Columna vertebral y Ortopedia

Columna vertebral y Ortopedia

martes, 28 de octubre de 2014

Misconceptions about Back Pain

http://blog.bonati.com/misconceptions-about-back-pain/


Misconceptions about Back Pain

It’s just a fact of life: as we age, our bodies just don’t work like they used to. And often, back pain is a common complaint. It’s not unusual for those suffering from back pain seek advice from family or friends before going to a doctor. Referrals can be great! But advice seeking can also lead to misconceptions about back pain and spine surgery.
Listed below are just a few of the misconceptions we’ve come across over the years. Have you been misled by any of these?
“The best way to deal with back pain is to rest until it goes away.”
Resting is not the only way to deal with back pain. In some cases limited activity may be necessary but you should try to keep moving as much as you can. Stretching properly helps keep your muscles active and can help you recover more quickly.
“If I have back pain, I must have injured my back in some way.”
                This is not necessarily true. There are a number of diseases that can cause back pain. Degenerative disc disease is a gradual process that commonly compromises the spine. The intervertebral discs in the lumbar spine are structures prone to the degenerative changes associated with wear and tear, aging, and misuse (e.g. smoking).
“Back pain happens to everyone as they get older.”
                While back pain is common and older patients are more susceptible, back pain can happen to anyone. From dogs to children to teens to adults to the elderly; anyone can be affected by back pain but it does not necessarily mean that they all will be. A healthy lifestyle and positive posture practice help keep the spine engaged, strong, and healthy.
“If I tell my doctor, they will try to get me to have surgery.”
                Research has found that in many cases physical therapy and exercising have helped relieve back pain. In some cases surgery may be necessary but it is not the only solution. Pain medication may also be administered as an attempt to avoid surgery.

sábado, 25 de octubre de 2014

ACL Risk – It’s In Your Genes

http://www.sportsmedres.org/2014/03/acl-risk-its-in-your-genes.html


ACL Risk – It’s In Your Genes

Genes encoding proteoglycans are associated with the risk of anterior cruciate ligament ruptures
Mannion S, Mtintsilana A, Posthumus M, van der Merwe W, Hobbs H, Collins M, & Septemeber AV.  British Journal of Sports Medicine.  2014 Published Online First: doi: 10.1136/bjsports-2013-093201
Take Home Message: Individuals with a history of an anterior cruciate ligament injury are more likely to have certain genetic variations compared with individuals without a history of a knee injury. While these findings are novel and interesting, researchers need to conduct more research to understand the multifactorial genetic risk behind anterior cruciate ligament injuries.  
If we could identify factors that may predict who is at an increased risk for anterior cruciate ligament (ACL) rupture then we may be able to implement individualized injury prevention programs.  Genetic variants may change ligamentous properties, predispose an individual to an ACL rupture, and thus be an important risk factor for an ACL rupture.  Mannion and colleagues compared the presence of genetic variations between 227 individuals with an ACL rupture history and 234 healthy controls.  All of the participants were physically active and Caucasian. The authors also analyzed a subset of 126 individuals with a history of a noncontact ACL rupture.  They evaluated 10 genetic variants (single nucleotide polymorphisms) among 5 genes that encode proteoglycans, which influence the structural integrity of ligaments. Individuals with a history of ACL injury (34%) were more likely to have a genetic variation in a gene encoding aggrecan, a proteoglycan, compared with healthy controls (28%).  Females with a history of an ACL injury were also more likely to have variations in the gene encoding decorin, another proteoglycan, compared with female healthy controls. 
This is one of the first studies to investigate and identify genetic variations that may be related to a history of an ACL injury.  These findings help us understand that an ACL may be at more risk for injury due to changes in proteoglycans, which may alter the ligament’s tensile threshold.  At this point in time, this does not directly affect clinical treatments; however, these findings could inspire new interventions to address changes in proteoglycans and eventually help us identify individuals “at-risk” for an ACL injury.  This may help us prevent injuries by identifying athletes at risk and offering them individualized injury prevention programs.  While the authors showed that genetics may influence the risk of ACL injuries, it only focused on 10 variations of 5 genes.  Since the risk of an ACL injury is likely influenced by many genes, it may be advantageous to conduct genome-wide studies to encompass all of the possible genes and variations that influence the risk of ACL injury. We have repeatedly seen that genetic variations may influence the risk of injury and that it could influence how we practice but we’ll need to watch this area of research carefully to see how it unfolds.    
Questions for Discussion:  Do you think that genetic testing will change the future of athletic participation (e.g., prevention programs, withheld from certain sports)?  What if you had a patient or family member who tested positive for a genetic variation that made them more susceptible to an injury – would you still permit them to participate in activities that made the risk higher? 
Written by: Nicole Cattano
Reviewed by: Jeffrey Driban

viernes, 17 de octubre de 2014

‪#‎Ligamentos‬ de la ‪#‎columna‬ ‪#‎vertebral‬. ‪#‎anatomía‬ ‪#‎xtensal‬ ‪#‎formación‬.

