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| LIU Kun,JIA Lianshun,SHI Jiangang.Clinical features and prognostic factors of foot drop caused by lumbar degenerative disease[J].Chinese Journal of Spine and Spinal Cord,2013,(4):302-306. |
| Clinical features and prognostic factors of foot drop caused by lumbar degenerative disease |
| Received:December 10, 2012 Revised:February 21, 2013 |
| English Keywords:Foot drop Lumbar degenerative disease Prognosis factors Outcome |
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| English Abstract: |
| 【Abstract】 Objectives: To analyze the clinical features and surgical outcome of foot drop due to lumbar degenerative disease and to determine risk factors. Methods: 1674 patients who suffered from lumbar disc herniation and/or lumbar spinal stenosis and underwent lumbar surgery from January 2005 to January 2010 were reviewed. A total of 135 patients with foot drop was included. There were 62 males and 73 females with a mean age at surgery of 55 years(range, 43-64 years). The tibialis anterior strength was 0, 1, 2, 3 level in 18, 34, 59, 24 patients respectively. All patients underwent modified PLIF and nerve roots decompression. The mean follow-up period was 1.3 years(range, 1-2 years). The clinical features and mechanism were analyzed. Age, sex, duration of palsy, preoperative tibialis anterior strength, numbness of affected lower limb, affected foot and nerve root compression were recorded and compared to determine the risk factors. Results: Foot drop was observed in 8.1% of all inpatients. Single, double and triple nerve root compression was noted in 43, 83, and 9 patients(32.8%, 61.5%, and 6.7%) respectively. L5 nerve root entrapment was observed in 126 of all 135 patients(93.3%). 113 patients(83.7%) had foot drop recovered after surgery, the tibialis anterior strength reached to 4 level or above in 21(15.6%) patients. The tibialis anterior strength remained unchanged at 6 months. At final follow-up, the tibialis anterior strength was 1, 2, 3, 4, 5 level in 28, 24, 62, 13, 8 patients respectively. The statistical analysis showed duration of palsy, preoperative tibialis anterior strength and age were risk factors that influenced recovery after operation. Conclusions: L5 nerve root palsy is most common in patients suffering from foot drop due to lumbar degenerative disease. Multilevel nerve root entrapment was not uncommon, which has bad prognosis. The course of disease, preoperative tibialis anterior strength and younger age are risk factors, and early prevention and intervention is critical. |
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