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Guia Lumbalgia (cambios 8 feb).FH10 - Digemid

Guia Lumbalgia (cambios 8 feb).FH10 - Digemid

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Bibliografía92 921. Atcheson SG, Dymeck T. Rapid resolution of chronic sciatica with intravenous infliximab afterfailed epidural steroid injections. Spine. 2004 Jun 15;29(12):E248-50.2. Olmarker K, Nutu M, Storkson R. Changes in spontaneous behavior in rats exposed to experimentaldisc herniation are blocked by selective TNF-alpha inhibition. Spine. 2003 Aug 1;28(15):1635-41; discussion 1642.3. Tobinick EL. Targeted etanercept for discogenic neck pain: uncontrolled, open-label results intwo adults. Clin Ther. 2003 Apr;25(4):1211-8.4. Onda A, Yabuki S, Kikuchi S. Effects of neutralizing antibodies to tumor necrosis factor-alpha onnucleus pulposus-induced abnormal nociresponses in rat dorsal horn neurons. Spine. 2003 May15;28(10):967-725. Tobinick EL, Britschgi-Davoodifar S. Perispinal TNF-alpha inhibition for discogenic pain. SwissMed Wkly. 2003 Mar 22;133(11-12):170-7.6. Karppinen J, Korhonen T, Malmivaara A, Paimela L, Kyllonen E, Lindgren KA, Rantanen P,Tervonen O, Niinimaki J, Seitsalo S, Hurri H. Tumor necrosis factor-alpha monoclonal antibody,infliximab, used to manage severe sciatica. Spine. 2003 Apr 15;28(8):750-3; discussion 753-4.7. Wehling P.Transfer of genes to intervertebral disc cells: proposal for a treatment strategy of spinaldisorders by local gene therapy. Joint Bone Spine. 2001 Dec;68(6):554-6.8. Yabuki S, Onda A, Kikuchi S, Myers RR. Prevention of compartment syndrome in dorsal rootganglia caused by exposure to nucleus pulposus. Spine. 2001 Apr 15;26(8):870-5.9. Olmarker K, Rydevik B. Selective inhibition of tumor necrosis factor-alpha prevents nucleuspulposus-induced thrombus formation, intraneural edema, and reduction of nerve conductionvelocity: possible implications for future pharmacologic treatment strategies of sciatica. Spine.2001 Apr 15;26(8):863-910.Cooper RG. Freemont AJ. TNF-a blockade for herniated intervertebral disc-induced sciatica: Away forward at last?.Rheumatology 2004;43(2):119-1216.3. TRATAMIENTOS QUE HAN SIDO EVALUADOS PERO NO PUEDENSER RECOMENDADOS6.3.1. Infiltraciones de toxina botulínicaRecomendaciónNo se recomienda prescribir infiltraciones de toxina botulina por lumbalgia inespecíficaSíntesis de la evidenciaLa infiltración de toxina botulínica es más eficaz que la infiltración Nivel Cde placebo para mejorar la lumbalgia a corto plazo.ComentariosLa repetición de infiltraciones de toxina botulínica puede debilitar los músculos. 1Pese a existir evidencia sobre la eficacia de esta tecnología (frente a placebo), nose recomienda esta tecnología. Esta es la única discrepancia clara que contienela Guía entre el sentido de la evidencia y la recomendación. Los motivos son lossiguientes:

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