Background: Spinal tuberculosis (TB) is a common form of extrapulmonary TB. Although the first li... more Background: Spinal tuberculosis (TB) is a common form of extrapulmonary TB. Although the first line of the treatment is anti-TB medications, patients with severe neurological deficits, spinal instability, and/or kyphotic deformity often warrant surgery. Here, we report five cases of spinal TB requiring operative intervention at Hasan Sadikin General Hospital, Bandung, Indonesia. Case Description: We operated on five patients with spinal TB cases from 2019 to October 2021. In addition to appropriate medical management, all five patients successfully underwent laminectomy with or without posterior stabilization. Conclusion: It is essential to establish the diagnosis and surgically manage patients with spinal TB early in the clinical course to minimize residual post-operative neurological deficits.
Introduction : Spinal implants were initially, and are still, used for the supplementation of bon... more Introduction : Spinal implants were initially, and are still, used for the supplementation of bony fusion. However, bony fusion operations were initially performed without implants.1 In the US, Wire and screw fixation of the unstable spine techniques remained to use until the pre-World War II years. 20 years after World War II, there were two major breakthroughs in spine surgery: the Harrington system for spine stabilization and deformity correction and the interspinous wiring technique of Rogers. Rogers described the technique of cervical interspinous wiring in the early 1940s. Harrington introduced his instrumentation system in 1962. Discussion : Since then, modifications of both techniques have been devised to increase their security of fixation. The next significant advance in dorsal spinal stabilization was the development of multisegmental spinal instrumentation. Multisegmental instrumentation permits sharing of the load applied to the instrumentation construct with multiple v...
Pendahuluan. Cedera tulang servikal merupakan cedera tulang belakang yang paling ditakuti, baik b... more Pendahuluan. Cedera tulang servikal merupakan cedera tulang belakang yang paling ditakuti, baik bagi dokter, pasien dan keluarganya. Semua pasien dengan cedera tulang servikal subaksial yang tidak stabil, harus segera dilakukan fiksasi menggunakan traksi servikal. Foto polos servikal lateral masih merupakan standar dalam menganalisis stabilitas stuktur tulang servikal dan masih memiliki nilai diagnostik tinggi dalam menge- valuasi keberhasilan traksi servikal pasien cedera tulang servikal. Keberhasilan traksi servikal dapat diprediksi dengan melihat tercapainya realignment tulang servikal berdasarkan evaluasi foto polos servikal lateral serial pada pasien cedera tulang servikal subaksial. Metode. Penelitian ini merupakan studi retrospektif yang dilakukan terhadap 30 pasien cedera tulang servikal subaksial yang masuk Unit Gawat Darurat (UGD) Rumah Sakit dr. Hasan Sadikin Bandung (RSHS) periode 2009–2013. Studi ini menggunakan metode statistik logistik regresi dengan kemaknaan berdasa...
Hypertrophy of the posterior spinal elements leading to compromise of the spinal canal and its ne... more Hypertrophy of the posterior spinal elements leading to compromise of the spinal canal and its neural elements is a well-recognized pathological entity affecting the lumbar or cervical spine. Such stenosis of the thoracic spine in the absence of a generalized rheumatological,metabolic, or orthopedic disorder, or a history of trauma is generally considered to be rare. Spinal ligaments, such as the ligamentum flavum (LF), are prone to degeneration and can lead to back pain and nerve dysfunction. Ossification of ligamentum flavum (OLF) is a pathological condition that cause neurological symptoms and usually occurs in the thoracic spine and less frequently in the cervical spine. However the disease is now being increasingly recognized as acause of thoracic myelopathy. We report a rare case of thoracic myelopathy caused by OLF. A 48-year-old male presented with a chief complaint of weakness of bilateral lower extremities. Neurological examination revealed sensory deficit at Th 11 level b...
Tuberculous spondylitis is a chronic infectious disease caused by Mycobacteriumtuberculosis on th... more Tuberculous spondylitis is a chronic infectious disease caused by Mycobacteriumtuberculosis on the vertebral bone. Involved less than 3% of all cases of TB, but the incidencevaries around the world, and is associated with the quality of public health and socioeconomicconditions.The purpose of this study is to investigate the presurgical aspects of nutrition inpatients with tuberculous spondylitis. A total of 39 consecutive patients between January 2011-December 2012 were evaluated retrospectively. All patients diagnosed with spondylitistuberculousis and treated with decompression, stabilization and fusion. All patients had beendiagnosed with Spondylitis tuberculousis based on history taking, physical examination,laboratory finding and MRI. Our study showed that of all subjects, ten male patients and eightfemale patients had cervical (n=1), thoracic (n=15), and lumbar (n=2) tuberculousspondylitis.The average age of the patients was 32.83 ± 12.25 (17-56) years old. The averagepreopera...
