Health-related quality of life in patients with low back pain in a low resource setting: a cross-sectional study at a tertiary hospital in Uganda.

Background: Low back pain is the leading global cause of years lost to disability. The study aimed to assess the health-related quality of life in patients with low back pain attending an outpatient clinic at a national referral hospital in Uganda. Methods: This was a hospital based cross-sectional study that involved 250 adult patients with low back pain. Data were collected using the modified short form-36 Health Survey questionnaire. Data were summarised using descriptive statistics. Analysis of Variance, the F-test and linear regression analysis were used for inferential statistics. Result: Majority of participants were female (66.4%) with a mean age of 60 years (SD 12.9, range 20- 87) and 44.6% were manual labourers. 70% of participants had had low back pain for more than one year and 74% had neuropathic symptoms. The total quality of life of participants was poor with a mean score of 31.9 (SD 15.6). The factors that significantly influenced quality of life included performing manual work (p=0.01), being unemployed (p=0.027) and weakness in the lower limbs (p=0.01). Conclusion: Patients with low back pain had a poor quality of life that was significantly influenced by being unemployed, doing manual work and clinical features of nerve compression.

Traumatic spondyloptosis of the lumbar spine: a case report.

INTRODUCTION: Spondyloptosis is the most severe of translation spine injuries. It results in complete disruption of the structural elements of the vertebral column and the adjacent paravertebral soft tissues, culminating in severe biomechanical instability. Although several cases of lumbosacral spondyloptosis have been documented, not many cases of traumatic lumbar spondyloptosis have been published in the literature. CASE PRESENTATION: We present a case of a 34-year-old man of Nilo-Hamitic ethnicity who presented to our unit with paraplegia following injury from the collapse of a concrete wall. Radiographic images showed spondyloptosis at the fourth lumbar vertebral level. He underwent surgery where decompression, reduction, posterior instrumentation and bone grafting through a posterior approach were done. He started regaining motor power 48 hours postoperatively. He is currently undergoing rehabilitation and is steadily improving, 2 months postoperatively. CONCLUSIONS: In limited-resource settings there is a tendency of "skilful neglect" of complex injuries. Where resources allow, surgical reconstruction of spondyloptosis should be attempted irrespective of the severity of the initial neurological deficit because there are chances of neurological improvement.