RESUMO
INTRODUCTION: Magnetic resonance imaging (MRI) is the most appropriate imaging method to investigate low back pain. As low back pain is very common, a large number of MRI scans are performed. OBJECTIVE: To evaluate the extraspinal findings and clinical effect of the T1-weighted spin echo (T1W SE) coronal sequence added to the lumbar MRI protocol for low back pain. MATERIALS AND METHODS: In 2015, we added a T1-weighted (T1W) coronal sequence to our routine lumbar MRI protocol. We retrospectively evaluated 969 lumbar MRI images for low back pain performed with this protocol. The extraspinal MRI findings obtained from them were then grouped as associated with low back pain (Category 1) and not associated with low back pain (Category 2). We also evaluated whether the recorded incidental extraspinal findings could be detected on conventional sagittal and axial images. RESULTS: Ninety-six (63%) of the extraspinal findings were associated with low back pain (Category 1) and 56 (37%), Category 2. Seventy-eight percent of the extraspinal findings were detected only on coronal-T1W images and not on conventional images. CONCLUSION: Adding coronal-T1W sequence to the routine protocol of lumbar MRI can help to identify extraspinal findings and guide clinical treatment.
Introducción. La resonancia magnética (RM) es el método de imágenes diagnósticas más apropiado para investigar el dolor lumbar. Dado que este es muy común, son muchas las resonancias magnéticas de este tipo que se hacen. Objetivo. Analizar los hallazgos extraespinales que se pueden detectar al agregar la secuencia coronal T1W al protocolo de imágenes de RM para el dolor lumbar y evaluar su efecto clínico. Materiales y métodos. En el 2015 se agregó una secuencia coronal ponderada en T1W al protocolo de resonancia magnética lumbar de rutina de nuestro hospital. Se evaluaron retrospectivamente 969 imágenes solicitadas en casos de dolor lumbar y realizadas con este protocolo. Los hallazgos obtenidos a partir de dichas imágenes se agruparon luego como asociados con el dolor lumbar (categoría 1) y no asociados con el dolor lumbar (categoría 2). Se evaluó, asimismo, si los hallazgos extraespinales registrados podían detectarse en imágenes axiales y sagitales convencionales. Resultados. Noventa y seis (63 %) de los hallazgos extraespinales se asociaron con lumbalgia (categoría 1) y 56 (37 %) correspondieron a la categoría 2. El 78 % de los hallazgos extraespinales se detectaron solo en imágenes coronales-T1W y no en las convencionales. Conclusión. La secuencia coronal-T1W agregada al protocolo de rutina de la resonancia magnética lumbar puede ayudar a detectar afectaciones extraespinales y guiar el tratamiento clínico.
Assuntos
Dor Lombar , Humanos , Dor Lombar/diagnóstico por imagem , Dor Lombar/patologia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Imageamento por Ressonância Magnética/métodos , Estudos RetrospectivosRESUMO
El dolor sacroilíaco es responsable de 15% a 30% de los cuadros de dolor lumbar bajo. El diagnóstico de esta patología es un desafío para el médico, debido a su compleja anatomía, el amplio diagnóstico diferencial, y las diversas etiologías que pueden provocar dolor en la articulación sacroilíaca. Una anamnesis ordenada y dirigida, asociada a un examen físico preciso, ayuda a orientar el diagnóstico. Las pruebas sacroiliacas específicas deben realizarse en aquellos pacientes con sospecha de dolor sacroilíaco, y deben interpretarse en conjunto y no de manera aislada. La resonancia magnética sirve para descartar otras causas de dolor lumbar bajo o diagnosticar casos de sacroileítis inflamatoria. La infiltración de la articulación es el gold standard para el diagnóstico, y debe realizarse en pacientes con alta sospecha de dolor sacroilíaco, por la anamnesis, examen físico, y tres o más pruebas sacroilíacas específicas positivas.
Sacroiliac pain accounts for 15% to 30% of low back pain conditions. Its diagnosis is a challenge for the physician due to its complex anatomy, the wide differential diagnoses list, and its several causes. Diagnosis requires a structured clinical history and an accurate physical examination. Specific sacroiliac physical examination tests should be performed in patients with suspected sacroiliac joint pain and interpreted together, not in isolation. Magnetic resonance imaging can rule out other causes of low back pain or diagnose inflammatory sacroiliitis. Joint infiltration is the gold standard for diagnosis, and it should be performed in patients with a high suspicion of sacroiliac joint pain based on anamnesis, physical examination, and three or more positive specific sacroiliac tests.
