Foot drop as the initial symptom caused by thoracic disc herniation

Area of Science:

• Neurology
• Orthopedic Surgery
• Spinal Disorders

Background:

• Foot drop, characterized by tibialis anterior muscle weakness or paralysis, can be an initial symptom of thoracic disc herniation.
• This study focuses on patients presenting with foot drop as their primary complaint due to thoracic disc herniation.

Purpose of the Study:

• To investigate the clinical characteristics of patients with foot drop caused by thoracic disc herniation.
• To evaluate the clinical efficacy of surgical treatment for this condition.

Main Methods:

• Retrospective analysis of 13 patients with foot drop as the initial symptom of thoracic disc herniation (Jan 2015-Dec 2020).
• Assessment of neurological function, tibialis anterior muscle strength, Japanese Orthopedic Association (JOA) score, lesion location, and herniation occupation rate pre- and post-operatively.
• Average follow-up period of 20.5 months.

Main Results:

• Surgical treatment in 12 patients resulted in tibialis anterior functional recovery in 83.4% (10/12) with an average recovery rate of 52.8%.
• Mean JOA score improved significantly from 6.8 to 8.9 (p < 0.05), with a 52.3% recovery rate.
• MRI revealed significant T11-L1 level compression (herniation >40% occupation) in all cases; CT indicated disc calcification in 84.6%.

Conclusions:

• Thoracic disc herniation, particularly calcified herniation at T11-L1, can manifest initially as foot drop.
• Surgical decompression with fixation is an effective treatment, achieving satisfactory recovery rates for foot drop associated with thoracic disc herniation.