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CORRELATION OF FUSION RATE ON LUMBAR SPINAL STENOSIS POST PLIF WITH FUNCTIONAL OUTCOME Dharma, Adi Surya; Ermawan, Rieva; Utomo, Pamudji; Handojo, Handry Tri
Biomedika Vol 11, No 2 (2019): Biomedika Agustus 2019
Publisher : Universitas Muhamadiyah Surakarta

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.23917/biomedika.v11i2.7613

Abstract

Lumbar spinal stenosis dengan instabilitas, salah satu pilihan pengobatannya dengan laminektomi dekompresi, stabilisasi posterior dan PLIF (Posterior Lumbar Interbody Fusion). Derajat fusi dapat ditentukan dengan pemeriksaan CT-scan post operatif. Sedangkan untuk menilai disabilitas dan skor fungsional pada pasien LSS menggunakan skor Oswestry Disability Index (ODI). Penelitian ini merupakan penelitian analisis observasional pada 18 pasien LSS yang telah dilakukan operasi instrumentasi PLIF. Pasien diminta mengisi kuesioner ODI dan dilakukan evaluasi CT Scan, kemudian dilakukan uji korelasi data yang didapat. Penelitian ini menunjukkan adanya korelasi yang signifikan antara derajat fusi dengan ODI. Koefisien korelasi antara derajat fusi dengan ODI didapatkan 0,904 dengan nilai signifikansi 0,00 (p<0,05). Derajat fusi post operasi dari gambaran CT Scan memiliki korelasi yang signifikan terhadap derajat disabilitas menggunakan skor ODI.Kata Kunci: Lumbar spinal stenosis, Fusion rate, PLIF, ODI Lumbar spinal stenosis with instability one of the treatment options is decompression laminectomy, posterior stabilization and PLIF (Posterior Lumbar Interbody Fusion). The degree of fusion can be determined by CT scan post -operatively. To assess disability and functional scores in LSS patients can use the Oswestry Disability Index (ODI). This study was an observational analysis study in 18 LSS patients who had PLIF instrumentation surgery. Patients were asked to fill in the ODI questionnaire and were evaluated for CT Scan, then the correlation data were obtained. This study shows a significant correlation between the degree of fusion and ODI. The correlation coefficient between the degree of fusion and ODI is 0.904 with a significance value of 0.00 (p <0.05). The degree of postoperative fusion of CT scans has a significant correlation to the degree of disability using the ODI score.Keywords: Lumbar spinal stenosis, Fusion rate, PLIF, ODI
Fusi In Situ Posterior for Congenital Scoliosis with Wedge Hemivertebrae Using Single Rod and Pedicle Screw Instrumentation in Girl 2 Years Old: A Case Report Utomo, Pamudji; Dharma, Adi Surya; Ermawan, Rieva
Indonesian Journal of Medicine Vol. 5 No. 2 (2020)
Publisher : Masters Program in Public Health, Universitas Sebelas Maret, Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (714.963 KB)

Abstract

Background: Many spinal vertebral anoma­lies often occur, both scoliosis and kyfosis. In scoliosis, congenital abnormalities caused by hemivertebrae are the most common cause of abnormalities. The choice of treatment used can be either non-operative or operative. How­ever, non-operative treatment does not show satisfactory results to prevent the development of deformity. Operative treatment is an option that is considered to indicate more satisfying results. A variety of procedures such as in-situ posterior or with or without instrumentation anteroposterior fusions, combined anterior and poste­rior convex hemiepiphysiodesis and hemi­arthrodesis, and hemivertebral excision with fusion. Fusi In-situ posterior is a procedure option that is considered more beneficial for both surgeons and patients. This study aimed to evaluate the fusi in situ posterior for conge­nital scoliosis with wedge hemivertebrae using single rod and pedicle screw instrumentation in girl 2 year old.Case Presentation: Girl 2 year old with wedge hemivertebrae operated with fusion in situ posterior using single rod and pedicle screw instrumentation.Results: The operative treatment was per­formed on 2 hours operation time with amount of bleeding produced is 80 cc. There were no cranckshaft phenomena and no clinical and radological features suggestive of spinal ste­nosis. There were no major vascular or neuro­gical complications related to the pedicle screws. Then patient wore body jacket for limitation movement before fusion.Conclusion: Posterior situ fusion is perform­ed as convex fusion to avoid curve progression. Fusion in situ posterior using single rod and pedicle screw instrumentation. In congenital scoliosis is minimal blood loss, less traumatic, simple, safe and effective procedure. This study showed the early fusi in situ posterior of conge­nital scoliosis structural changes occur above or below can reduce fusion length, prevent curve progression and effectively achieve a more satisfactory correction without hazardous iatro­genic spinal stenosis, crankshaft phenomena, or neurological complications. Further research is needed to assess the progress of the outcome of surgeryKeywords: congenital scoliosis, wedge hemi­vertebrae, convex, fusi in situ posteriorCorrespondence: Pamudji Utomo. Department of Orthopaedic & Traumatology, Faculty of Medicine, Universitas Sebelas Maret/ Prof. Dr. R. Soeharso Ortho­pae­dic Hospital, SurakartaIndonesian Journal of Medicine (2020), 05(02): 125-130https://doi.org/10.26911/theijmed.2020.05.02.05