Assuntos
Humanos , Articulação Sacroilíaca/patologia , Dor Lombar/patologia , Dor Lombar/diagnósticoRESUMO
BACKGROUND: Low back pain is the leading cause of years lived with disability in Brazil based upon Global Burden of Disease estimates. Since 1990, the number of years lived with disability has increased by 79.7%, and this number is expected to continue to rise due to population growth and ageing. Yet, similarly to other countries, little attention has been given to it in both the public and private health systems, arguably making it an overlooked epidemic in Brazil. There is evidence that Brazil has adopted unwarranted practices in the management of low back pain in a similar manner to what has been observed in high-income countries. To tackle the burden of low back pain in Brazil, we need highly coordinated efforts from government, the private sector, universities, health workers and civil society. OBJECTIVE: This masterclass intends to provide an overview of the challenges faced by Brazil in relation to low back pain management and propose potential solutions that could potentially be implemented based on experiences reported in the literature.
Assuntos
Dor Lombar/patologia , Brasil , Pessoas com Deficiência/estatística & dados numéricos , Humanos , Dor Lombar/epidemiologiaRESUMO
El tratamiento de las patologías discales y degenerativas que afectan a las articulaciones interfacetarias de la columna vertebral representan entre ambas más del 95% de los objetivos curativos en esta área del cuerpo, en razón de esto, esta investigación evalúa los efectos de los factores de crecimiento ozonizados en pacientes con diagnóstico de síndrome facetario lumbar, así como también, valorar la intensidad del dolor en el síndrome facetario, determinando el grado de movilidad articular previo y posteriora la infiltración. Métodos: la presente investigación se considera un estudio descriptivo y prospectivo, con un diseño es preexperimental, en pacientes que acudieron a la consulta de terapia del dolor del Hospital Dr. Pedro García Clara, en Ciudad Ojeda, estado Zulia-Venezuela. Los resultados se expresaron como valores absolutos, en porcentajes, media ± desviación estándar (M±DE), analizando las diferencias de los resultados mediante la prueba "t" de Student, cuando fueron aplicables, tomando un valor de p<0.05. Resultados: se evidencia, que los factores de crecimiento ozonizados infiltrados en los pacientes con diagnóstico de síndrome facetario lumbar, tienen efectos clínicos significativos, en cuanto a la disminución de la intensidad del dolor y el aumento del grado de movilidad articular. Conclusiones: el uso del plasma rico ozonizado es una técnica efectiva para disminuir la intensidad del dolor cuando es utilizado en el síndrome facetario ya que permite una aumento significativo de los grados de movilidad articulares de la columna lumbar (flexión, extensión e inclinación. Es una técnica sencilla, eficaz, económica y con efectos adversos mínimos(AU)
The treatment of the disc and degenerative pathologies that affect the interfaceative joints of the spine represent between them more than 95% of the healing objectives in this area of the body, because of this, this research evaluates the effects of the growth factors Ozonized in patients with a diagnosis of lumbar facet syndrome, as well as assessing the intensity of pain in facet syndrome, determining the degree of joint mobility before and after infiltration. Methods: the present investigation is considered a descriptive and prospective study, with a pre-experimental design, in patients who attended the pain therapy consultation of the Dr. Pedro García Clara Hospital, in Ciudad Ojeda, Zulia-Venezuela state. thee results were expressed as absolute values, in percentages, mean ± standard deviation (M ± SD), analyzing the differences of the results by means of the Student "t" test, whenapplicable, taking a value of p <0.05. Results: it is evidenced that infiltrated ozonized growth factors in patients with a diagnosis of lumbar facet syndrome, have significant clinical effects, in terms of the decrease in pain intensity and the increase in the degree of joint mobility. Conclusions: the use of ozonated rich plasma is an effective technique to reduce the intensity of pain when used in facet syndrome because it allows a significant increase in the degrees of joint mobility of the lumbar spine (flexion, extension and tilt.) It is a simple, effective technique, economic and with minimal adverse effects(AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Idoso , Dor Lombar/patologia , Dor Lombar/tratamento farmacológico , Dor Crônica/terapia , Vértebras Lombares/lesões , Infiltração-Percolação/efeitos adversos , Estudos ProspectivosRESUMO
