Lumbar spinal stenosis in an outpatient clinic in Lome, Togo

The purpose of this study was to determine the frequency and semiological characteristics of lumbar spinal stenosis in patients attending the rheumatology outpatient clinic at the Lomé Teaching Hospital. Medical records of 13081 patients seen over a 15-year period were retrospectively reviewed. A total of 760 (5.8%) had lumbar spinal stenosis. There were 556 women (73.2%) and 204 men (26.8%) with a mean age at onset of 52 years (range, 25 to 65 years). The mean duration of lumbar spinal stenosis was 4.5 years. The main symptom was nerve root pain in 712 (93.7%) involving one root in 248 cases and more than one root in 464. Most patients in this group were between the ages of 35 and 65 years. Pain was relieved by bending the spine forward in 456 patients (60%) and claudication was present in 643 patients (84.6%). Walking distance was less than 500 meters in 491 patients and more than 500 meters in 152. Pain was exacerbated by extension of the spine in 475 patients (62.5%) and associated with paresthesia in 532 patients (70%) and sphincter dysfunction in 155 patients (20.4%). Roentgenography of the lumbar spine was performed in 504 patients and showed abnormalities in 475. The most common radiographic abnormality was degenerative disk disease (n = 251). Myelography was performed in 56 patients, showing a rosary-like image in 31 cases and disk herniation in 23. Lumbar spinal stenosis in Black Africa appears to be more common than in industrialized countries and to affect mainly women in the fifth decade of life. The semiological profile of lumbar spinal stenosis appeared to be similar in Black Africa and industrialized countries.