Patterns of non-traumatic myelopathies in Yaoundé (Cameroon): A hospital based study

Background: The relative frequency of compressive and non-compressive myelopathies and their aetiologies have not been evaluated extensively in most sub-Saharan African countries. The case of Cameroon is studied. Methods: Admission registers and case records of patients in the neurology and neurosurgery departments of the study hospital were reviewed from January 1999 to December 2006. Results: 224 (9.7% of all admissions) cases were nontraumatic paraplegia/paraparesis or tetraplegia/ tetraparesis and 147 were due to myelopathies, representing 6.3% of all cases admitted during the study period and 65.6% of cases of paraplegia or tetraplegia; 88% were compressive myelopathies. Aetiologies were dominated by primary and secondary spinal tumours (mainly prostate carcinoma, lymphoma and liver carcinoma) that each accounted for 24.5% of cases. Other causes included spinal tuberculosis (12.9%), tropical spastic paraparesis (five positive for human T cell lymphotrophic virus (HTLV)-I and one for HTLV-II) (4.8%), spinal degenerative disease (4.1%), acute transverse myelitis (4.1%), HIV myelopathy (1.4%), vitamin B12 deficiency myelopathy and multiple sclerosis (0.7%). No aetiology was found in 21.1% of participants. Conclusions: Myelopathies in our setting are dominated by spinal compressions. Metastasis is a leading cause of spinal cord compression with liver carcinoma being more frequent than reported elsewhere. Infections nevertheless remain a major cause of spinal cord disease and both cancers and infections constitute public health targets for reducing the incidence of myelopathies.