Introduction: Drop foot may result from nerve root compression at L4–L5 (20%), L5–S1 (41.5%), or isolated L5 (25.2%). Transforaminal Microdiscectomy (TFMD) is a minimally invasive procedure that offers an alternative to open or endoscopic surgery in managing drop foot cases.

Subjects and Methods: This observational cohort study involved 21 patients with lumbar Herniated Nucleus Pulposus (HNP) presenting with drop foot and scheduled for TFMD. Three patients did not complete the treatment protocol, leaving 18 subjects for analysis. Exclusion criteria included malignancy, scoliosis, compression fracture, multiple sclerosis, prior spinal decompression surgery, refusal of treatment, or withdrawal from the study. Pain intensity was assessed using the Numerical Rating Scale (NRS), and motor strength was evaluated before the procedure, at week 2, and at month 3 post-TFMD.

Results: A total of 18 subjects were analyzed (33.3% male; mean age 59.4±7.9 years). Most had bilateral drop foot (66.7%) and underwent TFMD at two levels (61.1%). Significant motor strength improvement was observed in unilateral cases (p=0.018), but not in bilateral cases (p=0.223). NRS scores showed a significant reduction across all subjects, decreasing from 2.89 to 1.08 at month 3 (p<0.001).

Conclusion: TFMD is effective in reducing pain and improving motor function, particularly in unilateral drop foot cases. This procedure represents a promising therapeutic alternative with a low risk of complications.

Trianggoro Budisulistyo, Sp.N, Subsp.NN (K), Dipl.of Pain, RA is a Neurologist with a Subspecialty in Pain Neurology who specifically diagnoses and treats diseases related to pain complaints due to peripheral and autonomic nerve disorders.