Although there is no objective way to measure the contribution in which the disc extrusion or existence of an old PRAF had on pain or dysfunction, early detection is essential for optimizing patient management.
16) To date, PRAF have been estimated to occur in 0.
19,21,22) Some authors have postulated that injuries such as PRAF and pars stress reactions may be due to early sport specialization, as children expose themselves to similar repetitive motions that chronically load the non-fused structures in the spine.
Clinical presentation of PRAF is difficult to differentiate from other forms of discogenic low back pain in children, adolescents and young adults.
18) found that the most common signs and symptoms of those suffering from PRAF include paravertebral muscle spasm and tenderness, diminished deep tendon reflexes, sensory loss and motor loss.
When PRAF presents in adulthood, physical signs and symptoms are similar to lumbar disc herniation.
Since PRAF is an imaging-dependent diagnosis and that it often presents similar to lumbar disc herniation alone, this injury is easily missed when initial conservative management is effective.
The principles of conservative treatment for PRAF are similar to those for a herniated nucleus pulposus.
Several case reports involving the chiropractic management of pediatic and/or adolescent lumbar disc herniation with and without PRAF have been published.
Although speculative, this may have been the development of the initial PRAF lesion as the mechanism of injury and both the classification and age of the fracture (type III) are consistent.
Costos desagregados del programa en miles de dolares US y RCT PRAF
('000) RPS ('000) Ano 1999 2000 2001 2002 2000 2001 Costo total 482 2 483 1 669 1 930 1 149 1 348 del programa Costo de las -- 2 589 5 469 5 102 452 2 702 transferencias RCT -- 0,959 0,305 0,378 2,543 0,499 RCT sin diseno, -- 0,298 0,198 0,068 0,718 0,203 evaluacion externa, identificacion e incorporacion de beneficiarios RPS ('000) Ano 2002 Costo total 1 492 del programa Costo de las 3 192 transferencias RCT 0,467 RCT sin diseno, 0,212 evaluacion externa, identificacion e incorporacion de beneficiarios Nota: El tipo de cambio que se utilizo para PROGRESA y PAL fue la tasa promedio de 1999, 10 pesos por dolar, para el PRAF
se uso la tasa constante de L15 por dolar.