Evidence map›Paper›PMID 39961861›Full record

SynthesisEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2025

Prognostic factors and surgical outcomes of foot drop secondary to lumbar degenerative disease: A systematic review and Individual patient data meta-analysis.

Asfand Baig Mirza, Abbas Khizar Khoja, Vishvan Naidu, Suleyman Ullah, Jack Plume, Priyanka S Iyer, Arsalan Baig, Sami Rashed, Feras Fayez, Chaitanya Sharma and 11 more

Abstract readSystematic ReviewMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Foot drop secondary to lumbar degenerative disease: a scoping review of recovery patterns, predictors, and research gaps.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2026
    Review
  2. Article
  3. Article
  4. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

21 authors.

Asfand Baig Mirza *Department of Neurosurgery, Queens Hospital, Romford, London, UK. asfand.mirza@nhs.net.ORCID 0000-0003-4177-9615
Abbas Khizar Khoja *Department of Neurosurgery, Queens Hospital, Romford, London, UK.
Vishvan NaiduFaculty of Life Sciences and Medicine, GKT School of Medicine, King'S College London, London, UK.
Suleyman UllahFaculty of Life Sciences and Medicine, GKT School of Medicine, King'S College London, London, UK.
Jack PlumeFaculty of Life Sciences and Medicine, GKT School of Medicine, King'S College London, London, UK.
Priyanka S IyerFaculty of Life Sciences and Medicine, GKT School of Medicine, King'S College London, London, UK.
Arsalan BaigDepartment of Trauma and Orthopaedics, Barking, Havering and Redbridge University Hospitals, Romford, UK.
Sami RashedDepartment of Neurosurgery, Queens Hospital, Romford, London, UK.
Feras FayezDepartment of Neurosurgery, King'S College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
Chaitanya SharmaFaculty of Life Sciences and Medicine, GKT School of Medicine, King'S College London, London, UK.
Amisha VastaniDepartment of Neurosurgery, Queens Hospital, Romford, London, UK.
Jandira TrindadeDepartment of Neurosurgery, Royal London Hospital, London, UK.
Amr FahmyDepartment of Orthopaedic Spine Surgery, mid and South, Essex NHS Foundation Trust, Basildon, UK.
Ahmed SeragAI Innovation Lab at Weill Cornell Medicine, Doha, Qatar.
Irfan MalikDepartment of Neurosurgery, King'S College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
Gordon GrahovacDepartment of Neurosurgery, King'S College Hospital NHS Foundation Trust, Denmark Hill, London, UK.
Ali Nader-SepahiDepartment of Neurosurgery, University Hospital Southampton, Southampton, UK.
Jonathan BullDepartment of Neurosurgery, Royal London Hospital, London, UK.
Alexander MontgomeryDepartment of Neurosurgery, Royal London Hospital, London, UK.
Babak ArvinDepartment of Neurosurgery, Queens Hospital, Romford, London, UK.
Ahmed-Ramadan SadekDepartment of Neurosurgery, Queens Hospital, Romford, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo determine the surgical outcomes and prognostic factors in patients with unilateral footdrop secondary to lumbar disc herniation undergoing surgical intervention.

methodsA comprehensive literature search was conducted across PubMed, Ovid, Scopus, and Web of Science for relevant literature from inception to 26 March 2023. The quality of the studies was evaluated per the NHLBI Quality Assessment Tools. Articles reporting individualised patient data in adult patients with unilateral foot drop secondary to lumbar degenerative disease were included. For inclusion, patients had to be managed with a single-level lumbar discectomy ± laminectomy.

resultsThe search returned 1037 studies, of which 96 suitable individual patient records met inclusion criteria with 66 included in meta-analysis. Multivariate analysis revealed that the following factors significantly affected the extent of post-operative motor recovery: Patient age (P = 0.045); Duration of symptoms (P = 0.01); Degree of pre-operative weakness (P = 0.004); and Extent of recovery within the first three months after surgery (P = 0.006). Patients surgically managed within 6 weeks of symptom onset are up to 6 times more likely to demonstrate greater recovery at the final follow-up (median = 12 months). When comparing patients with a pre-operative MRC grade of 0 (complete loss of motor function), those with a pre-operative MRC grade of 2/5 or above were significantly more likely to have greater recovery of post-operative motor function. The extent of recovery within three months post-op also significantly predicted the final outcome. Patients who demonstrate recovery of at least 1 or more MRC power grades at 3 months have approximately a 30-fold probability of continuing to improve compared to those who demonstrate no improvement at this time point.

conclusionOur analysis demonstrates that (1) An age ≤ 47, (2) Duration of symptoms ≤ 6 weeks, (3) Pre-operative MRC grade (2/5 or 3/5) and (4) an improvement of at least one MRC grade within 3 months of surgery are positive prognostic factors for motor recovery in patients with unilateral footdrop secondary to lumbar disc herniation undergoing surgical intervention.

Indexed as

DiskectomyGait Disorders, NeurologicIntervertebral Disc DegenerationIntervertebral Disc DisplacementLumbar VertebraeHumansLaminectomyPrognosisRecovery of FunctionTreatment OutcomeLaminectomyLumbar degenerative diseaseLumbar discectomyPrognostic factorsSystematic reviewUnilateral footdrop

Identifiers

PMID39961861

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.