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  • RF10 The effectiveness of surgical intervention pertaining to painless foot drop caused by lumbar disc herniation: a systematic review and meta-analysis

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RF10 The effectiveness of surgical intervention pertaining to painless foot drop caused by lumbar disc herniation: a systematic review and meta-analysis
  1. Jack Wellington1,2,
  2. Vera Al Baaklini1,3,
  3. Andrea Fanti1,4,
  4. Syed Hasham Ali1,5,
  5. Shivaranghan Thayamanavan1,6,
  6. Alaa Al Jishi1,7,
  7. Morteza Khoshhal1,8,
  8. Jana Kotaich1,9,10,
  9. Amjad Hamza1,11,
  10. Neelofar Iqbal1,12,
  11. Aysha Rafeeque1,
  12. Hadi Farhat1,13,
  13. Jorge Eduardo Reyna Rodriguez1,14,
  14. Devanshi Jariwala1,
  15. Hsu Jen Yu1,15,
  16. Muqadas Munir1,16,
  17. Estephany Nicolr Fuentes Rocabado1,17,
  18. Claudio Bernucci1,4 and
  19. Saleem Abdulrauf1,18
  1. 1Abdulrauf University of Neurosurgery, California, USA
  2. 2Bradford Teaching Hospitals NHS Foundation Trust, Bradford, UK
  3. 3Faculty of Medicine, Saint George University of Beirut, Beirut, Lebanon
  4. 4ASST Papa Giovanni XXIII, Lombardy, Italy
  5. 5Department of Medicine, Dow University of Health Sciences, Karachi, Pakistan
  6. 6South West Acute Hospital, Western Health and Social Care Trust, Enniskillen, UK
  7. 7Beirut Arab University, Beirut, Lebanon
  8. 8University of Debrecen, Debrecen, Hungary
  9. 9Lebanese University, Rafic Hariri University Campus, Hadath, Lebanon
  10. 10MEDICA Research Investigation, Beirut, Lebanon
  11. 11American University of Beirut, Beirut, Lebanon
  12. 12Dow Medical College, Karachi, Pakistan
  13. 13University of Balamand, Beirut, Lebanon
  14. 14National School of Medicine and Homeopathy, IPN, Mexico
  15. 15University of Szeged, Szeged, Hungary
  16. 16University of Health Sciences, Lahore, Pakistan
  17. 17Universidad Mayor de San Simón, Bolivia
  18. 18George Washington University, Washington D.C., USA

Abstract

Introduction Since painless foot drop is an extremely rare presentation of lumbar degenerative disease, there is currently a paucity of evidence on management and outcomes which causes a lack of standardized treatment provided to patients. Our systematic review aimed to determine the effectiveness of surgical intervention concerning conservative management in patients with painless foot drop.

Methods A systematic database search was performed across PubMed/MEDLINE and Cochrane Library, between October 2022 and January 2023. Only studies reporting on painless foot drop due to degenerative lumbar disease in adults were included. Foot drop was determined by assessing the Medical Research Council (MRC) power grade of foot dorsiflexion, specifically defined as a Manual Muscle Testing score of 3 or lower were included.

Results 578 articles were screened and only 6 met the inclusion criteria. A significant association was demonstrated between the timing of the decompressive surgery (i.e., early decompressions performed better than delayed), MRC grade pre-operatively, and postoperative recovery. Relationships between age at surgery and higher rates of recovery could not be established.

Conclusion This is the first systematic review to explore the outcome of surgical versus conservative therapy for painless foot drop. The findings of this systematic review indicate that the duration of foot drop weakness and MRC grade before intervention were strong predictors of surgical outcome.

http://creativecommons.org/licenses/by-nc/4.0/

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjsit-2024-IDEAL.25

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