BACKGROUND: There is interest from authors and publishers in sharing the results of their studies over the Internet in order to increase their readership. In this way, articles tend to be discussed and the impact of these articles tends to be increased. In order to measure this type of impact, a new score (named Altmetric) was created. Altmetric aims to understand the individual impact of each article through the attention attracted online. OBJECTIVE: The primary objective of this study was to analyze potential factors related with the publishing journal and the publishing trial that could be associated with Altmetric scores on a random sample of low back pain randomized controlled trials (RCTs). The secondary objective of this study was to describe the characteristics of these trials and their Altmetric scores. METHODS: We searched for all low back pain RCTs indexed on the Physiotherapy Evidence Database (PEDro; www.pedro.org.au) published between 2010 and 2015. A total of 200 articles were randomly selected, and we extracted data related to the publishing trial, the publishing journal, methodological quality of the trials (measured by the 0-10 item PEDro scale), and total and individual scores of Altmetric mentioned and Altmetric reader. The study was a cross-sectional study, and multivariate regression models and descriptive statistics were used. RESULTS: A total of four variables were associated with Altmetric mentioned score: impact factor (ß-coefficient=3.4 points), number of years since publication (ß-coefficient=-4.9 points), number of citations divided by years since publication (ß-coefficient=5.2 points), and descriptive title (ß-coefficient=-29.4 points). Only one independent variable was associated with Altmetric reader score: number of citations divided by years since publication (ß-coefficient=10.1 points, 95% CI 7.74-12.46). We also found that the majority of articles were published in English, with a descriptive title, and published in open access journals endorsing the Consolidated Standards of Reporting Trials (CONSORT) statement. CONCLUSIONS: Researchers should preferably select high impact factor journals for submission and use declarative or interrogative titles, as these factors are likely to increase the visibility of their studies in social media.
Assuntos
Dor Lombar/diagnóstico , Estudos Transversais , Humanos , Dor Lombar/patologia , Projetos de PesquisaRESUMO
PURPOSE: Lumbar paraspinal muscle morphology has recently been evaluated in several studies with conflicting results. Several studies have performed single-slice evaluations of paraspinal muscle morphology, whereas other studies have done a multi-level assessment; this methodological difference might explain the observed different results. Our study evaluated if a single-slice axial measurement is representative of the entire lumbar musculature. METHODS: We included 80 adult patients who were consecutively evaluated with magnetic resonance imaging (MRI) for spinal symptoms. Using T2-weighted axial images, we measured the fat signal fractions (FSF) and cross-sectional area (CSA) of the erector spinae and multifidus at the five levels of the lumbar spine (from L1-L2 to L5-S1). We used the ANOVA test for repeated measurements (with Bonferroni correction) to compare the FSF and CSA among the levels. RESULTS: Erector spinae showed an increasing FSF from L1-L2 to L5-S1; all erector spinae FSF comparisons among the different levels were significantly different. Multifidus FSF also increased caudally below L2-L3, although significant differences were observed only with two or more levels of distance. The CSA of the erector spinae showed a caudal decrease (L4-L5 and L5-S1 being significantly smaller than all the levels above). The CSA of the multifidus showed that all levels exhibited a significantly different area compared to their adjacent level (except L5-S1 compared to L4-L5). CONCLUSIONS: No single-level FSF or CSA is representative of the whole lumbar spine. A standardized multi-level evaluation of the paraspinal musculature should be used in future research.
