Examining the Anatomy, Pathophysiology, and Clinical Presentation of Lower Extremity Neurologic Deficits: A Spine Surgeon's Guide to Foot Drop.

Abstract

Foot drop is relatively common and can be a notable source of patient dissatisfaction and even potential litigation. For the spine surgeon evaluating such a patient, the natural inclination is to investigate a spinal etiology; however, foot drop can develop from a multitude of distinct insults along several locations, extending from the cerebral cortex to the leg musculature itself. In-depth understanding of the relevant anatomy implicated in foot drop, as well as the pathologies that may impede those structures, is paramount to expanding a surgeon's differential diagnosis. Specific physical examination findings and diagnostic tests can further delineate the etiology of a patient's foot drop, guide treatment options, and help determine a patient's prognosis. Finally, clinical cases highlight how the application of a thorough grasp of relevant anatomy, a comprehensive physical examination, and appropriate diagnostic studies can accurately localize foot drop and enhance clinical decision making.