Questions posted in the Neurology and Neurosurgery Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: Diagnosis and Treatment

Forum: Neurology Forum
Topic: Movement


My condition is the inability to lift my left leg and also 'drop foot'. Of the 3 back surgeries I've had in as many years, the first was for a herniated disc, and for 4-5 months the problem was gone. When it returned, the 2nd surgery was for a pinched nerve...the drop foot was gone, but the leg still won't lift enough to walk without weaving or without pain in the hip and back. The 3rd surgery did'nt improve the leg condition, and the drop foot came back. My neurosurgeon agrees that there is a problem, but doesn't know where else to look or what to do. Can you
offer me any hope or any answers? I had to resign my job almost 2 years ago, so the mental and emotional stress are really taking a toll. My doctor seems reluctant to refer me to any facility, but I need help with a diagnosis or treatment. The problem exists, so there must be a way to find the cause - even if there's no cure. Can you help?



Thanks for your question. Your symptoms can be explained by a number
of different lesions at the spinal cord or peripheral nerves. The muscles
that "lift" your legs (also called hop flexors) are innervated by nerve
fiber that exit the spinal cord at the L2 level (second lumbar vertebrae);
the muscle that dorsiflex your ankle (i.e. Tibialis anterior) in innervated
by a L5 level nerve). Because of the anatomical arrangement of these
groups of nerve fibers the lesion(s) can be located at the spinal canal
(therefore, lesions at L2 and L5), or one or both of the lesions can
be located outside of the spinal canal and at the peripheral nerve.

A "drop foot" is a fairly common result of a Common Peroneal nerve lesion.
This nerve is very superficial when it "wraps around" the "head" of the
fibular bone - roughly a couple of inches below the lateral aspect of the
knee. Particularly, for thin people that crosses their legs while seated
a compression-type lesion of the common peroneal nerve is quite frequent.

An EMG/NCS study would be helpful in locating the site of your lesion
and help the planning of the next therapeutic step - it can, for instance,
make a distinction whether the "drop foot" is because of an intra-canal
lesion or a peripheral nerve lesion.

I hope this information is helpful. Best of luck.

This information is provided for general medical education purposes only.
Please consult your doctor regarding diagnostic and treatment options.




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