Foot Drop

A foot drop is a term used to describe the inability to extend or dorsiflex the foot.  This type of weakness classically results in the inability to walk without tripping because the toe of the foot is not able to clear the floor after taking a step.  Foot extension weakness is directly due to weakness of the tibialis anterior muscle that is responsible for this motor function.

Causes of Foot Drop

Causes of foot drop are due to conditions that affect innervation of the tibialis anterior muscle.  Common causes include L4/L5 radiculopathy or peroneal nerve palsy.  L4/L5 radiculopathy occurs in the lower lumbar spine and is usually due to a herniated disc that impinges upon the exiting L4 or L5 nerve root.  Peroneal nerve palsy on the other hand, is due to distal peripheral nerve injury in the leg just above the ankle.  Often, this occurs due to compression of the peroneal nerve by a tendon or a tumor or due to trauma.  To differentiate between radiculopathy versus peroneal nerve palsy your physician should check for foot inversion and gluteus medius weakness (internal rotation of flexed hip)–both are spared and peroneal nerve palsy and both should be involved with radiculopathy.  Other causes of foot drop include lumbar plexus injury, peripheral neuropathy, parasagittal brain lesions, spinal cord injury, muscular dystrophy, or ALS.

Treatment for Foot Drop

WARNING: If patients or healthcare providers suspect a foot drop, urgent neurosurgical evaluation is warranted!

Treatment for foot drop caused by a herniated lumbar disc usually involves surgical microdiscectomy.  In mild cases, nonsurgical management may be initially pursued.  This may include pain medication and physical therapy.  However, in cases of acute or abrupt foot drop patients should be immediately evaluated by a neurosurgeon.  Sudden and significant motor weakness may require urgent surgical intervention in an effort to prevent permanent disability.  Treatment for foot drop caused by peroneal nerve injury or peroneal nerve palsy may involve surgery that effectively decompresses the nerve from the offending tendon or tumor.  All cases of foot drop should be thoroughly investigated so that the specific cause can be identified and appropriately treated.

At Princeton Neurological Surgery Dr. John Lipani is a board-certified fellowship trained specialist in complex and minimally invasive spinal surgery in New Jersey.  Dr. Lipani specializes in the surgical treatment for foot drop caused by herniated discs, tumors, or other causes. Dr. Lipani treats patients from around the world, New York, Pennsylvania, and New Jersey including locally from Princeton, New Brunswick, Hopewell, Pennington and communities throughout Somerset, Middlesex, Ocean, Burlington, Monmouth and Mercer Counties for foot drop. Dr. Lipani offers image guided spine surgery approaches for foot drop treatment, tailored to the needs of each patient. For state-of-the-art foot drop treatment, call or email us to schedule a consultation at our offices in Hamilton, New Jersey or Bridgewater, New Jersey!

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