Kertmen H, Gürer B, Yimaz E R, Sekerci Z
Department of Neurosurgery, Ministry of Health Diskapi Yildirim Beyazit Education and Research Hospital, Ankara, Turkey.
Asian J Neurosurg. 2015 Apr-Jun;10(2):123-5. doi: 10.4103/1793-5482.144596.
Foot drop is defined as the weakness of the foot and ankle dorsiflexion. Acute unilateral foot drop is a well-documented entity, whereas bilateral foot drop is rarely documented. Slowly progressing bilateral foot drop may occur with various metabolic causes, parasagittal intracranial pathologies, and cauda equina syndrome. Acute onset of bilateral foot drop due to disc herniation is extremely rare. Here we present two cases of acute bilateral foot drop due to disc herniation. The first patient was a 45-year-old man presented with acute bilateral foot drop, without any sign of the cauda equina syndrome. Lumbar magnetic resonance imaging of the patient revealed L4-5 disc herniation. To our knowledge, this is the first presented case of acute bilateral foot drop without any signs of cauda equina syndrome caused by L4-5 disc herniation. The second patient was a 50-year-old man who was also presented with acute bilateral foot drop, and had T12-L1 disc herniation with intradural extension. Also this is the first presented case of T12-L1 disc herniation with intradural extension causing acute bilateral foot drop. We performed emergent decompressive laminectomy to both of the patients and extrude disc materials were excised. Both of the patients were recovered with favorable outcome.
足下垂定义为足部和踝关节背屈无力。急性单侧足下垂是一种有充分文献记载的病症，而双侧足下垂则鲜有记载。缓慢进展的双侧足下垂可能由多种代谢原因、矢状窦旁颅内病变和马尾综合征引起。因椎间盘突出导致的急性双侧足下垂极为罕见。在此，我们报告两例因椎间盘突出导致急性双侧足下垂的病例。首例患者为一名45岁男性，表现为急性双侧足下垂，无任何马尾综合征迹象。该患者的腰椎磁共振成像显示L4 - 5椎间盘突出。据我们所知，这是首例由L4 - 5椎间盘突出导致急性双侧足下垂且无任何马尾综合征迹象的病例。第二例患者为一名50岁男性，同样表现为急性双侧足下垂，患有T12 - L1椎间盘突出并伴有硬膜内延伸。这也是首例由T12 - L1椎间盘突出并伴有硬膜内延伸导致急性双侧足下垂的病例。我们对两名患者均进行了急诊减压椎板切除术，并切除了突出的椎间盘组织。两名患者均康复良好。