Assuntos
Tecido Adiposo/diagnóstico por imagem , Tecido Adiposo/patologia , Dor Lombar/diagnóstico por imagem , Dor Lombar/patologia , Vértebras Lombares/diagnóstico por imagem , Vértebras Lombares/patologia , Imageamento por Ressonância Magnética , Músculos Paraespinais/diagnóstico por imagem , Músculos Paraespinais/patologia , Radiculopatia/diagnóstico por imagem , Radiculopatia/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Interpretação de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , SoftwareAssuntos
Alopecia/patologia , Infarto Cerebral/diagnóstico por imagem , Infarto Cerebral/patologia , Leucoencefalopatias/diagnóstico por imagem , Leucoencefalopatias/patologia , Dor Lombar/diagnóstico por imagem , Dor Lombar/patologia , Doenças da Coluna Vertebral/diagnóstico por imagem , Doenças da Coluna Vertebral/patologia , Alopecia/diagnóstico por imagem , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Neuroimagem/métodosRESUMO
STUDY DESIGN: Cross sectional study. OBJECTIVE: The goal of this study is to identify relationships between objectively measured and subjectively scored parameters and reported pain. SUMMARY OF BACKGROUND DATA: Studies have demonstrated the unreliability of magnetic resonance imaging (MRI)-based parameters to identify pathological pain generators of chronic low back pain, but they were based on visual inspection and subjective assessment of lumbar disc features. Advancements in computer image analysis provide objective measurements of lumbar disc features. METHODS: Two radiologists evaluated 39 axial and sagittal T1- and T2-weighted MR images of patients with chronic axial low back pain (age, >65 yr) and graded 4 subjective lumbar disc parameters (T2 signal intensity, nucleus shape, Modic changes, and osteophyte formation) whose sum is the cumulative MRI score. Objective parameter, MRI index, was calculated as the product of the measured lumbar disc area and total disc MRI signal intensity. Discs were sorted from least to the most degenerated relative to each parameter. Pearson correlation coefficient and multiple linear regression analysis were performed between the reported pain score and each parameter. RESULTS: The most and least degenerated discs in each patient, as assessed by MRI index, had the highest negative and positive correlation coefficient and regression weight contribution, respectively. All subjective parameters had low correlation coefficients and regression goodness of fit. CONCLUSION: Although limited by small sample size, the objective parameter, MRI index, can be a potential imaging biomarker used to identify possible pain generators. This study presents a potential new application of MR imaging in identifying pain generators of patients with chronic low back pain.
Assuntos
Dor Crônica/diagnóstico , Degeneração do Disco Intervertebral/diagnóstico , Disco Intervertebral/patologia , Dor Lombar/diagnóstico , Vértebras Lombares/patologia , Imageamento por Ressonância Magnética , Medição da Dor , Percepção da Dor , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Dor Crônica/etiologia , Dor Crônica/patologia , Dor Crônica/psicologia , Estudos Transversais , Feminino , Humanos , Degeneração do Disco Intervertebral/complicações , Degeneração do Disco Intervertebral/patologia , Degeneração do Disco Intervertebral/psicologia , Modelos Lineares , Dor Lombar/etiologia , Dor Lombar/patologia , Dor Lombar/psicologia , Masculino , Valor Preditivo dos Testes , Índice de Gravidade de DoençaRESUMO
AIMS/OBJECTIVES/BACKGROUND: Studies have associated chronic low back pain (cLBP) with grey matter thinning. But these studies have not controlled for important clinical variables (such as a comorbid affective disorder, pain medication, age, or pain phenotype), which may reduce or eliminate these associations. METHODS: We conducted cortical thickness and voxel-based morphometry (VBM) analyses in 14 cLBP patients with a discogenic component to their pain, not taking opioids or benzodiazepines, and not depressed or anxious. They were age and gender matched to 14 pain-free controls (PFCs). An ROI-driven analysis (regions of interest) was conducted, using 18 clusters from a previous arterial spin labeling study demonstrating greater regional cerebral blood flow (rCBF) in these cLBP subjects than the PFCs. Cortical thickness and VBM-based gray matter volume measurements were obtained from a structural MRI scan and group contrasts were calculated. RESULTS: Multivariate analysis of variance showed a trend toward cortical thickening in the right paracentral lobule in cLBP subjects (F1,17=3.667, P<0.067), and significant thickening in the right rostral middle frontal gyrus (F1,17=6.880, P<0.014). These clusters were non-significant after including age as a covariate (P<0.891; P<0.279). A whole-brain cortical thickness and VBM analysis also did not identify significant clusters of thinning or thickening. Exploratory analyses identified group differences for correlations between age and cortical thickness of the right rostral middle frontal gyrus (cLBP: R=-0.03, P=0.9; PFCs: R=-0.81, P<0.001), that is, PFCs demonstrated age-related thinning while cLBP patients did not. CONCLUSIONS: Our pilot results suggest that controlling for affect, age, and concurrent medications may reduce or eliminate some of the previously reported structural brain alterations in cLBP.
