Slow Non-Traumatic Spinal Cord Compression in Children: Diagnosis and Management in Sub-Saharan Africa, Case of Senegal at the Fann National University Hospital Center (Dakar)
Introduction: Slow non-traumatic spinal cord compression in children is a diagnostic and therapeutic emergency. In our milieu the arrival of new imaging techniques such as magnetic resonance imaging, has considerably improved the diagnosis and prognosis of this condition. The aim of this work is to give the first view of Slow non-traumatic spinal cord compression in children by describing the epidemiological, clinical, therapeutic aspects and to know the etiologies in our context. Patients and Methods: This study is a retrospective, concentric study involving 57 children under 18 years old, collected at the Neurosurgery department of the National University Hospital Center (CHNU) of FANN, from January 1, 2010, to December 1, 2022. Results: The annual frequency was 4.38 cases. The average age was 9 years old. Adolescents represent 65% of the population. There was a male predominance with a sex ratio of 1.85 (37/20). Clinically, motor deficit, vesico-sphincteric disorders and lower back pain were the main reasons for consultation. The predominant FRANKEL classification stages were stages A. Standard radiography and spinal CT were performed in 4 and 31 children respectively. Only 26 children received spinal cord MRI. Topographically, the lesions predominated at the dorsal (34 cases) and cervical (10 cases) levels. Etiologically, infectious causes predominated with 27 cases followed by tumor causes (16 cases). 52 children (91.22%) benefited from surgical treatment. The evolution is favorable for 80% and stationary for 5%. Four children presented complications of recumbency: 2 cases of suppuration of the operating wound and 2 cases of thrombophlebitis. 20 children benefited from post-operative physiotherapy. Conclusion: Slow non-traumatic spinal cord compression in children remains a diagnostic emergency. In Senegal, infectious etiologies remain predominant. It would be important to strengthen primary and secondary prevention and improve the socio-economic conditions of the population.
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