Objective: To describe the epidemiological, clinical, diagnostic and therapeutic features of degenerative spine diseases managed in Chad. Methods: A retrospective, descriptive study conducted in the Rheumatology Department of the National Referral Hospital and the Internal Medicine Department of the Hospital of Refondation in Chad, from January 2019 to December 2024. We included patients with a degenerative spinal condition confirmed clinically and radiographically (Kellgren & Lawrence). Results: Of 6196 records, 3880 (62.6%) involved degenerative disease. The mean age was 58.4 years (25 - 85), and 65% were women. Low back pain accounted for 57.8% of consultations, followed by neck pain (23.6%) and thoracic pain (12.1%). Radiographic findings mainly included disc degeneration (65%), osteophytes (52%) and disc space narrowing (43%). Management relied on analgesics, NSAIDs, physical therapy, infiltrations, and surgery in 4% of cases. Conclusion: Degenerative spine diseases are the leading cause of spine-related consultations in Chad. Their functional burden calls for integrated prevention and management strategies adapted to local resources.
References
[1]
Gallucci, M., Limbucci, N., Paonessa, A. and Splendiani, A. (2007) Degenerative Disease of the Spine. Neuroimaging Clinics of North America, 17, 87-103. https://doi.org/10.1016/j.nic.2007.01.002
[2]
Prescher, A. (1998) Anatomy and Pathology of the Aging Spine. European Journal of Radiology, 27, 181-195. https://doi.org/10.1016/s0720-048x(97)00165-4
[3]
WHO Scientific Group on the Burden of Musculoskeletal Conditions at the Start of the New Millennium (2003) The Burden of Musculoskeletal Conditions at the Start of the New Millennium. World Health Organization Technical Report Series, 919, 1-218.
[4]
Ekman, M., Jönhagen, S., Hunsche, E. and Jönsson, L. (2005) Burden of Illness of Chronic Low Back Pain in Sweden. Spine, 30, 1777-1785. https://doi.org/10.1097/01.brs.0000171911.99348.90
[5]
Maniadakis, N. and Gray, A. (2000) The Economic Burden of Back Pain in the UK. Pain, 84, 95-103. https://doi.org/10.1016/s0304-3959(99)00187-6
[6]
Fianyo, E., Oniankitan, O., Tagbor, K.C., Kakpovi, K., Houzou, P., Koffi-Tessio, V.E.S., et al. (2017) Coût de la lombalgie commune en consultation rhumatologique à Lomé. La TunisieMédicale, 95, 168-171.
[7]
Chen, Z., Luo, R., Yang, Y. and Xiang, Z. (2021) The Prevalence of Depression in Degenerative Spine Disease Patients: A Systematic Review and Meta-Analysis. European Spine Journal, 30, 3417-3427. https://doi.org/10.1007/s00586-021-06977-z
[8]
Wettstein, M., Eich, W., Bieber, C. and Tesarz, J. (2018) Pain Intensity, Disability, and Quality of Life in Patients with Chronic Low Back Pain: Does Age Matter? Pain Medicine, 20, 464-475. https://doi.org/10.1093/pm/pny062
[9]
Ouédraogo, D., Ntsiba, H., Tiendrébéogo/Zabsonré, J., Tiéno, H., Bokossa, L.I.F., Kaboré, F., et al. (2013) Clinical Spectrum of Rheumatologic Diseases in a Department of Rheumatology in Ouagadougou (Burkina Faso). Clinical Rheumatology, 33, 385-389. https://doi.org/10.1007/s10067-013-2455-4
[10]
Stein, M. and Davis, P. (1990) Rheumatic Disorders in Zimbabwe: A Prospective Analysis of Patients Attending a Rheumatic Diseases Clinic. Annals of the Rheumatic Diseases, 49, 400-402. https://doi.org/10.1136/ard.49.6.400
[11]
Louw, Q.A., Morris, L.D. and Grimmer-Somers, K. (2007) The Prevalence of Low Back Pain in Africa: A Systematic Review. BMC Musculoskeletal Disorders, 8, Article No. 105. https://doi.org/10.1186/1471-2474-8-105
[12]
Mijiyawa, M., Koumouvi, K., Bellow, A., N’Dakena, K. and Doury, P. (1992) Pathologie dégénérative du rachis en consultation à Lomé (Togo). Revue du rhumatisme et des maladies ostéo-articulaires, 59, 797-800.
[13]
Houzou, P., Oniankitan, O., Kakpovi, K., Koffi-Tessio, V., Tagbor, K.C., Fianyo, E., et al. (2013) Profil des affections rhumatismales chez 13 517 patients ouest-africains. La TunisieMédicale, 91, 16-20.
