We have, 113 children aged 1 year 3 months to 18 years with an average age of 8 years are be hospitalized for non-traumatic spinal cord compression.

The majority of the children had less than 10 years (60.18%) and came from the regions of Dakar (61.95%), Diourbel (11.50%) and Thiès (8.85%). Mauritania and The Gambia were the regions of origin of patients who came from abroad (1.77%). There was a predominance of 66 Males (58%) for 47 Females (42%) with a sex ratio of 1.40.

The main reasons for consultation were spinal deformity (90.26%), spinal pain (71.68%), and functional limb impairment (63.72%).

The clinical symptomatology was polymorphous. Spinal cord compression syndrome was complete in 52 patients (46.02%) and incomplete in 61 patients (53.98%). The physical examination found a lesion syndrome (61.95%) and/or a syndrome under lesion (89.39%) and/or a spinal syndrome (90.26%). The onset of symptomatology was insidious in 66.37% of cases and acute in 33.63% of cases.

Some patients had extra-neurological signs: 42 patients (37.17%) had altered general state, 47 patients (41.59%) had pleuropulmonary involvement, 14 patients (12.39%) had adenoma, and 25 patients (22.12%) had a clinical anemic syndrome.

The standard radiography performed in 63 patients, showed vertebral (53.12%), disco-vertebral (34.37%), or disc (7.81%) lesions associated with kyphosis (18.75%) and/or scoliosis 19.17%).

Spine scanning performed in 21 patients revealed an expansive process compressing the marrow (18.28%) and myeloscanning performed in four (4) patients revealed a stop of the contrast agent.

MRI performed in 22 patients showed extramedullary intradural processes (33.33%), extradural lesions (14.28%) and intramedullary processes (28.57%). The myelography carried out in two (2) patients also showed a stop of the opaque column and of the contrast agent. Vertebral lesions were lytic-type geodesics, destruction of vertebral bodies, osteocondensation, aspects of vertebrae in patties; disc lesions were pinching or destroying. The dorsal stage was the majority (46%) followed by lumbar (terminal cone) (27%) and mixed or multi-stage (23%), cervical lesions were rare (3.33%).

In biology, 63 patients (59.43%) had hypochromic microcytic anemia, 31 children (29.24%) had high leukocytosis, 35 children (33.02%) had thrombocytosis and one (1) had thrombocytopenia. The CRP and sedimentation rate were high in 73 children (64.60%).

Pott’s disease was the majority (80%) followed by tumors (17%). Spondylodiscitis with mild bacteria (2%) and parasitic spinal cord compression (1%) were rare.

All children who suffered from Pott’s disease be cured by TB chemotherapy associated with a corset in 88.89% of cases, 2 Patients of this group had benefited fixation after laminectomy. 68% of the patients had a favorable recovery, and 20% had completely recovered after an average of 7 months of treatment and 3 Patients had died. The child with medullary compression by bilharzia who first simulated an intramedullary tumor had benefited from laminectomy and treatment based on Praziquantel and had a favorable outcome. Patients with mild spondylitis had benefited from non-specific treatment and 2/3 had complete recovery of their neurological disorders. We have 95% of children with tumors had benefited from decompressive laminectomy or laminotomy or myelotomy with tumor excision, 3 Patients in this group had benefited ostéosynthésis after laminectomy 58% of patients had good recovery and 1patient had died.

In our series, the majority age groups were small children aged 3 to 10 years, with a total of 54 patients (48%), followed by Grand children aged 10 years to 15 years with a total of 32 patients (28%). Our results are substantially comparable with most studies [2] [3] [4] [5] . We have a predominance of Males (58% of cases), which agrees with the data of the literature [3] [6] [7] [8] .

The frequency of Pott’s disease in Senegal in pediatric patients has estimated at 2.37% [23] .

Children aged 0 to 15 years account for 24% to 55.09% [24] [25] .

Pott’s disease remains the first etiology encountered in our study, 80% of children suffering from Pott’s disease responsible for spinal cord compression.

The mean age was 7.3 years with extremes of 1 year 3 months and 17 years, Mabiala et al. [26] had returned to an average age of 7.5 years with extremes of 11 months and 17 years.

We also report a male predominance with 60% of cases. These data is are be found it in other works [2] [4] [5] .

The concept of counting was be found in 23 patients (25.55%) of the cases, in the Ndiaye series 25.92% and in that of Mabiala et al. 50% [26] .

We have 52 Patients (57.78%) had received BCG vaccination (Bacille de Calmette and Guérin), 12 patients (13.33%) had not been vaccinated in the study of Mabiala et al. 36 patients (39.13%) had not been vaccinated with BCG [26] .

The concomitant involvement of the pleuropulmonary system was be found in 47.78% of our cases. Our results are relatively comparable to the results of Ndiaye, Eric, Loembe, Mabiala et al. Which gave 29.62%, 31%, 25.32% and 44.56%, respectively.

Apart from pleuropulmonary involvement, we obtained 15.55% lymph node location and 7.78% neuro-meningeal localization, which illustrates perfectly the data of the literature: all the viscera and noble organs of the organism can be affected [25] [26] [27] [28] .

The HIV had not be found about all patients who be tested, we think that because they are young people and their parents was not HIV and the child had not any contexte to contract this.

The intradermal-tuberculin reaction was positive in 64 patients (84.37%) of the cases that has be clinically tested. This result agrees perfectly with the results of Ndiaye [4] which found 83.33% and other data from the literature which vary between 62% to 91.61% of cases [24] [25] [26] [29] .