Assuntos
Córtex Cerebral/patologia , Substância Cinzenta/patologia , Dor Lombar/patologia , Dor Lombar/psicologia , Fenótipo , Adulto , Idoso , Estudos de Casos e Controles , Córtex Cerebral/irrigação sanguínea , Doença Crônica , Avaliação da Deficiência , Feminino , Seguimentos , Humanos , Processamento de Imagem Assistida por Computador , Dor Lombar/complicações , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Transtornos do Humor/etiologia , Medição da Dor , Escalas de Graduação PsiquiátricaRESUMO
Relata-se um caso de um paciente com queixa principal de dor lombar à esquerda, portador de angiomiolipomas renais (AMLRs) bilaterais, com a lesão mais volumosa de 6,2 cm em seu maior diâmetro, submetido a tratamento endovascular por embolização arterial superseletiva com microesferas. Os AMLRs são tumores benignos raros. A maioria é esporádica, enquanto uma minoria está associada à Esclerose Tuberosa Complexa (ETC). Os AMLRs maiores do que 4 cm devem ser tratados devido ao maior risco de complicações, principalmente hemorrágicas. A embolização arterial seletiva (EAS) é um tratamento efetivo e seguro para os AMLRs.
We report a case of a patient with a major complaint of left lumbar pain, diagnosed with bilateral renal angiomyolipomas (AMLRs), with the most voluminous lesion of 6.2 cm in its largest diameter, underwent endovascular superselective arterial embolization with microspheres. The AMLRs are rare benign tumors. Most are sporadic, while a minority is associated with Tuberous Sclerosis Complex (ETC). The AMLRs larger than 4 cm must be treated due to higher risk of complications, especially hemorrhagic. A selective arterial embolization (EAS) is an effective and safe treatment for AMLRs.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Angiomiolipoma/diagnóstico , Dor Lombar/patologia , Procedimentos Endovasculares/reabilitação , Embolização Terapêutica/métodosRESUMO
Disc herniation with posterior epidural migration is a rare and often symptomatic entity. Multiple are the natural barriers that prevent this pattern of migration. Enhanced magnetic resonance imaging is the diagnostic modality of choice in these cases. The diagnostic dilemma in this case was the contraindication to the use of contrast since the patient was known to have chronic renal failure.
Hérnia discal com migração epidural posterior é uma entidade rara e frequentemente sintomática. Múltiplas são as barreiras naturais que impedem esse padrão de migração. A ressonância magnética contrastada é a modalidade diagnóstica de escolha nesses casos. O dilema diagnóstico, neste caso, foi a contraindicação ao uso de contraste, uma vez que o paciente era portador de insuficiência renal crônica.
Assuntos
Humanos , Masculino , Pessoa de Meia-Idade , Deslocamento do Disco Intervertebral/complicações , Deslocamento do Disco Intervertebral/diagnóstico , Espaço Epidural , Hérnia/diagnóstico , Região Lombossacral , Meios de Contraste , Meios de Contraste , Dor Lombar/patologia , Espectroscopia de Ressonância MagnéticaRESUMO
We investigated a possible association between aggrecan gene polymorphism and lumbar degenerative disc disease in Turkish patients. One hundred 20-30-year-old patients with or without low back pain were selected for the study. Lumbar magnetic resonance imaging was performed on all patients. The patient group had low back pain clinically and degenerative disc disease radiographically. The control group included patients with and without low back pain: all were negative radiographically for degenerative disc disease. Genomic DNA was extracted from all participants. A PCR assay were used to evaluate variable number of tandem repeat polymorphism of aggrecan gene alleles to determine if there was any correlation with degenerative disc disease. Significant associations were found between short repeated alleles of the aggrecan gene and severe disc degeneration. A significant association was also found between short repeated alleles of the aggrecan gene and multilevel disc herniation as well as extrusion and sequestration types of disc herniation. In Turkish population, short repeated alleles of the aggrecan gene are associated with increased disc degeneration and disc herniation.
