Long term postoperative results and quality of life after surgery for lumbar spinal stenosis in sub-sahara African countries, the case of Cameroon: A cross-sectional study

Abstract

Objectives: Lumbar spinal stenosis is a frequent and disabling disease of the elderly. However, the impact of its surgery on the long term (≥5 years) postoperative results and quality of life has not yet been evaluated in our setting.

Methods: The study population consisted of 224 patients operated between 2010 and 2017 at the Yaounde Central Hospital and the Yaounde General Hospital, of whom 33 were evaluated. Long term postoperative results were defined as reoperations, indication for reoperation, time elapsed to reoperation and control-X ray findings. Quality of life (QOL) was evaluated using the Oswestry Disability Index (ODI) and Numerical Pain Rating Scale (NRS), and compared to reported preoperative values. The one-way analysis of variance and Kruskal-Wallis tests were used for associations between patient characteristics and quality of life outcomes.

Results: Participants had a mean age of 57.3 years. 21% of participants were reoperated at least once, two years later on average due to reappearance of their clinical pictures. QOL significantly improved from being crippled (mean ODI 67.5%) and having severe pain (mean NRS 8) before surgery, to moderate disability (mean ODI 34.4%, p < 0.01) and moderate pain (means NRS 4, p < 0.01) five years later. Having large family support was the only factor independently associated with improved ODI and NRS (p = 0.01).

Conclusion: Lumbar spinal stenosis surgery is still beneficial five years later. Large cohort studies need to be conducted in our setting.

Keywords: Cameroon; Long term result; Lumbar spinal stenosis; Quality of life; Surgery.

Fig. 1

Flow chart of participants.

Fig. 2

Gantt chart of preoperative Oswestry Disability Index. The numbers within circles are the average reverse coded response scores per section.

Fig. 3

Gantt chart of current Oswestry Disability Index. The numbers within circles are the average reverse coded response scores per section.

Fig. 4

ODI and time elapsed since the first intervention.

Fig. 5

NRS and time elapsed since the first intervention.

Fig. 6

ODI distribution with respect to spondylodesis