Foot Drop in North Texas

Spinal stenosis is a condition that is characterized by a narrowing of the spinal canal. The narrowing can occur in a single location or multiple locations up and down the spinal column. At any of these areas, the narrowing can cause pain and loss of sensation or compromise muscle control, depending upon the amount of narrowing. While cervical stenosis is associated with pain in the neck, lumbar stenosis can cause significant leg pain. When the stenosis occurs in the lumbar region of the spine, pinching the nerve that runs down the leg to the foot, it can create a condition called foot drop. This condition gets its name because patients with this issue cannot flex their foot upward and hold it. This lack of muscle control means the patient’s gait is affected. Dr. Kendall Carll is a board-certified spine surgeon who has been practicing for more than 15 years in the North Texas area. Using his experience, he can help patients identify possible causes of spinal stenosis and investigate options to eliminate the problem or help patients effectively cope with symptoms.

The spinal vertebrae are shaped with an opening in the middle, so that when they stack on top of one another, they create a central canal for the spinal cord. Spinal nerve branches extend from the central spinal cord, jutting through gaps in between each of the stacked spinal vertebrae and extending to the left and right of the spine into the body. Spinal stenosis is a narrowing of the channel at the center of the spinal column. This narrowing is most often caused by degenerative disc disease or inflammation associated with arthritis. The inflammation can also be caused by bone spurs that may form on an individual vertebra, and these bone spurs can intrude into the spinal canal and touch or squeeze the spinal cord or the individual nerve branches. While some individuals may be born with congenital stenosis, inflammation from previous back surgeries can also cause some degree of stenosis.

Symptoms of spinal stenosis may vary depending on the location of the conditions, but they commonly include:

• Intervals of pain in the affected area
• Pain during strenuous activity or exercise
• Relief of pain upon sitting or lying down

Similarly, the symptoms of foot drop that can develop through lumbar spinal stenosis include the inability to lift the toes and drag the feet or toes when walking, which causes an abnormal gait.

Spinal stenosis, leading to foot drop, involves a narrowing of the spinal canal that pinches nerves. This condition, influenced by various risk factors, can profoundly affect mobility and quality of life. Understanding and addressing these factors early can help manage symptoms effectively and prevent progression. The main risk factors for spinal stenosis leading to foot drop include:

• Age: Typically affects individuals over 50
• Degenerative changes: Such as arthritis and degenerative disc disease
• History of spinal injuries: Previous injuries can predispose one to spinal stenosis
• Congenital spinal deformities: Some individuals are born with a narrower spinal canal
• Inflammatory conditions: Conditions like arthritis can cause inflammation and bone spurs in the spine
• Previous spinal surgery: Surgeries can sometimes lead to scar tissue that contributes to narrowing

To validate a diagnosis of spinal stenosis that may be causing foot drop, Dr. Carll will likely order an x-ray to rule out other problems, followed by an MRI or CT scan with myelogram to look at the soft tissues surrounding the spine and the nerves. For certain types of spinal stenosis, Dr. Carll may also suggest a selective nerve root block, which involves injecting an anesthetic into the suspect nerve to evaluate the level of relief.

Most cases of spinal stenosis and/or foot drop may be treated with a combination of specialized exercise, physical therapy, bracing to ensure the correct foot posture while walking, and spinal injections or oral medications to reduce inflammation that might be causing the stenosis. In some cases, Dr. Carll may also prescribe pain medications and muscle relaxers. 

For severe cases of spinal stenosis, Dr. Carll may recommend surgery to remove a small section of bone from the vertebra near where the spinal cord is being compressed. By removing a section of vertebral bone, the surgeon gives the spinal cord more room. Once that part of the procedure is complete and within the same surgery, the surgeon may fuse the affected vertebra to the vertebrae immediately above and below to stabilize that section of the spine. This will be done by screwing metal strips, one on the left side of the vertebrae and one on the right, to fasten all three vertebrae together. A bone graft is typically placed over the screws and strips. Eventually, new bone will grow over the screws and create a single solid, stable bone structure.

If a herniated disc is the cause of the spinal stenosis, a common solution is to remove the affected disc. In some cases, the surgeon may insert a metallic spacer or bone material to keep the vertebrae separated. Typically, these procedures are performed using minimally invasive techniques. Like the procedure above, the removal of the intervertebral disc is usually accompanied by a spinal fusion procedure.

Is lumbar spinal stenosis serious?
The seriousness of lumbar spinal stenosis depends on the stenosis severity. There are two types: central and lateral or foraminal stenosis, each affecting different parts of the spine and nerves. Severity determines the symptoms and treatment necessity. More severe cases may require significant interventions, including surgery.

What happens if lumbar spinal stenosis is left untreated?
Without treatment, lumbar spinal stenosis can progress, leading to severe nerve compression, impacting bowel and bladder control, mobility, and self-care. Delaying treatment could exacerbate these issues in some cases.

How does spinal stenosis affect the legs?
Spinal stenosis can lead to leg issues like weakness, numbness, pain, and muscle cramping due to nerve compression. This affects muscle and skin functions in the legs.

Board-certified spine surgeon Dr. Kendall Carll is passionate about providing his patients with immediate and long-term pain relief from complex back problems. After providing a thorough exam using the latest diagnostic technologies, he will develop a treatment plan that addresses your condition and diminishes the pain. If you are suffering from lower back pain and neurological complications that have resulted in spinal stenosis and/or foot drop, we invite you to contact Spine Care of North Texas to schedule an appointment to address these issues. Medical studies have shown that these conditions can be reversed if it is diagnosed and addressed early.