This was a retrospective, descriptive study conducted in the Internal Medicine Department of the Hospital of Refondation of Chad (HRT) and the Rheumatology Unit of the National Referral Hospital of N’Djamena (Chad). The study period extended from January 1, 2019 to December 31, 2024, covering six full years.

All patients consulting for a spinal disorder were examined. Only records confirming a degenerative spinal disease (low back pain, neck pain, thoracic pain, disc degeneration, facet joint osteoarthritis, lumbar spinal stenosis, and vertebral compression fractures of degenerative origin) were included.

Complete medical record with a clinical diagnosis supported by standard imaging (X-ray) and confirmed according to the radiological criteria of Kellgren and Lawrence (grade ≥ 2). Radiographs were independently reviewed by two rheumatologists; in case of disagreement, a senior radiologist made the final decision. In total, 6196 spine consultations were screened: 3620 at the National Referral Hospital and 2576 at the Hospital of Refondation. Both centers applied identical inclusion criteria.

Patients with inflammatory spinal diseases (spondyloarthritis, rheumatoid arthritis), infectious diseases (Pott’s disease), or tumors were excluded.

Collected information included demographic data (age, sex, occupation), reasons for consultation, medical history, clinical findings, radiological data, treatments received, and clinical outcomes.

Health-related quality of life was assessed using three validated French instruments: 1) The SF-36, which includes eight domains (0 - 100) and yields two summary scores: Physical Component Summary (PCS) and Mental Component Summary (MCS), with higher scores indicating better quality of life. 2) The Nottingham Health Profile (NHP), covering six domains (pain, mobility, energy, sleep, emotional reactions, social isolation); higher scores indicate greater impairment. 3) The WOMAC index (pain, stiffness, function), also scored 0 - 100, with higher scores indicating worse symptoms. These instruments were administered to a subgroup of patients with chronic or severe forms, and mean scores were calculated for each domain.

Data were entered and analyzed using standard software (Excel/Sphinx). Descriptive statistics were used to summarize the data, including means ± standard deviation, medians [IQR], counts and percentages. In addition, simple comparative tests were performed to strengthen descriptive interpretations: Chi-square (χ²) tests were applied to compare categorical variables, notably the sex distribution across spinal segments. Student’s t-test (or Mann-Whitney U test for non-normal distributions) was used to compare mean ages between groups. Distribution normality was checked using the Shapiro-Wilk test. A p-value < 0.05 (two-tailed) was considered statistically significant. These analyses were exploratory in nature and intended to complement the main descriptive approach.

During the study period, six thousand one hundred and ninety-six records were collected in the Rheumatology Department. Among them, 3880 cases (62.6%) corresponded to a degenerative spinal disease.

The mean age of patients was 58.4 years, ranging from 25 to 85 years. The most represented age group was 50 - 59 years. Females predominated, accounting for 65% of cases, with a sex ratio of 0.5. See Table 1.

Table 1. Demographic characteristics of included patients.

Comparative analyses showed a significant female predominance in the low back pain group compared with cervical and thoracic pain groups (χ² = 10.8; p = 0.001). Mean age was also significantly higher among women than men (58.9 ± 11.7 vs 56.8 ± 10.9 years; t = 3.15; p = 0.002). These differences highlight age- and sex-specific patterns of degenerative spine diseases in Chad.

Most patients were housewives (34%), followed by farmers (22%), manual workers (18%), employees (15%), and retirees (11%). These occupational constraints partly explain the predominance of women and the middle-aged distribution. Physical activity levels were not systematically collected in all patients, which limits our ability to explore its relationship with clinical profiles. Future studies should address this aspect systematically.

Low back pain was the leading reason for consultation (57.8%), followed by neck pain (23.6%) and thoracic pain (12.1%). Some patients presented with mixed forms involving several affected spinal segments. See Table 2.

Table 2. Distribution of degenerative spine conditions in the cohort.

Disc degeneration was the most frequent lesion (65%), followed by osteophytes (52%) and disc space narrowing (43%). Cases of lumbar spinal stenosis accounted for about 10%, and degenerative vertebral compression fractures represented 8%. See Table 3.

Table 3. Radiographic findings observed in degenerative spine disease.

All patients received analgesics of different levels. Non-steroidal anti-inflammatory drugs (NSAIDs) were prescribed in 72% of cases, physical therapy in 41%, spinal infiltrations in 12%, and surgery in 4% of cases. Corticosteroids were used occasionally for acute painful episodes. See Figure 1.

Figure 1. Distribution of patients according to treatment received.

Quality of life assessment was performed in a subgroup of patients with chronic or severe functional limitations. The mean SF-36 general health score was 58.2 ± 12.5, and the SF-36 pain score was 54.6 ± 13.8, indicating a moderate reduction in quality of life. NHP scores revealed notable impairments in the pain (56.9 ± 13.7) and mobility (52.4 ± 10.5) domains. The mean WOMAC global score was 54.9 ± 13.9, reflecting moderate to severe functional limitations. These findings confirm the significant functional impact of degenerative spine diseases in this population. See Table 4.

Table 4. Quality of life and functional scores.

Most patients reported improvement after treatment. However, persistent chronic forms were noted, particularly in elderly subjects, postmenopausal women, and overweight patients.