Neurogenic hallux valgus. A rare complication of spinal surgery.

INTRODUCTION

Post-surgical lumbar spine syndrome is the result of failed or unsuccessful back surgery. It is defined as failure to relieve pain and disability in the lower back and extremities following surgery. This case report suggests inclusion of neurogenic hallux valgus to the list of potential complications following failed lumbar spine surgery.

CASE REPORT: A severe unilateral hallux valgus deformity with an irreducible dislocation of the metatarsophalangeal joint due to complete wasting of the abductor hallucis muscle was diagnosed in a 73-year-old woman admitted for a hip fracture. The patient reported that the deformity developed after a failed lumbar spine surgery, which included decompression and stabilization of L2-S1 with posterior instrumentation 6 years previously. The deformity progressively deteriorated over a 3-year-period. Three months following the hip fracture surgery, the patient went through a neurological examination and an electrophysiological study. The findings indicated that the left hallux valgus deformity most likely developed because of the abductor hallucis muscle wasting due to S1 nerve root injury secondary to the failed lumbar spine surgery.

CONCLUSION

Post-surgical lumbar spine syndrome may be a reasonable causative etiology of a severe unilateral hallux valgus deformity with an irreducible dislocation of the metatarsophalangeal joint due to complete wasting of the abductor hallucis muscle secondary to S1 nerve root injury.