Asian Australasian Neuro and Health Science Journal (AANHS-J), 2019
Cervical trauma is a serious condition, that may cause permanent disability or even death. Cervic... more Cervical trauma is a serious condition, that may cause permanent disability or even death. Cervical trauma occurs in 2-7% of blunt trauma patients. In Europe, the incidence of cervical trauma is approximately 9-17/100,000 annually,. The most common mechanisms of injury causing cervival trauma are traffic accidents and falls, which the most commonly injured vertebra is vertebral C2 (axis). Diagnostics of cervical trauma are based on good clinical assessment and prompt radiological imaging. Several patient groups, such as the elderly and patients with traumatic brain injury are highly susceptible to cervical trauma. The diagnostics of cervivcal trauma remain challenging for clinical practitioners and failure to diagnose cervical trauma in acute care may have serious consequences.
We are living in an era that performs minimally invasive approaches to many surgical aspects, and... more We are living in an era that performs minimally invasive approaches to many surgical aspects, and spine surgery is not an exception. Nowadays, minimally invasive spine surgery is a routine procedure in many countries around the world. It began in the mid-twentieth century and has now developed into a large field of progressive spinal surgery. This paper will review the philosophy, indications, patient selections, advantages, and disadvantages of minimally invasive spinal surgery.
The magnitude problems of brachial plexus lesions are not only about the surgical approaches but ... more The magnitude problems of brachial plexus lesions are not only about the surgical approaches but also the basic problems. Its vague clinical symptoms, the complexity of anatomy structure, the use of advanced imaging followed by electrophysiology to address the lesions, and the challenging of surgical timing and options make those lesions management more challenging. These challenges in Indonesia are more difficult because not so many neurosurgeons are familiar with brachial plexus surgery.Brachial plexus surgery is in evolution. For brachial plexus nerve sheath tumours, a fascicular level resection of tumours and preservation of uninvolved fascicles is now possible. Neuropathic pain may be improved by a dorsal root entry zone lesion procedure. The timing of surgery is different in each pathology, especially in traumatic injury. In traumatic injury, it depends on several factors, e.g. the mechanism of injury, type of injury, the speed of the vehicle, and the mode of fall while victim...
The incidence of spine injury following accidents are still very high in developing countries. Ma... more The incidence of spine injury following accidents are still very high in developing countries. Many problems occur after the accident including primary intervention on the scene, transportation to the public primary hospital, the referral system, and finally, the management at the central hospital.Cervical spinal cord injuries represent 20-33% of total spinal injuries with the prevalence of the subaxial levels. In patients with a preoperative neurological deficit due to spine trauma, in case of spinal cord compression or instability, surgery is often the treatment of choice to grant a chance of neurological recovery, early mobilization, and faster return to usual daily activities compared to the conservative treatment. In the past, many authors suggested a delayed surgical treatment to reduce postoperative complications rate, but recent studies have shown that an early decompression…
Background: Spinal tuberculosis (TB) is a common form of extrapulmonary TB. Although the first li... more Background: Spinal tuberculosis (TB) is a common form of extrapulmonary TB. Although the first line of the treatment is anti-TB medications, patients with severe neurological deficits, spinal instability, and/or kyphotic deformity often warrant surgery. Here, we report five cases of spinal TB requiring operative intervention at Hasan Sadikin General Hospital, Bandung, Indonesia. Case Description: We operated on five patients with spinal TB cases from 2019 to October 2021. In addition to appropriate medical management, all five patients successfully underwent laminectomy with or without posterior stabilization. Conclusion: It is essential to establish the diagnosis and surgically manage patients with spinal TB early in the clinical course to minimize residual post-operative neurological deficits.
Introduction : Spinal implants were initially, and are still, used for the supplementation of bon... more Introduction : Spinal implants were initially, and are still, used for the supplementation of bony fusion. However, bony fusion operations were initially performed without implants.1 In the US, Wire and screw fixation of the unstable spine techniques remained to use until the pre-World War II years. 20 years after World War II, there were two major breakthroughs in spine surgery: the Harrington system for spine stabilization and deformity correction and the interspinous wiring technique of Rogers. Rogers described the technique of cervical interspinous wiring in the early 1940s. Harrington introduced his instrumentation system in 1962. Discussion : Since then, modifications of both techniques have been devised to increase their security of fixation. The next significant advance in dorsal spinal stabilization was the development of multisegmental spinal instrumentation. Multisegmental instrumentation permits sharing of the load applied to the instrumentation construct with multiple v...
Pendahuluan. Cedera tulang servikal merupakan cedera tulang belakang yang paling ditakuti, baik b... more Pendahuluan. Cedera tulang servikal merupakan cedera tulang belakang yang paling ditakuti, baik bagi dokter, pasien dan keluarganya. Semua pasien dengan cedera tulang servikal subaksial yang tidak stabil, harus segera dilakukan fiksasi menggunakan traksi servikal. Foto polos servikal lateral masih merupakan standar dalam menganalisis stabilitas stuktur tulang servikal dan masih memiliki nilai diagnostik tinggi dalam menge- valuasi keberhasilan traksi servikal pasien cedera tulang servikal. Keberhasilan traksi servikal dapat diprediksi dengan melihat tercapainya realignment tulang servikal berdasarkan evaluasi foto polos servikal lateral serial pada pasien cedera tulang servikal subaksial. Metode. Penelitian ini merupakan studi retrospektif yang dilakukan terhadap 30 pasien cedera tulang servikal subaksial yang masuk Unit Gawat Darurat (UGD) Rumah Sakit dr. Hasan Sadikin Bandung (RSHS) periode 2009–2013. Studi ini menggunakan metode statistik logistik regresi dengan kemaknaan berdasa...
