Non-traumatic spinal cord diseases in Ibadan, Nigeria: aetiology and prognostic factors

In this hospital based study, we analysed the clinical records of 104 patients having various spinal cord diseases seen between 1988 and 1993 with a view to delineating diagnostic and prognostic features. The patients comprised 80 males and 24 females with a mean age of 45 years. The mean duration of disease at presentation was 11 months and the average duration of stay in hospital was five months. Spondylotic myelopathy (31 subjects) predominated. It showed cervical predilection, infrequent sphincteric dysfunction and low ESR. Tuberculous disease of the spine (26 subjects) was next in frequency. The presentation of the TB cases was similar to those of neoplastic causes but the latter had a worse prognosis. There was a predilection for the dorsal spine and a high ESR. Myelitis occurred in the younger age group, showed dorsal spine predilection and relatively low ESR. The prognostic factors include duration of disease at entry, duration of hospital stay, presence of complication, motor power above grade three and absence of flacidity. The preventable causes of death include: deep vein thrombosis with subsequent pulmonary embolism and septicaemia.