Rapid-Fire Presentations

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

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.

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