Drop foot from degenerative lumbar disorders can be a major problem. Drop foot is caused by pressure on the spinal nerve as it leaves the spinal cord in the low back area. When the nerve is impaired, muscle weakness occurs.
A person with drop foot drags the toes when walking. Drop foot causes tripping and falls. Sometimes patients change the way they walk to overcome this problem. The person lifts the knee higher to clear the toes as the foot moves forward. The result is a gait (walking) pattern referred to as steppage gait.
A brace or ankle-foot orthosis (AFO) can help by providing support and keeping the foot from dropping. Shoe wear is limited for people with drop foot. The AFO slips inside a standard shoe and can’t be worn with sandals or slippers. Drop foot is a special problem for people in Japan. Shoes (and braces) are removed indoors.
In this study, surgeons observed 46 patients with drop foot who had lumbar spine surgery. The goal was to find factors that predict who will recover from drop foot. The patients had decompressivesurgery with or without spinal fusion. Decompression takes pressure off the nerve. Part or all of the disc was removed. In some patients, bone around the spinal nerve was cut away too.
Motor recovery after surgery was excellent in 41 per cent of the patients. Another 20 per cent had good results. Results for the rest of the group were rated fair to poor. About one-third of the patients had complete recovery with normal muscle strength restored.
Recovery was best in younger patients who had symptoms for the shortest amount of time. Strength before the surgery was also a factor affecting the outcome. Patients with low strength before surgery had poorer results afterwards. For those patients who made a full recovery, the length of time varied from six weeks to two years after surgery.