Bilateral foot drop post laminectomy

[smjsmj]

Just hoping for some thoughts/ ideas on a patient. Post laminectomy bilateral foot drop is preventing safe mobility - actually there is no muscle activity below the knee. These muscular symptoms were not there before the surgery - spinal stenosis was causing snesation changes but no muscle changes. Post op initially no sensation, that is back....how long is it likely for muscle activity to return. he is working hard, and could likely ambulate safely with AFO's but this is not ideal for the patient.

thanks for any thoughts.

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[physiobob]

He needs a urgent review with the surgeon first. Once we know why he has these new symptoms of a bilateral footdrop when it wasn't there before then we can comment. This really is urgent!

[smjsmj]

Surgeon aware. Not overly concerned and saying we just have to wait for activity to return.

[physiobob]

Has the surgeon given a reason why there is now a bilateral foot drop when there was not prior to the surgery? Once might expect swelling, haematoma etc. Could also be poor surgery. I would hassle for the reason and perhaps see if nerve conduction tests are available to monitor the situation.

It is true this can happen post surgery and it does usually resolve over time (could be 12-18 months though) but there are many reasons for this and one would want to rule out anything that could be corrected by going in again now to sort it out. Is there a post OP MRI?

p.s. Where is the Location "Anon"?

[smjsmj]

Thanks for the advice. I kept location anonymous to ensure confidentiality for the pt.