[14]
Nakua, E.K., Otupiri, E., Dzomeku, V.M., Owusu-Dabo, E., Agyei-Baffour, P., Yawson, A.E., et al. (2015) Gender Disparities of Chronic Musculoskeletal Disorder Burden in the Elderly Ghanaian Population: Study on Global Ageing and Adult Health (SAGE WAVE 1). BMC Musculoskeletal Disorders, 16, Article No. 204. https://doi.org/10.1186/s12891-015-0666-3
[15]
Stewart Williams, J., Ng, N., Peltzer, K., Yawson, A., Biritwum, R., Maximova, T., et al. (2015) Risk Factors and Disability Associated with Low Back Pain in Older Adults in Low-and Middle-Income Countries. Results from the WHO Study on Global Ageing and Adult Health (Sage). PLOS ONE, 10, e0127880. https://doi.org/10.1371/journal.pone.0127880
[16]
Borenstein, D. (1996) Epidemiology, Etiology, Diagnostic Evaluation, and Treatment of Low Back Pain. Current Opinion in Rheumatology, 8, 124-129. https://doi.org/10.1097/00002281-199603000-00007
[17]
Nguyen, C., Sanchez, K., Roren, A., Palazzo, C., Falcou, L., Drapé, J., et al. (2016) Anatomical Specificities of the Degenerated Cervical Spine: A Narrative Review of Clinical Implications, with Special Focus on Targeted Spinal Injections. Annals of Physical and Rehabilitation Medicine, 59, 276-281. https://doi.org/10.1016/j.rehab.2015.12.006
[18]
Freund, M. and Sartor, K. (2006) Degenerative Spine Disorders in the Context of Clinical Findings. European Journal of Radiology, 58, 15-26. https://doi.org/10.1016/j.ejrad.2005.12.005
[19]
Rat, A. and Guillemin, F. (2004) Épidémiologie et impact médico-économique des cervicalgies. Revue du Rhumatisme, 71, 653-658. https://doi.org/10.1016/j.rhum.2004.05.005
[20]
Mäkela, M., Heliövaara, M., Sievers, K., Impivaara, O., Knekt, P. and Aromaa, A. (1991) Prevalence, Determinants, and Consequences of Chronic Neck Pain in Finland. American Journal of Epidemiology, 134, 1356-1367. https://doi.org/10.1093/oxfordjournals.aje.a116038
[21]
Brattberg, G., Thorslund, M. and Wikman, A. (1989) The Prevalence of Pain in a General Population. The Results of a Postal Survey in a County of Sweden. Pain, 37, 215-222. https://doi.org/10.1016/0304-3959(89)90133-4
Vogt, M., Simonsick, E., Harris, T., Nevitt, M., Kang, J., Rubin, S., et al. (2003) Neck and Shoulder Pain in 70-to 79-Year-Old Men and Women: Findings from the Health, Aging and Body Composition Study. The Spine Journal, 3, 435-441. https://doi.org/10.1016/s1529-9430(03)00150-5
[24]
Goode, A.P., Freburger, J. and Carey, T. (2010) Prevalence, Practice Patterns, and Evidence for Chronic Neck Pain. Arthritis Care & Research, 62, 1594-1601. https://doi.org/10.1002/acr.20270
[25]
Adebajo, A. and Davis, P. (1994) Rheumatic Diseases in African Blacks. Seminars in Arthritis and Rheumatism, 24, 139-153. https://doi.org/10.1016/s0049-0172(05)80007-1
[26]
Aggarwal, R., Liao, K., Nair, R., Ringold, S. and Costenbander, K.H. (2009) Anti-Citrullinated Peptide Antibody Assays and Their Role in the Diagnosis of Rheumatoid Arthritis. Arthritis Care & Research, 61, 1472-1483. https://doi.org/10.1002/art.24827
[27]
Alonge, T., Adebusoye, L., Ogunbode, A., Olowookere, O., Ladipo, M., Balogun, W., et al. (2017) Factors Associated with Osteoporosis among Older Patients at the Geriatric Centre in Nigeria: A Cross-Sectional Study. South African Family Practice, 59, 87-93. https://doi.org/10.1080/20786190.2016.1272248
[28]
Amor, B., Dougados, M. and Mijiyawa, M. (1990) Critères de classification des spondylarthropathies. Revue du rhumatisme et des maladies ostéo-articulaires, 57, 85-89.
[29]
Aspray, T.J., Prentice, A., Cole, T.J., Sawo, Y., Reeve, J. and Francis, R.M. (1996) Low Bone Mineral Content Is Common but Osteoporotic Fractures Are Rare in Elderly Rural Gambian Women. Journal of Bone and Mineral Research, 11, 1019-1025. https://doi.org/10.1002/jbmr.5650110720
[30]
Bija, M.D., Luma, H.N., Temfack, E., Gueleko, E.T., Kemta, F. and Ngandeu, M. (2018) Patterns of Knee Osteoarthritis in a Hospital Setting in Sub-Saharan Africa. Clinical Rheumatology, 37, 2731-2736.
[31]
Dougados, M., Nakache, J.P. and Gueguen, A. (1996) Criteria for Generalized and Regional Osteo-Arthritis. Revue du Rhumatisme, 63, 569-575.
[32]
Woolf, A.D. and Pfleger, B. (2003) Burden of Major Musculoskeletal Conditions. Bulletin of the World Health Organization, 81, 646-656.
[33]
Fianyo, E., Lekpa, F.K., Apetse, K., Limazié, Y.M., Tchaou, M. and Oniankitan, O. (2026) Models of Low Back Pain at Diagnosis in a Community Hospital in Lomé, Togo. Open Journal of Rheumatology and Autoimmune Diseases, 16, 25-35. https://doi.org/10.4236/ojra.2026.161003
[34]
Hoy, D., Bain, C., Williams, G., March, L., Brooks, P., Blyth, F., et al. (2012) A Systematic Review of the Global Prevalence of Low Back Pain. Arthritis & Rheumatism, 64, 2028-2037. https://doi.org/10.1002/art.34347
[35]
Garba, H.A.A., Bouchrane, R., Bah, A., Aziz, H.H.A., Niasse, M. and Saïdou, D. (2025) Spinal Disorders in Sub-Saharan Africa: A 10-Year Hospital Experience from Senegal. Open Journal of Rheumatology and Autoimmune Diseases, 15, 181-190. https://doi.org/10.4236/ojra.2025.154021
[36]
Woolf, A.D., Erwin, J. and March, L. (2012) The Need to Address the Burden of Musculoskeletal Conditions. Best Practice & Research Clinical Rheumatology, 26, 183-224. https://doi.org/10.1016/j.berh.2012.03.005
