Epidemio-clinical and therapeutic profile of non-traumatic medullary-radicular compressions at the University Hospital of Kinshasa

Abstract

Context and objectives. As the world's population ages, non-traumatic medullary-radicular compressions are becoming more common. This work aims to describe their epidemio-clinical and therapeutic aspects at the University Hospital of Kinshasa. Methods. It is a descriptive cross-sectional study from 2016 to 2022 concerning 61 cases. Variables of interest included: sex, age, cause, level of lesion, ASIA score, treatment, complications, and destination. Data were analyzed using SPSS 26 and STATA 16 software. Results. One hundred and twenty patients were operated on for medullary-radicular compression, including 61 non-traumatic (50.8%) and 59 traumatic (49.2%). Among the non-traumatic, 31 patients were male (50.8%) and 30 females (49.2%). The average age was 51.51 ± 14.21 years. Patients between the ages of 40 and 69 accounted for 68.8%. The annual curve was increasing. On admission, the clinical presentation was dominated by an incomplete neurological deficit (67.2%). The mean time to diagnosis was 188.57 days. Degenerative pathologies (63.9%) including 31 herniated discs (79.4%) and 8 cases of canal narrowing (20.6%) predominated, followed by tumors 14 (22.9%) half of which included metastases. The most performed surgical procedures included decompression laminectomy (26.2%), laminectomy-discectomy (24.5%) and laminectomy-arthrodesis (32.7%). The postoperative course was unremarkable in 67.2%, except for 15 cases of surgical site infection (24.6%) and 3 deaths (4.9%). ASIA score on dischached improved in 62.7% (p<0.001). Only 2 patients (9.8%) continued their treatment in a rehabilitation centre. Conclusion. Non-traumatic medullary-radicular compressions are frequent in the service, more caused by herniated discs and tumours. Both sexes are equally affected and the age group is ranging from 40 to 69 years. The neurological deficit is often incomplete cord injury. Laminectomy, discectomy and arthrodesis are commonly performed. The postoperative outcome is generally better.