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Open Access 01-04-2021 | Laminectomy | Original Article - Spine degenerative

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

Authors: Andreas K. Demetriades, Marco Mancuso-Marcello, Asfand Baig Mirza, Joseph Frantzias, David A. Bell, Richard Selway, Richard Gullan

Published in: Acta Neurochirurgica | Issue 4/2021

Abstract

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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Title: Acute bilateral foot drop with or without cauda equina syndrome—a case series
Authors: Andreas K. Demetriades
Marco Mancuso-Marcello
Asfand Baig Mirza
Joseph Frantzias
David A. Bell
Richard Selway
Richard Gullan
Publication date: 01-04-2021
Publisher: Springer Vienna
Keywords: Laminectomy
Lumbar Prolapsed Disc
Disc Herniation
Published in: Acta Neurochirurgica / Issue 4/2021
Print ISSN: 0001-6268
Electronic ISSN: 0942-0940
DOI: https://doi.org/10.1007/s00701-021-04735-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Introduction

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Introduction

Methods

Results

Conclusion

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