Hypertrophy of the posterior spinal elements leading to compromise of the spinal canal and its ne... more Hypertrophy of the posterior spinal elements leading to compromise of the spinal canal and its neural elements is a well-recognized pathological entity affecting the lumbar or cervical spine. Such stenosis of the thoracic spine in the absence of a generalized rheumatological,metabolic, or orthopedic disorder, or a history of trauma is generally considered to be rare. Spinal ligaments, such as the ligamentum flavum (LF), are prone to degeneration and can lead to back pain and nerve dysfunction. Ossification of ligamentum flavum (OLF) is a pathological condition that cause neurological symptoms and usually occurs in the thoracic spine and less frequently in the cervical spine. However the disease is now being increasingly recognized as acause of thoracic myelopathy. We report a rare case of thoracic myelopathy caused by OLF. A 48-year-old male presented with a chief complaint of weakness of bilateral lower extremities. Neurological examination revealed sensory deficit at Th 11 level b...
Tuberculous spondylitis is a chronic infectious disease caused by Mycobacteriumtuberculosis on th... more Tuberculous spondylitis is a chronic infectious disease caused by Mycobacteriumtuberculosis on the vertebral bone. Involved less than 3% of all cases of TB, but the incidencevaries around the world, and is associated with the quality of public health and socioeconomicconditions.The purpose of this study is to investigate the presurgical aspects of nutrition inpatients with tuberculous spondylitis. A total of 39 consecutive patients between January 2011-December 2012 were evaluated retrospectively. All patients diagnosed with spondylitistuberculousis and treated with decompression, stabilization and fusion. All patients had beendiagnosed with Spondylitis tuberculousis based on history taking, physical examination,laboratory finding and MRI. Our study showed that of all subjects, ten male patients and eightfemale patients had cervical (n=1), thoracic (n=15), and lumbar (n=2) tuberculousspondylitis.The average age of the patients was 32.83 ± 12.25 (17-56) years old. The averagepreopera...
Asian Australasian Neuro and Health Science Journal (AANHS-J), 2019
Cervical trauma is a serious condition, that may cause permanent disability or even death. Cervic... more Cervical trauma is a serious condition, that may cause permanent disability or even death. Cervical trauma occurs in 2-7% of blunt trauma patients. In Europe, the incidence of cervical trauma is approximately 9-17/100,000 annually,. The most common mechanisms of injury causing cervival trauma are traffic accidents and falls, which the most commonly injured vertebra is vertebral C2 (axis). Diagnostics of cervical trauma are based on good clinical assessment and prompt radiological imaging. Several patient groups, such as the elderly and patients with traumatic brain injury are highly susceptible to cervical trauma. The diagnostics of cervivcal trauma remain challenging for clinical practitioners and failure to diagnose cervical trauma in acute care may have serious consequences.
We are living in an era that performs minimally invasive approaches to many surgical aspects, and... more We are living in an era that performs minimally invasive approaches to many surgical aspects, and spine surgery is not an exception. Nowadays, minimally invasive spine surgery is a routine procedure in many countries around the world. It began in the mid-twentieth century and has now developed into a large field of progressive spinal surgery. This paper will review the philosophy, indications, patient selections, advantages, and disadvantages of minimally invasive spinal surgery.
The magnitude problems of brachial plexus lesions are not only about the surgical approaches but ... more The magnitude problems of brachial plexus lesions are not only about the surgical approaches but also the basic problems. Its vague clinical symptoms, the complexity of anatomy structure, the use of advanced imaging followed by electrophysiology to address the lesions, and the challenging of surgical timing and options make those lesions management more challenging. These challenges in Indonesia are more difficult because not so many neurosurgeons are familiar with brachial plexus surgery.Brachial plexus surgery is in evolution. For brachial plexus nerve sheath tumours, a fascicular level resection of tumours and preservation of uninvolved fascicles is now possible. Neuropathic pain may be improved by a dorsal root entry zone lesion procedure. The timing of surgery is different in each pathology, especially in traumatic injury. In traumatic injury, it depends on several factors, e.g. the mechanism of injury, type of injury, the speed of the vehicle, and the mode of fall while victim...
The incidence of spine injury following accidents are still very high in developing countries. Ma... more The incidence of spine injury following accidents are still very high in developing countries. Many problems occur after the accident including primary intervention on the scene, transportation to the public primary hospital, the referral system, and finally, the management at the central hospital.Cervical spinal cord injuries represent 20-33% of total spinal injuries with the prevalence of the subaxial levels. In patients with a preoperative neurological deficit due to spine trauma, in case of spinal cord compression or instability, surgery is often the treatment of choice to grant a chance of neurological recovery, early mobilization, and faster return to usual daily activities compared to the conservative treatment. In the past, many authors suggested a delayed surgical treatment to reduce postoperative complications rate, but recent studies have shown that an early decompression…
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