. Triamcinolone and lidocaine have analgesic and anti-inflammatory properties for improving intraepidural circulation adjacent to the lesion sites. (5) Conclusion: Drop foot caused by mechanical compression of LDH ought to be treated immediately. Lateral or posterolateral compression has better outcomes associated with anatomical structures. Discectomy through transforaminal approach that is followed by caudal epidural steroid injection (CESI) under fluoroscopic guidance is a safer and minimally invasive treatment with promising outcomes.

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Neurological function following early versus delayed decompression surgery for drop foot caused by lumbar degenerative diseases

Cited by 10 publications

References 27 publications

Successful Osteopathic Manipulative Treatment of Foot Drop

Successful Osteopathic Manipulative Treatment of Foot Drop

Acute bilateral foot drop with or without cauda equina syndrome—a case series

Percutaneous Discectomy Followed by CESI Might Improve Neurological Disorder of Drop Foot Patients Due to Chronic LDH

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