Adjacent Segment Syndrome: Case Study and Management at Niamey National Hospital

Background Adjacent segment (AS) syndrome is a commonly observed complication after spinal arthrodesis, characterized by degeneration of the segments adjacent to the fusion. This pathology can lead to severe complications, including pain, neurological deficits, and surgical reinterventions. There is no literature on such pathology in Sub-Saharan Africa. We report two cases of adjacent segment degeneration cared for at Niamey National Hospital, focusing on diagnosis, treatment, and outcome. Case description Patient 1–65 years old male admitted for cauda equina syndrome, three years after lumbar recalibration and osteosynthesis for a narrow lumbar canal. Imagery workup showed disassembly of osteosynthesis, a screw malposition and neo kyphosis. The surgery consisted of lengthening recalibration and readjusting the osteosynthesis prolonged up to D12. The outcome was satisfactory after physiotherapeutic rehabilitation, with free-of-event follow-up. Patient 2–62 years old female admitted for cervical cord compression syndrome, Frankel B with polypnea, 6 months after C4-C5 ACDF. The cervical CT scan revealed a C2-C3 listhesis with 50% cervical canal reduction, responsible for cord compression. She went on cervical traction for resuscitation and, unfortunately, could not survive to benefit from the surgery. Conclusions Though a rare complication, ASD should be considered, especially when the factors described in the literature are encountered. This should be part of the surgical planning to avoid further complications and ensure the long-term well-being of the patients.