Progressive foot drop caused by below-knee compression stocking after spinal surgery

Abstract

Foot drop is a debilitating condition, which may take many months to recover. The most common cause of foot drop is a neuropathy of the common peroneal nerve (CPN). However, similar symptoms can be caused by proximal lesions of the sciatic nerve, lumbar plexus or L5 nerve root. We present a rare and unusual case of a patient undergoing spinal surgery at the level of L5/S1 and presenting 4 weeks postoperatively with progressive foot drop. Although the initial concern was a postoperative lesion at L5, the cause for this delayed presentation was extrinsic compression of the CPN at the level of the fibular head by a tight-fitting below-knee thromboembolic deterrent stocking. Compression stockings are widely used in all branches of medicine and in the community. It is important to recognize this potential cause of progressive foot drop early as it is preventable by simple measures, which can significantly reduce morbidity.