Epidemiological profile, surgical management and early outcomes of lumbar arthrodesis for degenerative and isthmic lumbar spine disease: a 110-patient cohort study at the Department of Neurosurgery, Ouakam Military Hospital, Dakar, Senegal

Abstract Background Degenerative lumbar spine disease (disc herniation, lumbar spinal stenosis and degenerative spondylolisthesis) and isthmic spondylolisthesis are common reasons for neurosurgical consultation and an increasingly frequent indication for instrumented fusion worldwide. Data on the surgical management of these conditions remain scarce in sub-Saharan Africa. This study aimed to describe the epidemiological profile, surgical management, and early outcomes of lumbar arthrodesis for degenerative and isthmic lumbar spine disease in our department. Methods This was a retrospective, descriptive and analytical study of a cohort of 110 patients who underwent lumbar arthrodesis for degenerative or isthmic lumbar disease at the Department of Neurosurgery of Ouakam Military Hospital. Epidemiological, clinical, surgical and outcome parameters (visual analog scale [VAS] score, MacNab criteria, Bridwell fusion grade) were analyzed. Results Mean age was 44.9 ± 12.0 years (range 25–72) with a male-to-female ratio of 1.75 (70 men/40 women). Median time to consultation was 6 months (mean 18.4 months). A neurological deficit was present in 21.8% of patients. CT was performed in all patients and MRI in 58.2%. Disc herniation (49.1%) and spondylolisthesis (45.5%; isthmic n = 30, degenerative n = 20) were the predominant diagnoses. All patients were operated on through an exclusive posterior approach with interbody cage placement in 43.6% of cases (PLIF or TLIF). Mean VAS score decreased from 6.3 ± 1.3 preoperatively to 2.3 ± 1.4 postoperatively ( p < 0.001). According to MacNab criteria, functional outcome was excellent or good in 94.5% of cases. Radiological fusion was satisfactory (Bridwell grade I–II) in 81.8% of cases. The complication rate was 28.8% among the 104 patients with available data; no deaths were reported. Clinical outcomes were comparable between posterolateral fusion alone and interbody fusion, with no significant difference in VAS improvement or MacNab functional outcomes. However, interbody fusion was associated with a significantly higher rate of radiographic fusion according to the Bridwell classification. Conclusion In our setting, lumbar arthrodesis for degenerative and isthmic lumbar disease provides satisfactory early functional outcomes, comparable to international data, despite frequently delayed presentation and limited access to MRI.