Assuntos
Agrecanas/genética , Degeneração do Disco Intervertebral/genética , Degeneração do Disco Intervertebral/patologia , Vértebras Lombares/patologia , Adulto , Alelos , Matriz Extracelular/patologia , Feminino , Humanos , Dor Lombar/genética , Dor Lombar/patologia , Imageamento por Ressonância Magnética , Masculino , Repetições Minissatélites/genética , Polimorfismo de Nucleotídeo Único , Sequências Repetitivas de Ácido Nucleico , TurquiaRESUMO
O objetivo deste estudo foi comparar os efeitos analgésicos das freqüências de base da corrente interferencial em pacientes com lombalgia resultante de osteoartrose. Foram selecionados 14 indivíduos,de ambos os gêneros, atendidos em 06 sessões, durante 02 semanasno setor de Fisioterapia do Hospital da Universidade Católica deBrasília (HUCB). Os mesmos foram distribuídos de forma aleatória em dois grupos: um que recebeu a eletroestimulação com freqüênciade 4000 Hz e outro de 2000 Hz; os demais parâmetros utilizados foram os mesmos para ambos os grupos: freqüência de amplitudemodulada (AMF) de 25 Hz e duração de 25 minutos. A análise comparativa foi realizada através da Escala Visual Analógica (EVA) e por meio de dois questionários de incapacitação funcional pela lombalgia: o Revised Oswestry Pain Questionnaire e o Roland-MorrisDisability Questionnaire. Os resultados demonstraram uma melhora signifi cativa da lombalgia ao comparar os momentos pré-tratamentoe pós-tratamento das duas freqüências de base, tanto em relação à EVA, quanto aos questionários. Não foi encontrada diferença significativa do efeito analgésico entre as duas freqüências de base.
The aim of this study was to compare the analgesic effects of the interferential therapy current frequencies in patients with low backpain from osteoarthrosis. Fourteen patients from both genders were selected and submitted to six physical therapy sessions, for two weeksat Universidade Católica de Brasilia Hospital. They were randomly distributed into two groups: one with the electrical stimulation with frequency of 4000 Hz and other with 2000 Hz; the other parameters were the same for both groups: amplitude modulated frequency(AMF) of 25 Hz, for 25 minutes. The comparative analysis was carried out using the analogue visual scale and two questionnaires for low back pain functional disability: the Revised Oswestry PainQuestionnaire and the Roland-Morris Disability Questionnaire. Results showed a signifi cant low back pain reduction when pretreatment and pos-treatments were compared to the analogue visual scale and both questionnaires. There was no difference of the analgesic effect between the two current frequencies.
Assuntos
Analgésicos/efeitos da radiação , Analgésicos/uso terapêutico , Dor Lombar/patologia , Dor Lombar/reabilitação , Dor Lombar/terapia , Osteoartrite , Serviço Hospitalar de FisioterapiaRESUMO
O objetivo deste estudo de corte transversal foi estimar a prevalência de dor crônica na população de Salvador, Bahia e identificar fatores associados a esta morbidade. Foi realizado em amostra populacional de 2.297 indivíduos com idade ≥ 20 anos, em Salvador, Bahia. Aplicou-se um questionário padronizado domiciliar para coleta de dados sobre dor e características sócio-demográficas, associado à medida da circunferência abdominal. O critério para classificação de dor crônica foi duração superior a 6 meses. Foram estimadas as prevalências de dor pelo OR ajustado com IC a 95 por cento e com valor de p<0,1 para as análises univariadas e p<0,05 regressão logística. A presença de dor crônica foi encontrada em 41,4 por cento da população total do estudo. Medindo-se a associação, os fatores mais encontrados na análise bruta foram: sexo, idade, situação conjugal, fumo, consumo de álcool (todos com p<0,05). Na análise multivariada, sexo feminino, idade, fumo e obesidade central se sustentaram como fatores associados; enquanto que consumo moderado de álcool e situação conjugal solteiro estiveram menos associados. Conclui-se que a presença de dor crônica predominou em mulheres, idosos, obesos, fumantes e ex-fumantes.
Assuntos
Humanos , Dor Lombar/patologia , Dor/diagnóstico , Epidemiologia/classificação , Razão de Chances , PrevalênciaRESUMO
La discopatía aguda y el dolor por estenosis del canal espinal son los diagnósticos más frecuentes de dolor lumbar bajo sin y con irradiación (lumbociatalgia o lumbocruralgia) y de dolor cervical sin y con irradiación (cervicobraquialgia). La postura tradicional ha sido la de administrar antiinflamatorios no esteroides (AINEs) para estas lumbalgias o cervicalgias agudas y crónicas... En este trabajo presentamos la experiencia clínica con una asociación a dosis fija de diclofenac, betametasona y ciánocobalamina administrada por vía oral en el tratamiento de la patología dolorosa de la columna lumbar y cervical aasociada a compresión neural en 200 pacientes ambulatorios. La asociación demostró ser muy eficaz en controlar el dolor y mejorar la funcionalidad de los pacientes y se asoció a escasos efectos colaterales digestivos.