[Multimodal treatment of chronic unspecific low back pain]. / Tratamiento multimodal para lumbalgia crónica inespecífica.

UNLABELLED: A prospective longitudinal was conducted using three multimodal treatment regimens that included a different NSAID for each of the regimens (thiaprofenic acid, piroxicam, meloxicam), a steroid (betamethasone) and a muscle relaxant (tetrazepam). 240 patients with a history of chronic low back pain for more than six months were treated; they were divided into three groups of 80 patients assigned to each regimen. RESULTS: Patients treated with thiaprophenic acid and meloxicam improved a total of 6 points, going from an initial mean score of 8 in the VAS at the onset of treatment, to a score of 2 at the end of treatment during a mean of 3 months. Patients treated with piroxicam had a 5-point improvement in the VAS, from a mean score of 7 at the onset of treatment to a mean score of 2 in a mean of 3 months. COMPLICATIONS: The meloxicam group had less epigastric complications, 1.25% compared with 2.91% for the thiaprophenic acid group and 3.75% for piroxicam. CONCLUSION: This combination, which includes an antiinflammatory agent, a steroid and a muscle relaxant, is an appropriate treatment regimen because it includes drugs that act on the antiinflammatory component, the pain component and the emotional component, which are the most common factors mentioned as probable causes of unspecific low back pain.

[Proximal tibial valgus osteotomy semi-invasive technique. A report on 66 cases]. / Osteotomía tibial proximal valguizante. Técnica semiinvasiva. Reporte de 66 casos.

The purpose of the present study is to report sixty six high tibial lateral osteotomies (HTO) make on patients with osteoarthrosis of the medial compartment, using modified semi invasive technique. With this technique the incision is 5-6 mm, fibular head is not resect, biceps femoris tendon is not cut, no internal fixation is place; the median follow-up was 6.4 years. The status of the patient at the final follow-up was analyzed using Knee Society Score (KSS), and Visual Analogue Scale (VAS). An average of 85 points was achieved after HTO compared to 55 points preoperative and 83 points after HTO compared to 51 points preoperative, was obtained at the evaluation with KSS. The only complication was superficial infections (4%). Serious complications did not appear. There was not pseudoarthrosis.