Operated herniated disk and lumbar spinal stenosis in Togolese patients: anatomical aspects and results of surgical treatment

Objective: To determine the anatomical aspects and results of surgical treatment of herniated disk and lumbar spinal stenosis observed in the Rheumatology unit of CHU SO of Lomé. Patients and methods: This was a transversal study conducted on a series of patients cases admitted to the Rheumatology Unit of CHU SO of Lomé and who underwent surgery for a herniated disk or lumbar spinal stenosis. Results: One hundred and two patients (37 women, 65 men) were included in the study: 30 (8 women, 22 men) underwent surgery for a herniated disk and 72 (29 women, 43 men) for a lumbar spinal stenosis. Both diseases have occurred in individuals in the prime of age, 92 (90%) with an age between 40 and 60 years. The time between the intervention and the evaluation of the treatment was 9 years on average for the herniated disk and 13 years for the lumbar spinal stenosis. Herniated disk occurred in discs L4L5 and/or L5S1. Lumbar spinal stenosis was showing a rosary image. The responsible factors for the narrowing were hypertrophy of the yellow ligament, posterior interapophysis osteoarthritis and degenerative disc disease. The outcome of surgical treatment was satisfactory in 29 of the 30 patients operated on for herniated disk, and 70 of the 72 were operated on for lumbar spinal stenosis. It has resulted in the disappearance of the nerve root pain and the resumption of normal activity. Low back pain requiring the use of analgesics was present in 40 of 102 patients (39%). Twenty patients, including 10 of the 15 who underwent fusion made use of a lumbar belt. Two patients were subjected to reoperation. Spondylodiscitis complicated the postoperative course of one female patient. Conclusion: Our results are very similar to those described in the literature both on anatomical aspect and therapeutical aspect