Efficacy of whole-body cryotherapy in the treatment of chronic low back pain: Quasi-experimental study.

STUDY DESIGN: Single arm, quasi-experimental study design. BACKGROUND: To describe the effects of whole-body cryotherapy on pain, disability, and serum inflammatory markers in patients with chronic low back pain. METHODS: A quasi-experimental trial was performed on adult patients between 18 and 65 years with chronic low back pain. After obtaining informed consent, participants underwent 20 sessions of whole-body cryotherapy (at -160 °C) during a 5-week time span. Patient reported pain and disability measures (Pain Numerical Rating Scale [PNRS], Oswestry Disability Index [OSI], and Roland Morris Questionnaire [RMQ]) were obtained at each of the twenty sessions. Blood samples were obtained to analyze serum inflammatory markers at baseline, 10th and 20th session. RESULTS: Forty-one participants were included in the study. A significant decrease was observed between the initial and final PNRS, ODI, and RMQ scores (p < 0.001). A significant reduction in the PNRS was found after 4 sessions of whole-body cryotherapy (p < 0.001). We observed decreasing values of pro-inflammatory serum marker IL-2 (p = 0.046) and a significant increase in the anti-inflammatory serum marker IL-10 (p = 0.003). No adverse events were reported during the study. CONCLUSIONS: Whole-body cryotherapy is an effective therapy for pain and disability treatment in chronic low back pain. It also produces changes in serum markers of inflammation, decreasing pro-inflammatory markers and increasing anti-inflammatory markers.

Two-year prevalence of spinal gunshot injuries in Mexico: A single center experience.

OBJECTIVE: The purpose of this study is to report epidemiological and clinical data of the patients that were admitted with spinal gunshot injuries. METHODS: This was retrospective study and observational study. Patients who had a spinal injury secondary to a gunshot wound that was admitted to our hospital (level III trauma center) from July 2018 through July 2020 were included in the study. Demographic and clinical data including age, gender, civil status, occupation, level of injury (cervical, thoracic, or lumbar), degree of neurological impairment at admission, associated injuries, treatment established, length of hospital stay, and mortality rate were recorded. RESULTS: A total of 55 patients were included in the study, of which 50 patients (90.9%) were men and five female patients (9.09%). The average age was 30.2 years. Three patients died during hospitalization representing a mortality rate of 5.45%. CONCLUSIONS: Spinal gunshot injuries are associated with significant sequelae, requiring long and costly treatments. This study obtained one of the highest incidences of gunshot injuries to the spine reported in the literature.

OBJETIVO: El propósito de este estudio es reportar datos epidemiológicos y clínicos de los pacientes que ingresaron con heridas por arma de fuego en columna. MÉTODOS: Estudio retrospectivo y observacional. Se incluyeron pacientes que presentaban una lesión medular a secundaria a una herida por arma de fuego que ingresaron en nuestro hospital (centro de trauma de nivel III) desde julio de 2018 hasta julio de 2020. Se registraron datos demográficos y clínicos que incluían edad, sexo, estado civil, ocupación, grado de lesión (cervical, torácica o lumbar), grado de deterioro neurológico al ingreso, lesiones asociadas, tratamiento establecido, duración de la estancia hospitalaria y tasa de mortalidad. RESULTADOS: Se incluyeron en el estudio un total de 55 pacientes, de los cuales 50 pacientes (90,9%) eran hombres y 5 mujeres (9,09%). La edad media fue de 30,2 años. Tres pacientes fallecieron durante la hospitalización lo que representa una tasa de mortalidad del 5,45%. CONCLUSIONES: Las lesiones por arma de fuego en la columna están asociadas con secuelas importantes, que requieren tratamientos largos y costosos. Este estudio obtuvo una de las incidencias más altas de heridas por arma de fuego en la columna vertebral reportadas en la literatura.

Comparación de cuatro técnicas quirúrgicas para el manejo de la espondilitis tuberculosa de la columna torácica en adultos.

OBJETIVO: Comparar la eficiencia de las cuatro técnicas quirúrgicas más utilizadas para el manejo de la espondilitis tuberculosa. MÉTODO: Estudio retrospectivo en el que se incluyeron pacientes adultos con diagnóstico confirmado de espondilitis tuberculosa, afectación de dos niveles vertebrales o menos y sin deformidad vertebral grave. Se recopilaron y revisaron los expedientes médicos, los estudios de imagen y los datos demográficos de los pacientes intervenidos para analizar retrospectivamente los resultados clínicos y funcionales de cada grupo. Las variables primarias fueron la erradicación de la infección, la fusión vertebral y las complicaciones. Entre las variables secundarias se estudiaron el sangrado intraoperatorio, la estancia hospitalaria y el tiempo quirúrgico. RESULTADOS: Entre los grupos analizados no hubo diferencias significativas (p ≥ 0.05) en la mayoría de las variables analizadas, pero sí (p ≤ 0.001) respecto al sangrado, el tiempo quirúrgico, la estancia intrahospitalaria y las complicaciones, a favor del abordaje posterior único. CONCLUSIONES: El abordaje posterior único logró una eficacia clínica similar a la del resto de los abordajes en términos de erradicación de la infección y fusión vertebral; sin embargo, se asoció a menores tiempo quirúrgico, sangrado, estancia hospitalaria y complicaciones. OBJECTIVE: To compare the efficiency of the 4 most used surgical techniques for the management of tuberculous spondylitis. METHOD: Retrospective study in which adult patients with a confirmed diagnosis of tuberculous spondylitis, involvement of two vertebral levels or less, and without severe vertebral deformity were included. The medical records, imaging studies, and demographic data of the operated patients were collected and reviewed to retrospectively analyze the clinical results of each group. The primary variables were cure of infection, spinal fusion, and complications. The secondary variables included intraoperative bleeding, hospital stay, and surgical time. RESULTS: There were no significant differences (p ≥ 0.05) in most of the variables analyzed, however, there were (p ≤ 0.001) regarding bleeding, surgical time, hospital stay and complications between the groups analyzed, with a lower result in all cases for the single posterior approach. CONCLUSIONS: The single posterior approach obtained a clinical efficacy similar to the rest of the approaches in terms of eradication of the infection and vertebral fusion, however, it was associated with less surgical invasion (surgical time and bleeding), a shorter hospital stay and complications.