J Minim Invasive Spine Surg Tech.  2016 Sep;1(1):32-35. 10.21182/jmisst.2016.00045.

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

• Kim JK

• KMID: 2562011
• DOI: http://doi.org/10.21182/jmisst.2016.00045

Abstract

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.

Keyword

Foot drop; ACDF (anterior cervical discectomy and fusion); Spinal stenosis; Laminectomy