Operative Results of Lumbar Disc Herniation and Lumbar Canal Stenosis with Foot Drop.

概要

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Eighteen cases of lumbar disc herniation (LDH) and thirty two cases of lumbar canal stenosis (LCS) with foot drop were reviewed. The average age at the time of operation was 40.4 years (LDH), and was 59.2 years (LCS). Follow-up period after the operation averaged 30.6 months (LDH), and 31.9 months (LCS).We devised two types of classification according to neurological symptoms, namely cauda equina or nerve root type with operative methods selected for each type. Love's method was mainly performed for LDH, laminectomy for cauda equina lesions, and fenestration for neve root lesions.Operative results were assesed using the JOA score and Hirabayashi's method. Average recovery rate was 84.6% for LDH, and 61.9% for LCS. The main factors influencing the prognosis were morbidity period, bladder bowel disturbance, and the strength of the tibial anterior muscle. Three cases of LDH and nine cases of LCS remained with foot drop postoperatively.Surgery was not as effective for the recovery of foot drop, but was useful for treatment of intermittent claudication and lower extremity pain. Because the symptoms are progressive, the operation should be done as soon as possible even with elderly patients.
西日本整形・災害外科学会の論文