In our series, 66.67% of our patients had paralysis of the lower limbs. HOFFMAN found 39.06% in a series of children with Pott’s disease [29] .

Eric found 66% in a general population [27] , Mabiala et al. Accounted for 37%.

However, Ndiaye had 100% lower limb paralysis in his series. Our results are perfectly because our series of studies was multicentric (Pediatrics, Neurology, Neurosurgery) whereas the Ndiaye series has only used for neurology and most of the children in his series came to consult Paralysis of the lower limbs.

The second major sign in our series was a spinal deformity of 53.33% kyphosis, 26.67% gibbosity, 23.33% scoliosis. Ndiaye [4] found a gibbosity in 55.55% in his series we find rather 53.33% kyphosis, however Eric and Loembe [25] [27] had regained a gibbosity in 38.31% to 52%, our results approach significantly.

The rate of sedimentation was high and CRP (chain reaction protein) was highly positive in 75.55% of the cases. These results are comparable to other studies [4] [26] [27] .

The koch bacillus was searched in 62 patients (68.89%) and was found in 6.45% of the cases, Loembe found in 28.12% of its patients [25] .

The anatomy of cytology and pathology revealed a multinucleated giant cell histiocytic granuloma with tuberculoid or tuberculous tuberculous necrosis in the patient of our series.

Dorsal location was the most frequent in our study series (46.67%), followed by lumbar localization (26.67%), which is comparable to the data in the literature (Table 6).

The number of vertebrae reached at the imaging performed in 79 patients was two in the majority of cases 49.36% as reported in other series, 65.38% in the Ndiaye series, 44% Hoffman and 36% in the Garst series [4] [28] [29] . (Figure 1)

All authors agree on the principle of antituberculous chemotherapy for 9 to 12 months of treatment for patients with Pott’s disease. This treatment is associated with a corset, this association is indicated in the child with a minimal deformation and a neurological deficiency less severe [24] [25] [30] [31] [32] .

In our series, Pott’s disease has occurred on the AS sickle cell (10%), we have 13% of malnutrition, 03 cases of type 1 diabetes, 01 case of acute lymphoid leukemia type 1, trisomy 21 (01 case), congenital heart disease (02 cases).

All our patients benefited from antituberculous chemotherapy associated with a corset in 88.89% of cases. 02 patients had benefited from decompressive laminectomy and ostéosynthésis in neurosurgery with anti-tuberculosis treatment.

In children, we observe rather spondylodiscitis, The attack can sometimes be brutal thus achieving a picture of vertebral osteomyelitis [33] .

We report three (03) cases of spinal cord compression in our series.

We have two girls for one boy. The extreme ages were 5 years and 12 years 6 months, the average age was 8.5 years. The affected levels were lumbar in all cases. All our patients had a standard X-ray. The spinal sites were disc and vertebral lumbar in the 3 patients. The isolated germs were, Aureus Meti Staphylococcus, Gram Negative Anaerobic Bacillus, Streptococcus A.

In the Zomaleto series the predominant disco-vertebral lesions were lumbar associated with neurological suffering and the predominant isolated bacteria were gram negative bacilli [34] .

The treatment of this localization is above all medical, the excision of the intramedullary granulomas is discouraged by the majority of the authors [3] .

In our patient the diagnosis was selected after laminectomy T12 to L2, myelotomy and total excision of intramedullary macroscopic lesion simulating an intramedullary tumor foranatomy pathological cytology which had demonstrated a granulomatous rearrangement withmicroabscess associated with parasitic structures suggestive of bilharziasis. (Figure 2, Figure 3)

The authors report that this is a rare cause of bone marrow compressions BA.MC et al. [35] .

They represent 17% of the causes of spinal cord compression in our series. This is consistent with Diallo’s findings, which found tumor causes in 15% of cases [1] .

We report 36.84% intramedullary lesional process, 42.11% intradural and extramedullary process and 21.05% extradural process. These lesions were extended in height in 09 patients, in width in 3 patients, in comparison with the posterior vertebral arches in 05 patients, and in 02 patients in the lower ones.

Our results are somewhat closer to the results of Obilat [8] who had 33.3% of extramedullary intradural tumors in his study series, Elboukili [3] who had 28% intramedullary tumors in his series.

EL Mahdi et al. [36] found 33.33% for each topographic type of process, and Lefebvre et al. [37] who had recovered 61.11% extradural tumor process.

The majority of the dorsal floor was in our series, ie 47.37%. EL Mahdi et al. [36] found it in 58.77% of the cases in their series.

The histology in 6 patients showed 5.26% type II neurofibroma (Figure 4), 5.26% extramedullary intradural arachnoid cyst, 5.26% intramedullary arachnoid cyst with cytochemistry of the CSF - like content, 5.26% 5.46% grade I terminal cone ganglioneurinoma and 5.26% meningothelial meningioma. Our results are comparable to data from the literature [3] [36] [38] .

Elboukili [3] found 8% arachnoid cyst in his series, 12% ependymoma. Saouab

[39] reported a case of ganglioneurinoma in his series with 3.64% astrocytomas, EL Mahdi [36] found 4.83% of meningiomas.

94.74% of our patients had benefited from decompressive laminectomy with tumor excision.

Some authors prefer a laminotomy to laminectomy in all cases where it is possible to minimize the risk of destabilization of the spine after the opening of the spinal canal [38] .