Thigh weakness/foot drop after spine surgery

I have foot drop but it wasn't entirely clear what was causing it. An MRI revealed severe lumbar stenosis and a lumbar fusion surgery was recommended because of the acute onset of foot drop. An EMG/NCS revealed the foot drop was likely the result of peroneal nerve dysfunction.

I have not done the lumbar fusion surgery that was recommended 6 years ago for severe lumbar stenosis. The neurosurgeon now says the lumbar fusion will help my pain symptoms but my foot drop isn't likely to improve.

@luamiller First, let me welcome your participation on Connect. I am a spine surgery patient for cervical canal stenosis. I experienced foot drop when my spinal cord was getting pressure from a disc osteophyte complex in the central canal. I do also have a bulging lumbar disc. My foot drop was intermittent. When muscle spasms were straightening my spine in my neck, it caused pressure and foot drop. When my physical therapist worked on me to correct the neck curve as best she could, the foot drop resolved. This is how it was before I had any spine surgery. The other time I had foot drop was immediately after a whiplash from a traffic accident that caused all of this. That lasted about a month, and it was around 20 years until my spine condition later required surgery. There has been no foot drop since my cervical surgery several years ago.

Foot drop can be caused by a cervical or a lumbar spine problem. It just depends on if the same pathway is affected as it passes through the spinal cord. The spinal cord floats in fluid and can move around and that can also cause symptoms to be intermittent or reproducible with specific movements, posture, or neck position. My very first symptom of cervical stenosis was a pain in my ankle like a dog was biting me, and it happened only when I turned my head to the side. If I straightened my neck, it went away. As time and stenosis progressed, I was no longer able to turn symptoms on and off with body position, and my surgery was about 3 years after that first symptom.

Have you had a recent evaluation of your cervical spine or imaging? Have you discussed this with your surgeon?

Thank you for your response. I did discuss it with my surgeon & his PA after my follow-up appointments as well as last summer. They seem to want me to give it more time. My foot drop isn't a typical foot drop in the sense that I can move my foot, but more rather is it steming from the weakness in my thigh and I am toe dragging and a foot slap when I walk. My surgery was fall of 2021, I am fused from L1-S1.

That is exactly how my foot drop is. I would say it is very typical for foot drop.

My foot doesn't flop around or anything. I can still walk reasonable well. I just can't stand on my tippy toes very well. When the surgeon asks me to hold my foot up while he gently pushes it down, I have little or no strength to hold my foot up. I have no pain in my foot but it is weak and numb like it is asleep.

An electromyogram (EMG) and nerve conduction study (NCS) was done to "delineate the damage" as it was phrased. These tests were also done to try to determine what was causing my foot drop.

Any type of nerve damage takes time to improve. Doctors generally say to wait a year to see if it gets better. They especially say this when they don't think they can help the situation.

My foot hurts when I don't wear my bracing. I'm sure it is from dragging my foot thru. They haven't suggested any EMG testing or anything. I think they are wanting it to go away 🙂

My AFO brace ends up hurting my foot more than anything else. I wear the brace when I want to walk for exercise but not all the time.
https://www.flintrehab.com/afo-brace-for-foot-drop/
I have tried a couple of different types of braces but decided to not bother anyone about finding me a better one.

I was in an exercise class and a therapist noticed I was having a problem with my gait. She told me I had foot drop. She was very nice and picked out a brace for me. It worked the best of any so I just use that one when I think about it.

My daughter says I won't ever be able to sneak up behind her no matter how hard I try.

Several years ago I had a Spinal Tap at JFK Hospital in Boynton Beach Fl.
The Tech twice missed the vein. Terrible pain. That night Sciatica in left leg. Terrible Pain.
Foot Drop came next, Then Neuropathy and numbness came.
I may have Sinal Stenosis. Could it be the cause of all my problems.

Foot Drop Anyone?

A lot of people with spinal cord injury/myelopathy have foot drop. Mine is fairly minor so I do not wear a brace. There are good hinged braces available for people with foot drop — occupational or physical therapists could help you with this.

Hello @gba, I moved your message to the "Thigh weakness/foot drop after spine surgery" discussion, https://connect.mayoclinic.org/discussion/thigh-weaknessfoot-drop-after-spine-surgery/.

@donnadrury shared her experience with you. I'd also like you to meet @dadcue and @luamiller who have also shared their foot drop experience in this discussion.

@gba, could you share a bit more about your foot drop? If you are comfortable, what brought on your foot drop and how are you currently coping?