Table XXV shows that the
discrepancies between the imaging results and the intraoperative results were
of the order of 6.3 and 24.4% concerning the medial and posterolateral disc
hernias respectively. A statistically significant link was noted between
subtypes of LDH and intraoperative diagnosis (p?0.001).
DISCUSSION
The clinical and para clinical profile of the Congolese from
Kinshasa suffering from lumbar disc herniation is that of a female individual
(55.6%), aged on average 44.7 #177; 12.3 years, obese (39.4%), complaining
mainly of lumbosciatic L5 (28.8%), more lateralized on the left (14.4%),
triggered by the lifting effort and whose neurological disorders were marked by
hypoesthesia and anesthesia respectively at (8, 1 et 7, 5%), associated with
motor disorders (49.4%).Conventional X-ray was pathological in 80.0%, CT in
100% and MRI in 30.0% of operated patients.The analysis of the results revealed
statistically significant links (69.3%) respectively between the medical
imaging results and the intraoperative results, then (82.9%) between the LDH
subtypes and the results of the inflammatory balance sheet. This led us to
point out some peculiarities of the environment, even if the study corroborates
the observations of the literature globally.
SOCIO-EPIDEMIOLOGICAL PROFILE
. The age
This study shows that 110 out of 160 patients (68.8%) were
aged between 31 and 50 years old. The mean age was 44.7 #177; 12.3 years with
extremes ranging from 16-79 years. LDH was overwhelmingly a pathology of young
adults. The latter would generally be exposed to heavy work, incriminated in
the pathogenesis of LDH. Our results are very close to those found in the
literature. Indeed, LDH lumbosciatica occur most often in young adults aged 30
to 50 years [16]. Some small variations were noted according to the series, but
most often, the age of the patients at the time of the diagnosis is 50 % of the
times between 36 and 55 years [17-18]. At CNHU Hubert Maga of Cotonou, Tononhi
studies showed an average age of 44.9 years [16]. Tchuindjang found that the
most affected age groups were between the ages of 31 and 60, with the
prevalence of the 41 to 50 age group and a median age of 45.6 years. Ouattara
had found a median age of 43.5 years with a predominant attack between 40 and
49 years. Kutoloka, in his series, found an average age of 48.4 years [12,
19].
The
sex
In this study the female predominance was found in 110 cases
(55.6%) out of a total of 160 patients, with a sex ratio of 0.8 in favor of the
woman. We believe that it is possible that the large participation of Congolese
women in the activities of survival pushes them to exert activities of effort
thus overloading their lumbar spine. The high number of maternity could also
play a role in lumbar spine imbalance.Our results would be close to those of
Bamako study in 2005 that found a female predominance with a sex ratio of
1.95.Unlike the study conducted in Burkina Faso where the sex ratio was 1.9 in
favor of men [8, 9].Our results are, on the other hand, in contradiction with
some data of the literature which are unanimous on the male predominance of the
herniated disc as well in Mali, in Africa or even in the world with a sex ratio
oscillating between 1.4 according to Diarra M and 1.9 according to Tchuintdjang
K [8, 20].
| 
