By: 3 April 2015
Surgery may not fix long-term palsy of spine disease

Duration of palsy should be considered when selecting candidates for surgical management of painless foot drop in patients with degenerative lumbar disorders, according to research published in the October issue of the Journal of Spinal Disorders & Techniques.

Hiroyuki Aono, of the Osaka National Hospital in Japan, and colleagues conducted a retrospective study of 20 patients with painless drop foot who received lumbar spine surgery for degenerative lumbar disorders. Preoperative strength of the tibialis anterior and duration of palsy were recorded.

The researchers found that 65 percent of patients recovered from drop foot following lumbar spine surgery. The main cause of drop foot was impairment of the L5 nerve root, and surgical outcome was poorer among patients with a longer duration of palsy.

“Duration of palsy had the greatest effect on recovery,” wrote the authors. “As the only goal of this surgery is improvement in the strength of the tibialis anterior, caution must be exercised when considering surgery for patients with longstanding palsy.”