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Doctoral Thesis
DOI
https://doi.org/10.11606/T.17.2019.tde-20022019-111113
Document
Author
Full name
Bruno Carvalho Portes Lopes
E-mail
Institute/School/College
Knowledge Area
Date of Defense
Published
Ribeirão Preto, 2018
Supervisor
Committee
Lauretti, Gabriela Rocha (President)
Maranho, Daniel Augusto Carvalho
Oliveira, Renê Donizeti Ribeiro de
Oliveira, Valdeci Manoel de
Title in Portuguese
Disfunção da articulação sacroilíaca (DASI) e dor lombar. Avaliação em amostra de população brasileira
Keywords in Portuguese
Articulação sacroilíaca
DIANA
Dor lombar
Radiofrequência
Abstract in Portuguese
Foram examinados 192 pacientes consecutivamente com o objetivo de alcançar 50 pacientes com diagnóstico de DASI (26% incidência). Dos 50 pacientes submetidos ao bloqueio intra-articular sacroilíaco com dexametasona e lidocaína; 41 pacientes (82%) relataram melhora da dor e da qualidade de vida; e um menor consumo de analgésicos de resgate nos 6 meses subsequentes. O bloqueio trouxe uma melhora da dor imediata de forma segmentar nas regiões dos dermátomos, havendo uma queda do nível médio de dor de 8 para 3 (p<0.001). O consumo de analgésicos de resgate também foi significativamente reduzido (p<0.01). Entretanto, 9 pacientes (18%) não relataram melhora duradoura no terceiro mês de avaliação e foram submetidos a ablação por radiofrequência de resfriamento dos ramos sacrais e do ramo mediano de L4-L5. Ao avaliar os 9 pacientes submetidos a radiofrequência um não obteve sucesso e foi diagnosticado com cisto sacral. Outro não ficou satisfeito com nenhum dos procedimentos. Este paciente tinha um histórico de síndrome póslaminectomia, e na ocasião estava em uso de 40mg de metadona e 1200mg de gabapentina diariamente. Os outros 7 pacientes obtiveram sucesso (78%).
Title in English
Sacroiliac joint disfunction (SIJD) and lumbar pain. Evaluation in a Brazilian population
Keywords in English
DIANA
Lumbar pain
Radiofrequency
Sacroiliac joint
Abstract in English
192 patients were consecutively examined in order to reach 50 patients with SIJD diagnosis (26% incidence). From the 50 patients submitted to intra-articular dexamethasone plus lidocaine SIJ block; 41 patients (82%) refereed pain and quality of life improvement; and lesser rescue analgesics consumption during 6 consecutive months. The block induced a prompt onset of pain relief in a strictly segmental manner nearby the dermatomes, and there was a drop in mean pain score from 8 to 3 cm (p <0.001). Rescue analgesics consumption was also significantly reduced (p<0.01). However, 9 patients (18%) did not refer long lasting improvement in the third month of evaluation and underwent cooled radiofrequency ablation of sacral and radiofrequency ablation of L4-L5 median branch. When one evaluate the 9 patients who underwent radiofrequency, one was not successful and had diagnosis of cystic sacral formation. Other was not happy at all with any of the procedures. This patient had past history of post-laminectomy syndrome, and was at the time using 40 mg methadone and 1200 mg gabapentin daily. The other 7 patients were successful (78%).
 
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Publishing Date
2019-08-14
 
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