Abstract

TREND OF SPINAL CORD COMPRESSION SYNDROMES: AN ANALYSIS OF 529 CASES IN A TERTIARY HOSPITAL, IN NORTH-WESTERN NIGERIA

Balarabe S. A.* and Halima M.

ABSTRACT

Background: Neurological disorders contributed to ninety two( 92) million Disability-Adjusted Life Years (DALYs) in 2005 and is projected to increase to 103 million in 2030. In view of this considerable morbidity associated with neurological diseases, there is need to pay critical attention to the trends of and frequency of chronic neurological diseases such as spinal cord syndromes, so as to mitigate their unfavourable outcomes. The socio-demographic and epidemiological transition in developing countries has changed the pattern of morbidity and mortality among patients with neurological diseases. The change in paradigm has brought non-communicable diseases to the forefront of the health care delivery system. Spinal cord is the major conduit through which motor and sensory information travels from the periphery(body) to the centre (brain) and visa-vasa.Therefore, lesions affecting the spinal cord are associated with meriad of motor and sensory abnormalities, through compressive (eg.Tuberclosis of the spina) or non-compressive (eg. tranverse myelopathy) mechanisms. This study tends to shed some light on compressive myelopathies in the North-Western region of Nigeria. Material and Method: The Neurology unit inpatient and outpatient database from 2010 to 2014 was used to identify patients with a diagnosis of spinal cord compression syndrome. Demographic and other relevant data were obtained for all clinic visits and admissions, that included age, sex and comorbid conditions. The data were analyzed for Frequency distribution, Age, Sex as well as cross tabulation of Age and Sex, Sex and diagnosis. Result: There were a total of 529 cases of spinal cord compression syndromes seen and managed by the unit during the study period, which constituted 20.9% of all the neurological disorder in the same period. Males were 277(52.4%), Females were 252(47.6%). With the male to female ratio 1.1:1. The mean age was 37.7 with SD± 17.8, and age range of 17-88 year. The common cord compression syndromes were: Tuberculosis (TB) of the spine which accounted for 186(35.2%), followed by Cervical Spondylosis 175(33.1%), Lumber Spondylosis 124(23.4%), Disc prolapse 17(3.2%), Combined Cervical and Lumbar Spondylosis and Cervical Injury accounted for 8(1.5%) each, Cauda-equina syndrome 4(0.8%), Spondylolisthesis 3(0.6%), Cervical ankylosing spondylitis 2(0.4%), metastatic prostatic carcinoma and thoraco-lumbar spondylosis accounted for 1(0.2%) each. Conclusion: This study revealed that tuberculosis of the spine is the most predominant cord-compression syndrome. Therefore, clinicians practicing in developing countries like Nigeria must be aware of the many potential etiologies for spinal cord diseases , and should pursue an order, efficient, and cost-effective evaluations based on the patient's clinical history and examinations. This call for all hands to be on deck among policy makers in the region. Additionally, there is equally the need for modern neuro-diagnostic facilities such as Magnetic Renance Imaging (MRI), to be made available in our various hospitals in the region.

Keywords: Spinal Cord Syndrome, Retrospective Study, Cord Compression Syndrome, North-Western Nigeria, Relative Frequency.