Foot Drop after Anterior Cervical Discectomy and Fusion: A Case Report

A foot drop is caused by weakness or paralysis of the muscles of the anterior compartment of the leg. These muscles dorsiflex and evert the ankle and extend the toes. Typically, a foot drop results from lower motor neuron disease or peroneal nerve injury, with cases caused by upper neuron pathology...

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Main Author: Jin-Kuk Kim
Format: Article
Language:English
Published: Korean Minimally Invasive Spine Surgery Society 2016-09-01
Series:Journal of Minimally Invasive Spine Surgery and Technique
Subjects:
Online Access:http://www.jmisst.org/upload/pdf/jmisst-2016-00045.pdf
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author Jin-Kuk Kim
author_facet Jin-Kuk Kim
author_sort Jin-Kuk Kim
collection DOAJ
description A foot drop is caused by weakness or paralysis of the muscles of the anterior compartment of the leg. These muscles dorsiflex and evert the ankle and extend the toes. Typically, a foot drop results from lower motor neuron disease or peroneal nerve injury, with cases caused by upper neuron pathology being very rare. Here, we present the case of a 67-year-old man who developed a foot drop after C3-C4/C4-C5 anterior cervical discectomy and fusion performed as treatment for herniated discs at these levels, and spinal stenosis. Pre-operatively, ankle dorsiflexor strength was graded as 4+/5, bilaterally. After surgery, a left foot drop was identified in the recovery room, with dorsiflexor strength of 0/5. Magnetic resonance imaging showed a thickening of the ligamentum flavum (yellow ligament) at C4-C5, compared to its thickness on pre-operative imaging. A C3-C5 laminectomy was performed with recovery of dorsiflexion strength to a grade of 3/5. High pressure exerted on the anterior cervical cord, due to spinal canal stenosis, was considered to be the cause of the transient left drop foot after surgery. Central causes of drop foot in patients with cervical spine stenosis should be investigated, in particular after anterior cervical discectomy and fusion.
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spelling doaj.art-d1f9153c7ced4d33886d2bc05d8938752023-01-17T04:07:14ZengKorean Minimally Invasive Spine Surgery SocietyJournal of Minimally Invasive Spine Surgery and Technique2508-20432016-09-0111323510.21182/jmisst.2016.000456Foot Drop after Anterior Cervical Discectomy and Fusion: A Case ReportJin-Kuk Kim0 Department of Neurosurgery, Hanil Hospital, Jinju, KoreaA foot drop is caused by weakness or paralysis of the muscles of the anterior compartment of the leg. These muscles dorsiflex and evert the ankle and extend the toes. Typically, a foot drop results from lower motor neuron disease or peroneal nerve injury, with cases caused by upper neuron pathology being very rare. Here, we present the case of a 67-year-old man who developed a foot drop after C3-C4/C4-C5 anterior cervical discectomy and fusion performed as treatment for herniated discs at these levels, and spinal stenosis. Pre-operatively, ankle dorsiflexor strength was graded as 4+/5, bilaterally. After surgery, a left foot drop was identified in the recovery room, with dorsiflexor strength of 0/5. Magnetic resonance imaging showed a thickening of the ligamentum flavum (yellow ligament) at C4-C5, compared to its thickness on pre-operative imaging. A C3-C5 laminectomy was performed with recovery of dorsiflexion strength to a grade of 3/5. High pressure exerted on the anterior cervical cord, due to spinal canal stenosis, was considered to be the cause of the transient left drop foot after surgery. Central causes of drop foot in patients with cervical spine stenosis should be investigated, in particular after anterior cervical discectomy and fusion.http://www.jmisst.org/upload/pdf/jmisst-2016-00045.pdffoot dropacdf (anterior cervical discectomy and fusion)spinal stenosislaminectomy
spellingShingle Jin-Kuk Kim
Foot Drop after Anterior Cervical Discectomy and Fusion: A Case Report
Journal of Minimally Invasive Spine Surgery and Technique
foot drop
acdf (anterior cervical discectomy and fusion)
spinal stenosis
laminectomy
title Foot Drop after Anterior Cervical Discectomy and Fusion: A Case Report
title_full Foot Drop after Anterior Cervical Discectomy and Fusion: A Case Report
title_fullStr Foot Drop after Anterior Cervical Discectomy and Fusion: A Case Report
title_full_unstemmed Foot Drop after Anterior Cervical Discectomy and Fusion: A Case Report
title_short Foot Drop after Anterior Cervical Discectomy and Fusion: A Case Report
title_sort foot drop after anterior cervical discectomy and fusion a case report
topic foot drop
acdf (anterior cervical discectomy and fusion)
spinal stenosis
laminectomy
url http://www.jmisst.org/upload/pdf/jmisst-2016-00045.pdf
work_keys_str_mv AT jinkukkim footdropafteranteriorcervicaldiscectomyandfusionacasereport