Nath Rahul K, Somasundaram Chandra
Texas Nerve and Paralysis Institute, Houston, TX.
Eplasty. 2023 Mar 10;23:e16. eCollection 2023.
Injury to the neurological pathway that enables ankle dorsiflexion is likely to cause foot drop. This pathway includes the motor cortex; lumbosacral plexus; and the sciatic, tibial, and peroneal nerves. Nerve damage typically occurs due to compression, entrapment, traction, or direct trauma to the nerve due to several etiologies. However, there are limited reports on the incidence, etiology, and factors associated with foot drop.
The authors reviewed their clinic's data from 1022 patients with foot drop from 2004 to present to determine the incidence, causes, and risk factors of foot drop. Microsoft Excel was used for descriptive statistical data analysis and graphing.
A total of 21 causes of foot drop were found. Of 1022 patients, 142 (13.9%) had foot drop after lumbosacral (LS) spine surgery, while 131 patients (12.8%) with LS spine complications who had not undergone surgery also reported foot drop. The LS spine complications and surgeries were influenced by age (median age, 63 and 55 years, respectively) and were marginally higher in male patients (54%). A total of 79 patients (7.8%) with foot drop had previously undergone hip replacement surgery. Older age (median age, 60 years) and female sex (85%) were risk factors for hip replacement surgery resulting in foot drop. In contrast, younger age and male sex were the risk factors for gunshot and stab wounds, injection drug use, drug or medication overdoses, and motor vehicle accidents resulting in foot drop.
Failed back surgery syndrome is the leading cause of foot drop after lumbosacral spine and hip replacement surgeries in both male and female older (median age, 60 years) patients. However, most (85%) of the foot drop patients in the present study who underwent hip replacement surgery were female patients. Sports and recreational activities, motor vehicle accidents, drug use, and violence are common causes of foot drop in younger male adults.
使踝关节背屈的神经通路受损很可能导致足下垂。该神经通路包括运动皮层、腰骶丛以及坐骨神经、胫神经和腓总神经。由于多种病因，神经损伤通常是由神经受压、卡压、牵拉或直接创伤引起的。然而，关于足下垂的发病率、病因及相关因素的报道有限。
作者回顾了其诊所自2004年至今1022例足下垂患者的数据，以确定足下垂的发病率、病因和危险因素。使用Microsoft Excel进行描述性统计数据分析和绘图。
共发现21种导致足下垂的病因。在这1022例患者中，142例（13.9%）在腰骶部（LS）脊柱手术后出现足下垂，而131例未接受手术但有LS脊柱并发症的患者（12.8%）也报告有足下垂。LS脊柱并发症和手术受年龄影响（中位年龄分别为63岁和55岁），男性患者的比例略高（54%）。共有79例（7.8%）足下垂患者此前接受过髋关节置换手术。年龄较大（中位年龄60岁）和女性（85%）是髋关节置换手术导致足下垂的危险因素。相比之下，年龄较小和男性是枪伤、刺伤、注射吸毒、药物或药物过量以及机动车事故导致足下垂的危险因素。
失败的脊柱手术综合征是老年（中位年龄60岁）男性和女性腰骶部脊柱及髋关节置换手术后足下垂的主要原因。然而，在本研究中，接受髋关节置换手术的足下垂患者大多数（85%）为女性患者。体育和娱乐活动、机动车事故、吸毒和暴力是年轻男性成年人足下垂的常见原因。
