Foot drop caused by single-level disc protrusion between t10 and l1.

NewsBot · Dec 18, 2013

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Foot drop caused by single-level disc protrusion between t10 and l1.
Zhang C, Xue Y, Wang P, Yang Z, Dai Q, Zhou HF.
Spine (Phila Pa 1976). 2013 Dec 15;38(26):2295-301.

STUDY DESIGN:
Retrospective investigation of surgical treatment of 25 patients with foot drop from single-level disc protrusion in the region of T10 to L1.
OBJECTIVE:
To describe cases of foot drop from single-level disc protrusion in the region of T10 to L1 and surgical outcomes.
SUMMARY OF BACKGROUND DATA:
Three cases of foot drop from T12-L1 disc protrusion are reported in the literature. Little is known, however, about foot drop resulting from single-level disc protrusion between T10 and L1 or its surgical outcomes.
METHODS:
Between January 1995 and October 2010, a total of 25 patients (mean age: 44 yr; range, 21-68 yr) presented to our department with single-level disc protrusion between T10 and L1 (6 at T10-T11, 7 at T11-T12, and 12 at T12-L1) with associated foot drop and without cervical or lumbar spinal stenosis or other neurological disease. The average follow-up period was 46.5 months. We treated all cases surgically with circumferential decompression with fixation. We assessed neurological status, tibialis anterior muscle strength, magnitude of local kyphosis, and cross-sectional area at the level of compression of the dural sac preoperatively and at the final follow-up.
RESULTS:
Preoperatively, all 25 patients exhibited both foot drop resulting from a lower motor neuron lesion and pathological reflexes resulting from an upper motor neuron lesion. Postoperatively, the mean calculated muscle strength recovery rate was 95%. Mean Japanese Orthopaedic Association score increased from 5.92 ± 1.22 points preoperatively to 9.56 ± 0.92 points at the final follow-up. Magnetic resonance imaging indicated that the cross-sectional area increased from 36.3 ± 7.3 mm preoperatively to 133.1 ± 6.1 mm postoperatively.
CONCLUSION:
Foot drop can be caused by single-level disc protrusion between T10 and L1 and is usually associated with an upper motor neuron lesion. Pathological reflexes resulting from disc protrusion occurring between T10 and L1 differ depending on the level of the protrusion. Circumferential decompression with fixation may be an effective treatment option for this syndrome.
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Admin2 · Dec 18, 2013

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Help with a case of drop foot

HansMassage · Dec 21, 2013

This is actually an area I specialize in treating. Enervation between T10 and L1 affects the Psoas Minor Muscles. These stabilize the pelvis when the foot on the opposite side comes off the ground. Imbalance with one side chronically contracted and the other slack causes a twist in the pelvis and the resulting antalgic posture and gait.

NewsBot · Jan 9, 2014

Sensorimotor polyneuropathy and foot-drop as result of a prostate cancer paraneoplastic syndrome.
Bodkin JJ1, Duff M2, Seereiter PJ Jr3, Chevli KK4.
Res Rep Urol. 2013 Dec 6;5:159-62. doi: 10.2147/RRU.S52712.

Paraneoplastic syndromes (PNS) vary in incidence and manifestation based on tumor histology. PNS secondary to urologic malignancies have an extremely low incidence. Most reported cases of PNS from urologic malignancies are associated with adenocarcinoma. Peripheral neuropathy-associated PNS from urologic malignancy are exceedingly rare. An 80-year-old male developed a paraneoplastic sensorimotor polyneuropathy and foot-drop after a diagnosis of clinical stage T2cN0M0, Gleason grade 5+4 prostate cancer. A thorough workup is needed in order to adequately assess and treat PNS. Careful analysis must be used to determine the root cause of a patient's symptoms.
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NewsBot · Jan 21, 2014

Foot drop resulting from degenerative lumbar spinal diseases: Clinical characteristics and prognosis.
Wang Y, Nataraj A.
Clin Neurol Neurosurg. 2014 Feb;117C:33-39.

Foot drop is a condition that can substantially add to the disability of patients with degenerative lumbar spinal disorders. The most common degenerative conditions associated with foot drop are lumbar disc herniation and lumbar spinal stenosis. The level most commonly affected is the L4/5 spinal level. Most patients are treated with surgery, although there is insufficient evidence to support that surgery is superior to conservative therapy. In most surgical patients, foot dorsiflexion will improve to some degree. The preoperative power of foot dorsiflexion is the key factor associated with prognosis.
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NewsBot · Jan 23, 2014

The unique case of foot drop secondary to a large ovarian cyst.
Ahmad M, Kumar A, Thomson S.
Br J Neurosurg. 2014 Jan 22.

We describe the unique case of a 58-year-old woman who presented with right leg radiculopathy caused by an ovarian cyst mimicking lumbar pathology. A review of the literature shows that this is a rare case where a histologically confirmed benign ovarian cystadenoma (of indeterminate type) is shown to cause foot drop and radiculopathy.
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NewsBot · Nov 5, 2014

Cerebral infarction presenting with unilateral isolated foot drop.
Kim KW, Park JS, Koh EJ, Lee JM.
J Korean Neurosurg Soc. 2014 Sep;56(3):254-6.

Weakness of the dorsiflexor muscles of the ankle or toe, referred to as foot drop, is a relatively common presentation. In most cases, foot drop is caused by a lower motor neuron disease such as peroneal peripheral neuropathy, L4-5 radiculopathic sciatic neuropathy, or polyneuropathy. Although upper motor neuron lesions can present as foot drop, the incidence is very rare. Here, we report an extremely rare case in which foot drop was the only presenting symptom of cerebral infarction.
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NewsBot · May 23, 2022

Foot drop as the initial symptom caused by thoracic disc herniation
Menglin Cong et al
Eur Spine J. 2022 May 22

Background: Foot drop is a syndrome resulting from weakness or paralysis of the tibialis anterior muscle. Some patients with thoracic disc herniation seek medical help complain of foot drop as the initial symptom. The study investigated the clinical characteristics of these patients and clarified the clinical efficacy after treatment.

Methods: A total of 13 patients with foot drop as the initial symptom arising from thoracic disc herniation were collected from January 2015 to December 2020. The average follow-up period was 20.5 months. We recorded neurological functions, the tibialis anterior muscle strength, Japanese Orthopedic Association score (JOA), location of the lesion, and occupation rate of herniation in the spinal canal preoperatively and at the final follow-up.

Results: None pathological reflex was found in the patients. Surgical treatment was performed in 12 of the 13 patients, and tibialis anterior functional recovery was observed in 83.4% (10/12) of the cases, with an average recovery rate of 52.8 ± 18.5%. The mean JOA score increased from 6.8 ± 1.9 points preoperatively to 8.9 ± 1.3 points postoperatively (p < 0.05), achieving a mean recovery rate of 52.3 ± 13.1%. The MRI showed the conus medullaris was obviously compressed at the level of T11-L1, and the occupation rate of herniation was more than 40% in all patients, with an average of 65.4 ± 16.3%. CT indicated that 84.6% of the cases had calcification in intervertebral discs.

Conclusion: Foot drop can be the initial symptom caused by thoracic disc herniation at the T11-L1 level, especially for the calcified disc herniation. A satisfactory recovery rate can be achieved by surgical decompression with fixation.
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