Comparative Studies of the Incidence of Surgically Treated Symptomatic Prolapsed Lumbar and Sacral Intervertebral Discs in Males in Basel (Switzerland), Jamaica (West Indies) and Imo and Ebonyi States (South East Nigeria)

Objective and Background: There are various postulated possible causes of surgically symptomatic prolapsed intervertebral discs in the lumbar and sacral regions. They may be acting singularly or collectively. Yet, these factors have not been satisfactorily confirmed. Therefore, the continued search for predeterminants of this lesion, in males, is hereby being encouraged, and, our views are being presented.Method: From 1971 to 2009, eighty eight (88) locations of symptomatic prolapsed intervertebral discs in the lumbar and sacral regions in 68 males were treated by us in Basel (Switzerland): 67, in Imo and Ebonyi States (Nigeria): 1 and none in Jamaica (West Indies). The clinical features were those of lower back pains, with or without radiation into the lower extremities, sensory loss and paresis of the limbs. There was a case of loss of urinary bladder and ano-rectal control. All lesions were confirmed through cauda-equinograms and treated under general anaesthsia in knee-chest position (MECCA position). The patients were followed for 3 to 6 months postoperatively.Results: In Basel (Caucasian population only), there were 84 locations in 67 patients, 4 locations in 1 patient in Imo and Ebonyi States (African population only) and none in Jamaica (mixed population). Their ages ranged from 23 to 70 years in Basel and the only patient in Nigeria was 67 years old. The patients all tolerated the procedures very well and there were no complications postoperatively.Conclusion: We found surgically treated symptomatic prolapsed lumbar and sacral intervertebral discs in males to have occurred more in Basel, Switzerland than in Imo and Ebonyi States of Nigeria and/or Jamaica, West Indies.Key Words : Comparative, Studies, Symptomatic, Prolapsed, Intervertebral, Discs, Males, Switzerland, Nigeria, Jamaica

Surgically Treated Symptomatic Prolapsed Lumbar and Sacral Intervertebral Discs in Females: A Comparative Study of Incidence and Causative Factors and Treatment

Background and Objective: There are various postulated possible causes of surgically symptomatic prolapsed intervertebral discs in the lumbar and sacral regions. They may be acting singularly or collectively. Yet, these factors, which could vary in different environments, have not beensatisfactorily confirmed. The intention of this study is to share the experience of the author in the occurrence, possible causative factors, and treatment of surgically symptomatic prolapsed lumbar and sacral intervertebral discs in females, and to compare this experience in Switzerland, Nigeria, and Jamaica using surgery records for a period of over 39 years.Materials and Methods: Records of these cases were examined and analyzed with the intent of comparing the frequency of occurrence and possible causative factors of this lesion in some countries. Results: There were 60 locations in 51 patients in Basel (Caucasian population only), 4 locations in 1 patient in Imo and Ebonyi States (African population only), and none in Jamaica (mixed population). The patients’ ages ranged from 19 to 71 years in Switzerland, and the only patient in Nigeria was 49 years old.Conclusion: The study revealed that surgically treated symptomatic prolapsed lumbar and sacral intervertebral discs in females occurred more in Basel, Switzerland, than in Imo and Ebonyi States of Nigeria and none occurred in Jamaica, West Indies. Racial differences, certain sporting/recreational activities, smoking, and type of profession could have contributed to the development of this disease.Keywords: Females, possible causes, prolapsed disc