[Uncomplicated herniated discs and sciatica: epidemiologic and semiotic aspects in 143 black African subjects].

OBJECTIVES

To study the epidemiologic and semiotic characteristics of uncomplicated sciatica in patients in a university hospital in Côte d'Ivoire.

PATIENTS AND

METHODS

This retrospective study included 143 patients with an uncomplicated herniated disc hospitalized in the Cocody University Hospital from 1998 through 2002; patients were excluded if they were excessively sensitive to pain, had related motor deficits, cauda equina syndrome, or were resistant to medical treatment.

RESULTS

Patients' average age was 42.5 years (range: 15-81), 58% were women, and mean body mass index (BMI) was 26.16. Ninety-nine (69.2%) reported relatively sedentary work. The disorder was characterized by an antalgic position (in 46.9%), an abnormal Schöber index in 117 (81.8%), the "bell sign" (in 63.6%) and a cough impulse in 58.7%. Lasègue's sign was homolateral at 114 (79.7%), and the average amplitude 42.2 degrees (range: 10 to 80). Paresis of 3/5 or higher was observed in 32 patients (22.4%). Radiography showed a disc disorder in 63% of cases; posterior osteoarthritis in 39.2% and a narrowed lumbar channel in 14 %. Computed tomography was performed for 56 patients and confirmed the presence of a hernia (median: 42,8%; paramedian: 48,2%; foraminal: 8,0%) of L4-l5 in 43 patients (77%); a large hernia, defined by a size greater than half of the rachidian channel, was found in eight (14,3%). After medical treatment, the course was favourable during this hospitalisation.

CONCLUSION

Contrary to preconceived ideas, uncomplicated sciatica of black subjects has the same characteristics as in the white population.