Bilateral Foot Drop Without Cauda Equinae Syndrome Due To L4-L5 Disc Prolapse: A Case Report

Aims: Lumbar disc prolapse in elderly patients at L4-L5 level presenting as bilateral foot drop without other features of cauda equine syndrome has been rarely reported. Methods: This is a report of an elderly lady with presenting with sudden backache and radiating pain to both legs with bilateral foot drop. There was no urinary or bowel involvement. Clinical examination showed a bilateral L5 radiculopathy with normal perianal sensation. Investigations excluded other causes of bilateral foot drop. MRI revealed a L4 L5 central disc prolapse causing severe canal stenosis at that level. Results: Patient underwent L4 L5 laminectomy and discectomy. At follow up a month later her bilateral foot drop had improved to normal and she was independent. Conclusion: This case highlights the fact that though very rare, L4 -L5 disc prolapse can manifest with bilateral foot drop and surgery can produce a good result.