Epidemiological, Clinical and Therapeutic Aspects of Spinal Pathology in Military People in a Country at War

Abstract

Introduction: Lumbar and sciatic pain are frequent motives of disability in military people in Mali. As spine surgery isn’t recognized enough, our study aims to analyze etiologies, epidemiology, clinical features and surgical standards in order to improve troop abilities. Methodology: Our descriptive and retrospective study has included 31 operated military patients who underwent medical or surgical procedures between 2010 and 2018 in the Military Neurology/Neurosurgery Unit and Mère-Enfant Hospital Neurosurgery department. Results: Among 553 seen in consultation, fifty percent were between 30 and 50 years old. Main motive was sciatic pain (65.5%). Seventy eight percent of our patients were field militaires and sub-officers, and 83.2% were males. All of them have benefited a CT scan or MRI with medical treatment in rheumatology or neurology. Thirty-one patients underwent spine surgery and were included in the study, so 6% (mean age: 43.52 years, 90.3% males). Lumbar spine surgery represented 54.8% of cases with lumbar canal stenosis in 64.5% of cases. It appeared that spondylolisthésis with isthmic fracture was frequent (12.9%), and traumatic cervical spine fractures were dominant in 2012. Instrumented arthrodesis was performed for 41.9% of patients, lumbar discectomy for 32.3% and laminectomies for 22.6%. Degenerative etiology was found in 77.4% of cases and we’ve noticed a good outcome in 93.5% of operated cases. Conclusion: Spinal pathology in military people in Mali is in relation with training, weight carrying and transport conditions on tough terrain. Traumatic traffic injuries are the most common even in war time.