Zaher Dannawi

Background/Objectives: There exists a need to capture the current landscape of the literature for lumbar decompression on muscle strength, as measured by manual muscle testing (MMT), in cohorts with foot drop secondary to lumbar degenerative disease (LDD). Methods: A literature search of PubMed, EMBASE, CINAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus, and Web of Science was conducted from each database’s inception to 21 March 2025. Eligible studies reported patients with LDD-related foot drop treated surgically. This review was registered in PROSPERO (ID: CRD42024550980). Results: A total of 20 studies comprising 918 patients met the eligibility criteria, with most cases attributable to lumbar disc herniation (79% of patients, 95% CI: 0.72–0.85, I² = 96%) or spinal stenosis (22% of patients, 95% CI: 0.15–0.30, I² = 96%). Following surgery, 60% of patients (95% CI: 0.44–0.75, I² = 97%) achieved an MMT score of 4–5, indicating recovery, while 82% (95% CI: 0.76–0.88, I² = 89%) demonstrated an improvement of at least one MMT grade. No improvement was seen in 18% of patients (95% CI: 0.12–0.24, I² = 89%). For pain, the preoperative VAS mean was 5.91 (95% CI: 4.21–7.60, I² = 99%), while the postoperative mean was 1.00 (95% CI: −0.05–2.06, I² = 99%). Overall complications were reported at 1% (95% CI: −0.00–0.02, I² = 0%). Conclusions: Lumbar decompression achieves clinically meaningful recovery of LDD-induced foot drop. However, this meta-analysis highlights the overlooked portion of patients who will not respond, providing a sequential approach for future investigation of these cohorts through foundational evidence of the present literature base.

Purpose: To investigate the effects of prolonged taping on patellofemoral pain (PFP). Methods: A literature search of PubMed, EMBASE (Elsevier), CiNAHL, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Scopus, and Web of Science was conducted from database inception to 28 June 2024. Eligible studies reported PFP patients over 18 years of age undergoing an exercise protocol with additional taping that was maintained outside of exercise sessions (PROSPERO ID: CRD42023422792). Results: Seventeen studies met the eligibility criteria with 348 patients (n = 221 Kinesio taping, McConnell taping n = 127). For pain, the Kinesio baseline scores were 5.73 (95% CI: 4.73–6.73, I²= 97%), and the McConnell scores were 5.05 (95% CI: 3.82–6.28, I² = 95%). At the combined recent follow-up, the Kinesio scores were 2.14 (95% CI: 1.11–3.18, I² = 98%), and the McConnell scores were 2.58 (95% CI: 0.79–4.37, I² = 98%). For functionality, the Kinesio baseline scores were 64.19 (95% CI: 53.70–74.68, I² = 98%), and the McConnell scores were 68.02 (95% CI: 65.76–70.28, I² = 0%). At the combined recent follow-up, the Kinesio scores were 84.23 (95% CI: 79.44–89.01, I² = 95%), and the McConnell scores were 86.00 (95% CI: 83.82–88.17, I² = 0%). The minimum clinically important difference (MCID) was achieved for both modalities at 6 weeks and beyond. Conclusions: Prolonged taping that remains on PFP patients outside of isolated exercise sessions appears beneficial in reducing pain and increasing functionality.

The traditional treatment for patients with radiculopathy and myelopathy caused by degenerative disc disease was anterior cervical discectomy and fusion (ACDF). However, a documented complication of ACDF is adjacent segment degeneration (ASD). An alternative that was developed was total disc replacement (TDR). The aim of this study was to determine and compare the short- and medium-to-long-term outcomes after a TDR or ACDF. A retrospective review of 154 patients who had single and two-level ACDFs and 90 TDRs performed by a single surgeon between 2011 and 2017 was conducted. Parameters for comparisons include both radiological evaluation and patient-reported outcome measures (PROMS) at six weeks, one year, and two years postoperatively. The Neck Disability Index (NDI) and the visual analogue scale (VAS) for neck and arm pain are used to evaluate pain, function, patient satisfaction, and overall clinical success. TDR and ACDF showed significant improvement in NDI and VAS when compared to pre- and post-operatively at both six weeks (p<0.05 & P=0.032, respectively) and two years (p<0.05 & 0=0.026, respectively). TDR vs. ACDF showed no significant difference (p<0.05). VAS scores after ACDF showed improvement from 13.41 to 3.94 at two years (p<0.001). TDR showed similar scores of 12.5 to 3.55 (p<0.001). The radiological fusion rate at 12 or 24 months showed no significant difference between the two groups. There were two cases that required re-operation after ACDF (1.2%), and two that required TDR (2.2%). Both TDR and ACDF lead to clinically significant improvements in pain and function scores. We did not find a statistically significant difference in NDI and VAS in the neck and arm. The results are in agreement with others' assessments of these two treatment modalities. Our conclusions supplement the literature about these operative options for degenerative disc disease of the cervical spine and are a useful addition to the armamentarium in the assessment of patients with degenerative pathology of the c-spine.