Herniated disk at the L4-5 level is a common cause of foot drop. Foot drop is weakness bending your foot upwards towards your nose. This may range from mild to severe. As the weakness increases the foot tends to slap down when walking or must be lifted up high to prevent it from snagging on the floor. The weakness may be from dysfunction of the nerve from compression or from nerve damage. The damage may increase the longer the foot drop is present. Usually early surgery is recommended to prevent damage.
The purpose of surgery is to remove the disk and “un-pinch” the nerve. Normal back surgery mainly decompresses the L5 nerve root, but endoscopic transforaminal surgery (such as JOIMAX) enters through the foramen and opens up the foramen taking pressure off the L4 nerve in the foramen and L5 nerve in the spinal canal. Therefore second surgery or surgical approach is not needed. Other advantages include pen sized scope, very small skin incision, minimal muscle damage, same day surgery and quick recovery.
If the foot drop continues after surgery then there may be continued compression at that level or maybe unrecognized compression at the L5-S1 foramen or more likely nerve damage. Nerve damage may improve over months or years or may be permanent.
Sometimes scar tissue is found on post-operative MRI in people who are not improving. Removal of the scar tissue will unlikely help your nerve improve. Continued foot drop after surgery is likely due to preoperative nerve damage.
For more information please contact Executive Spine Surgery at 908-452-5612.