Background and Aim: Tandem Spinal Stenosis (TSS) can be defined as simultaneous stenosis of two distinct spinal (cervical, thoracic and lumbar) areas. Characterized by an association of the spinal, radicular and medullary signs of the limbs, the planning of his surgery remains controversial. We reported the one that was set up on the cases observed at the Brazzaville Academic Hospital. Methods and Materials/Patients: A retrospective study of 16 patients operated for TSS, from June 2009 to May 2019, was conducted. We analyzed the demographic, clinical, paraclinical, therapeutic and evolutionary data of these patients. Results: For ten years, a total of 16 patients (9 men and 7 women) with SST have been received. The average age was 57 years (ranged 41-72 years). The signs evolved for 17.6 months (13 and 30 months). These were lombo-sciatalgias in 15 cases, signs of medullary compression: cervical in 14 cases and thoracic in 2 cases. Medical imaging had objective 13 cervico-lumbar associations, two thoraco-lumbar associations and one cervico-thoracic. The surgery was performed in one stage in two cases and two stages in 14 cases. These were laminectomies for lumbar and thoracic disorders, discectomy or somatotomy in the cervical segment. The order of surgical management was cervico-thoraco-lumbar (cranio- caudal order). Signs improved in 13 patients and stabilized in 3 patients. Conclusion: TSS is not uncommon. It should be researched in a patient with bifocal spinal and radiculo-medullary signs. Their early surgical treatment, in one or two stages, yields satisfactory results.
Introduction: Pediatric Neurosurgery is a growing specialty in its own right worldwide. Its practice in sub-Saharan Africa remains confronted with many challenges, notably the absence of a pediatric neurosurgeon, the lack of a dedicated service and the absence of multidisciplinary pediatric collaboration (neuroanesthesist, neurologist, oncologist and psychotherapist). The objective of this preliminary study is to describe the practice of pediatric neurosurgery at the HSMEBG and to present perspectives for its improvement. Methods: This is a retrospective, monocentric, descriptive study covering the period from March 2021 to March 2022 at the Pediatric Surgery Department of the HSMEBG. Résults: During the study period, 50 children were hospitalized for a neurosurgical condition. The sex ratio was 1.77. The average age was 6 years with extremes of 2 weeks and 16 years. Most children were from the emergency department (46%). Computed tomography (CT) was performed in 35 patients (70%), magnetic resonance imaging (MRI) in 4% and plain radiography in two patients (8%). Malformative, traumatic (cranial and spinal) and tumor pathology were the most frequent with 42%, 36% and 12% respectively. Twenty-six patients were operated (52%). We recorded one postoperative infection (2.5%). The overall mortality was 8% (N = 4). Conclusion: This preliminary study allowed us to identify the epidemiological and clinical profile of the patients treated in our context as well as the therapeutic approach. Malformative pathology remains the most frequent, followed by traumatic and tumor pathology.
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