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Cervical Myelopathy: Diagnostic Aspects, Surgical Treatment and Evolution of Patients Operated upon in Yaounde

Open Journal of Modern Neurosurgery 2024年第1期14卷 72-82页

作者： Bello Figuim Djoubairou Ben Ousmanou Oumarou Haman Nassourou ndome toto orlande Amadou Tidjani Djientcheu Vincent de Paul Yaounde Central Hospital Faculty of Medicine and Biomedical Sciences of the University of Yaounde 1 Yaounde Cameroon Yaounde Military Hospital Faculty of Medicine and Pharmaceutical Sciences of the University of Douala Douala Cameroon Douala General Hospital Faculty of Medicine and Pharmaceutical Sciences of the University of Douala Douala Cameroon Higher Institute of Health Sciences Université des Montagnes Bangangté Cameroon

Introduction: Although cervical myelopathy is the most common degenerative cervical spine pathology in adults, the indications and approaches of surgical treatment have not yet been clearly defined in the literature. Very few studies exist regarding these aspects in our setting, and they are mostly outdated. This study aimed to describe the diagnostic aspects, current surgical treatment with technical improvements, and progression in patients. Patients and Methods: We conducted a multicentre retrospective descriptive study over a 10-year period between January 2011 and January 2020 in three referral centres in Yaoundé. All patients who underwent surgery for cervical myelopathy were included. Results: Fifty-two patients were recruited. The rate of operated cervical myelopathies among all degenerative spinal pathologies was 14.05%. The M/F sex ratio was 3/1, and the average age was 52 ± 10 years. All included patients had gait problems, 90.38% demonstrated motor deficiency, and 67.30% experienced at least three levels of compression. Surgery was decided based on the Nurick grade;a posterior approach was applied to 86.54% of patients. Postoperative progression showed a neurological improvement of 82% with an average follow-up of 4 years. Conclusion: In this study, the patients who underwent surgery were relatively young, their clinical presentations were mostly advanced, and surgical management showed good results in well-selected cases.

关键词： Cervical Myelopathy Diagnosis Treatment Evolution Cameroon

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Surgical Management of Lumbar Spinal Canal Stenosis with Instrumentation at the Yaounde Central Hospital: Comparison of Unilateral versus Bilateral Pedicle Screw Fixation Combined with Transforaminal Lumbar Interbody Fusion

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Open Journal of Modern Neurosurgery 2024年第3期14卷 179-189页

作者： Orlane toto ndome Nassourou Oumarou Haman Dimitri Fogue Jean Bruno Ndoumou Ronaldo Fonju Anu Indira Baboke Vincent De Paul Djientcheu Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Neurosurgery Douala General Hospital Douala Cameroon Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Department of Neurosurgery Yaounde General and Central Hospitals Yaounde Cameroon Cameroon Academy of Young Scientists Yaounde Cameroon

Introduction: The choice of adopting unilateral pedicle screw fixation or using bilateral pedicle screw fixation in lumbar spinal stenosis remains controversial. In our context, very few studies have been performed comparing the clinical effectiveness of unilateral versus bilateral fixation in the surgical management of lumbar spinal canal stenosis. Objective: Evaluate the impact on quality of life and clinical efficacy of unilateral spondylodesis compared to bilateral spondylodesis in the surgical management of lumbar spinal canal stenosis at the Yaounde Central Hospital. Methods: This was a retrospective descriptive cross-sectional study for a period of 4 years, from June 2015 to June 2019. It involved all patients operated for lumbar canal stenosis and who underwent spondylodesis or spinal fusion at the neurosurgery department of the Yaounde Central Hospital. Results: A total of 68 participants were recruited during our study period. 32 (47%) of the study population were in the 50 - 60 age group, with a mean age of 56.98 years ranging from 41 to 75 years. Females, housewives and farmers were the most affected. In our study, 72% of patients had unilateral spondylodesis and 28% had bilateral fusion. Preoperatively, 71% of patients had insurmountable pain, refractory to medical treatment. At 3 months postoperatively, 73.7% of patients with bilateral setup had moderate pain compared to 69% of those with unilateral setup. At 6 months postoperatively, 79% of patients with bilateral fusion had mild pain compared to 82% of patients with unilateral setup. At 1 year postoperatively, all patients had mild pain. Preoperatively, 66.2% of patients were unable to walk and 19.1% of patients were bedridden according to the Oswestry score. At 3 months postoperatively, 10.2% of patients with unilateral setup were unable to walk compared to 10.5% of patients with bilateral fixation, while 67.3% of patients with unilateral fixation had moderate disability compared to 52.6% of patient

关键词： Lumbar Spinal Canal Stenosis Instrumentation Surgery Quality of Life

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Current Epidemiology of Intracranial Metastases in Two University Teaching Reference Hospitals of the Town of Yaounde, Cameroon: Analysis of 35 Cases Recorded in the Neurosurgery Departments

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Open Journal of Modern Neurosurgery 2024年第2期14卷 124-136页