martes, 14 de octubre de 2014

Ankylosing Spondylitis Surgery

domingo, 12 de octubre de 2014

Finding the Right Spine Specialist

 
 
 
 
 

jueves, 9 de octubre de 2014

Perfil de seguridad de los AINE y los opioides en el tratamiento del dolor musculoesquelético

 http://onlinelibrary.wiley.com/doi/10.1111/acem.12212/full

 Side Effects From Oral Opioids in Older Adults During the First Week of Treatment for Acute Musculoskeletal Pain





martes, 7 de octubre de 2014

Discusión entre pares / Masculino de 45 aňos de edad, intento suicida caida de 8 mts de altura sin lesión de calcaneo astragalo

Traumatologia de Altura ha añadido 6 fotos nuevas.

Caso #20
Mne Mles envio.este caso de masculino de 45 aňos de edad, intento suicida caida de 8 mts de altura sin lesión de calcaneo astragalo
Solo fracturas expuestas de tibia manejadasLes.envio.este casito de masculino de 45 aňos de edad intento suicida caida de 8 mts de altura sin lesión de calcaneo astragalo
Solo fracturas expuestas grado II de tibia manejadas con limpieza y estabilización con fijador externo
  • Jose Elias Kuffaty Pena Hola aunque la fractura es abierta grado 2 .de pilon hay que sintetizar el perone dandole su longitud original asi se arma la columna lateral de la tibia y fijacion externa con distraccion para que la ligamentotaxia haga su trabajo. Tobillo doloroso en futuro artrodesis
    8 horas · Me gusta · 1
  • Juan Manuel Duran Parada coincido con jose en todo menos ennla clasificacion yo creo q es grado IIIA
    8 horas · Me gusta · 3
  • Jose Elias Kuffaty Pena Yo tambien juan esa grado de conminucion no acompaña a una abierta grado 2
  • Jose Elias Kuffaty Pena Ojo haganle una rx a la columna (fractura de vertebra)
  • Juan Manuel Duran Parada esperar tenes buena base osea para arrrodesar mas adelante
  • Victor Hugo Montes Velasco Linda fractura !!! Traumatismo de muy alta energía y seguro q con gran compromiso de partes blandas, habrá q ver si no pasa de una III A a una Gustillo III B sería bueno ver fotos luego de la segunda toilette . Tto. Control de daños con tutor externo y esperar las partes blandas para decidir algo más . Saludos Dr. Juancito Durán !!
  • Wilson Onishi Sadud paciente politraumatizado... es expuesta grado IIIA pot ser lesion de alta energia.. buen manejo inicial com fij ext.. es una lesion severa de pilon tibial.... en mi opinion esperar 21 dias para hacerle tx fefinitivo... por q yo xreo q el px ha debido tener algo mas... iss mayor de 17... pedimos a Mne Mles que nos de mas datos del paciente... craneo torax abdomen???
  • Mne Mles Tce severo, neumotorax, paciente que curso en uci desde el 9 sep 2014, actualmente sin compromiso de partes blandas, abdomen y columna sin mayor problema. Saludos colegas
    6 horas · Me gusta · 1
  • Wilson Onishi Sadud Gracias.... esto indica politraumatizado... a la fecha ya cumplio el periodo de ventana inmunologica.... el derecho restituir la colimna lateral de la pierna y manejar con fij ext. la tibia, para luego artrodesis.. izq se puede manejar con sistema lcp y tb restitur la columna lateral.... en mi opinion... esperamos los resultados... un caso muy interesante complicado y de muy mal pronostico..
    6 horas · Editado · Me gusta · 2
  • Fernando Bacarreza Bruno Un caso por demás difícil por la conmorvilidad de un paciente poli traumatizado la fractura muy inestable, creo que el tratamiento inicial esta bueno aunque preferiría una fijación con un fijador híbrido con ligamentotaxia para luego planificar la definitiva
    5 horas · Me gusta · 1
  • Mne Mles Gracias por sus opiniones
    5 horas · Me gusta · 1
  • Marco A. Paredes Núñez Caso bastante complejo e interesante. 
    Como el paciente se encuentra en condiciones de ser operado. Quisiera saber si la articulación sub astragalina se encuentra bien? 
    Desde ya, me parece que no se salva de la artrosis tibioastragalina.
  • Jose Gregorio Millan Jimenez este caso es muy complejo primero un tratamiento psiquiatrico, luego control de dano controlar el proceso infeccioso, luego alargamiento de tibia y por ultimo artrodesis de tobillo.
  • Marco A. Paredes Núñez Mne Mles : El manejo inicial es buenisimo.
    Estas pensando artrodesar la tibio astragalina o también la sub astragalina ?
    1 hora · Me gusta · 1
  • Mne Mles Estamos pensando en estabilizar la izquierda con lcp y la derecha aun no hemos decidido
  • Mne Mles Por cierto gracias por su interés en el caso