Abstract:Objective To analyze the effect of degenerative lumbar spine disease after foot drop surgery.Methods We retrospectively analyzed the clinical characteristics,surgical treatment,and prognosis of 143 cases of degenerative lumbar spine in Beijing Shijitan Hospitalof Capital Medical University.The age,gender,duration of preoperative paralysis,and the strength of the tibialis anterior muscle TA before surgery were recorded and compared with the patient's postoperative condition.Results 143 patients were followed up for an average of (2.5±0.5) years.Among the 143 patients with lumbar degenerative foot drop,76 had lumbar disc herniation,the responsible segments were L4~5,and the L5 nerve root was compressed;67 patients were patients with lumbar spinal stenosis,of which 46 were L4~5 spinal stenosis,L5 nerve root compression,17 patients with L4~5 and L5S1 spinal stenosis,L5 and S1 nerve root compression,4 patients with L3~4,L4~5,and L5S1 spinal stenosis,and L4,L5 and S1 nerve root.After surgery,81 patients (56.64%) had TA muscle strength of ≥4 and were cured,and 62 patients (43.36%) had TA muscle strength of ≤3.Although the muscle strength of TA was improved before surgery,it was not cured,and the follow-up of 6 months after operation showed that the muscle strength of TA was almost stable.In the last follow-up,there were 5、17、14、26、70、11 patients with TA muscle strength of 0、1、2、3、4、5.Multivariate logistic regression showed that duration of paralysis,muscle strength before TA,and age were factors that affected postoperative recovery.Conclusion L5 nerve roots are most often affected in patients with dropfoot caused by degenerative lumbar spine.In most patients,the muscle strength of TA has improved after surgery,but few patients can completely recover from foot drop.The duration of paralysis is short,better preTA muscle strength and lesion segments are the three important factors affecting the effect of surgery.
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