作者： Nassourou Oumarou Haman Ronaldo Fonju Anu Orlane ndome toto Bello Figuim Indira Baboke Marguerite Gwladys Nzedzou Vincent de Paul Djientcheu Department of Surgery and Specialties Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Department of Neurosurgery Yaounde General Hospital Yaounde Cameroon Department of Surgery and Specialties Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Neurosurgery Douala General Hospital Douala Cameroon Department of Neurosurgery Garoua General Hospital Garoua Cameroon

Background: The incidence of intracranial metastases (ICMET) has been steadily rising, and its frequency with respect to primary brain tumours is relatively high. Objective: The objectives of this study were to elucidate the current epidemiology and describe the clinical, diagnostic and therapeutic features of ICMET in Yaounde. Method and findings: A descriptive cross-sectional study was done in the neurosurgery departments of the General and Central Hospitals of Yaounde during the period from January 2016 to December 2022. We included all medical booklets of patients admitted for a tumoral intracranial expansive process with our target population being patients with histological evidence of ICMET, and did a retrospective inclusion of data using a pre-established technical form aimed at collecting sociodemographic data, clinical data, paraclinical data, and the treatment procedures. Analysis was done using the SPSS statistical software. A total of 614 cases of intracranial tumors were included among whom 35 presented histological evidence of ICMET. This gives a frequency of 5.7%. The sex ratio was 0.94, the mean age was 55.68 +/- 14.4 years, extremes 28 and 86 years and the age range 50 - 59 was affected in 28.57% of cases. The clinical presentation included signs of raised intracranial pressure (headache, blurred vision, vomiting) in 26 cases (74.3%), motor deficit 48.6%, seizures 17.1%. The mode of onset was metachronous in 71.4% and synchronous in 28.6%. The imaging techniques were cerebral CT scan in 82.9%, cerebral MRI in 40%, TAP scan in 22.9%. The metastatic lesions were supratentorial in 94.3% and single in 62.9%. The primary cancers found were breast cancer (31.4%), lung cancer (25.7%), prostate cancer (17.1%), thyroid cancer (5.7%), colon cancer (2.9%), and melanoma (2.9%). The therapeutic modalities were total resection (68.6%), radiotherapy (37.1%). Conclusion: Intracranial metastases are relatively frequent. There is a female sex predominance and the ag

关键词： Intracranial Metastases Epidemiology Yaounde

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Metastatic Spinal Tumors: Diagnostic Methods, Management and Prognosis at the Yaounde Central Hospital and Yaounde General Hospital

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Open Journal of Modern Neurosurgery 2024年第2期14卷 158-169页

作者： Nassourou Oumarou Haman Figuim Bello Orlane ndome toto Roland Ndouh Nchufor Nya Durand Bakop Ronaldo Foalou Anu Vincent de Paul Djientcheu Faculty of Medicine and Biomedical Sciences University of Yaounde 1 Yaounde Cameroon Neurosurgery Department Yaounde General Hospital Yaounde Cameroon Cameroon Academy of Young Scientists Yaounde Cameroon Department of Neurosurgery Garoua General Hospital Garoua Cameroon Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Department of Neurosurgery Douala General Hospital Douala Cameroon Facuty of Health Sciences University of Bamenda Bamenda Cameroon

Introduction: Metastatic spinal tumors (MST) refer to secondary involvement of the vertebral column by hematogenously-disseminated metastatic cells. They could affect either the bony structures or the spinal cords. Mechanical instability and neurologic deficits resulting from spinal cord compression are the most common manifestations. Surgical intervention remains the most effective treatment for about 20% of patients who present with spinal cord compression. The prognosis is relatively poor. This work has as objectives to describe: the diagnostic tools, the different modalities of management and the prognostic elements of spine metastasis. Methodology: We conducted an ambispective cross-sectional descriptive study;with retrospective data collection from January 2015 to December 2021 and prospective collection from January to April 2022 in the “Neurosurgery” unit of the Yaounde Central Hospital and the “Oncology and Neurosurgery” units of Yaounde General Hospital. Result: We included 101 patients. The M/F sex ratio was 1.66. The average age of the participants was 56.44 years (±14.19 SD) with a median of 58 years. Metastatic spinal tumors were discovered in 61.39% of patients with a previously known primary tumor and 21.78% of patients had newly discovered tumors. The neurologic examination revealed a vertebral syndrome in 79.21% of cases, radicular syndrome in 60.40% and sub-lesional syndrome in 59.89%. Sensory disorders accounted for 39.60% and sphincter disorders accounted for 34.65%. According to the degree of severity, the lesions were classified as Frankel E (37.62%) followed by Frankel D (21.78%). Metastatic lesions were mostly found at the thoracic vertebrae (68.25%) and lumbar vertebrae (22.22%). The most represented primary tumors were: prostate tumors (41.58%) and breast tumors (23.76%);followed by malignant hemopathies (15.84%). Computed-tomography scan (CT-scan) was the most frequent diagnostic imaging technique used (71.28%). Analgesic treatment mostly

关键词： Metastases Spinal Tumors Diagnosis Prognosis Spinal Cord Compression

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