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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

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

Secondary Knee Osteoarthritis with Medial Instability and Tibial Defect due to Chronic Abscess Treated by Total Knee Arthroplasty with Metal Augmentation - Case Report Soetjahjo, Bintang; Hancoro, Udi Herunefi; Ermawan, Rieva; Saputra, Rhyan Darma; Akbar, Hillan
Indonesian Journal of Medicine Vol. 6 No. 2 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Background:Knee osteoarthritis (OA), known as degenerative joint disease, is typically the result of wear and tear and progressive loss of articular cartilage, most common in elderly women and men. Knee OA is a leading cause of disability and increase with an aging and overweight population. Total Knee Arthroplasty (TKA) is a common surgical treatment of OA knee that highly cost-effective procedure. Stable placement of components is difficult and thus it presents technical challenges for the surgeon but various options are available for managing these defects.Case Report: A 58 years-old housewife came to our clinic due to chronic left knee pain with associated instability since two years ago and getting worse in last three months. She already had knee joint supplementation injections and physical therapy but no improvements. Based on our clinical and radiological findings, our assessment was secondary left knee osteo-arthritis with medial instability and tibial defect due to chronic abscess. Patient underwent TKA to correct this condition. A revised implant was used to close the defect in the medial part of the tibia and soft tissue reconstruction procedure was used to correct the instability.Result: On the first postoperative month, the patient underwent rehabilitation and physical therapy to strengthen her lower limb muscles. On the second month, she started to walk using walking assisted device. On the ninth months follow-up, the patient was able to walk normally without assisted device, the pain disappeared and the symptoms of knee instability were reduced.Conclusion:Bone defects are commonly encountered during TKA, which still has no standard treatment to cure. In this case, the use of metal augmentation with revision implant give satisfactory results with good clinical outcome.Keywords: Osteoarthritis, Total Knee Arthro¬plasty, knee instability, tibial defect, metal augmentationCorrespondence:Bintang Soetjahjo. Dr. Moewardi Hospital. Jl. Kolonel Sutarto 132, Jebres, Surakarta, Central Java 57126, Indonesia. Mobile: +628122987359. Email: bjortho@yahoo.comIndonesian Journal of Medicine (2021), 06(02): 168-176https://doi.org/10.26911/theijmed.2021.06.02.06

Masalah Perioperatif pada Kasus Emergensi Ortopedik Selama Pandemi Covid-19: Laporan Kasus Amputasi Darurat Pasien Suspek Covid-19 Soetjahjo, Bintang; Hancoro, Udi Herunefi; Ermawan, Rieva; Saputra, Rhyan Darma; Nugroho, Bagus Jati; Abdulhamid, Muhammad
SENADA : Semangat Nasional Dalam Mengabdi Vol. 1 No. 3 (2021): SENADA: Semangat Nasional Dalam Mengabdi
Publisher : Perkumpulan Dosen Periset Indonesia

Show Abstract | Download Original | Original Source | Check in Google Scholar

Penyakit Coronavirus 2019 (COVID-19), yang disebabkan oleh severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), telah menyebar ke seluruh dunia. Selama epidemi COVID-19 yang sedang berlangsung, banyak rumah sakit yang menunda sebagian besar operasi elektif. Namun, beberapa operasi darurat, terutama untuk pasien trauma, tidak bisa dihindari. Untuk pasien yang dicurigai atau dikonfirmasi COVID-19, protokol standar yang terkait persiapan pra operasi, manajemen intraoperatif, dan pengawasan pasca operasi harus diterapkan untuk menghindari infeksi nosokomial dan memastikan keselamatan pasien juga tenaga Kesehatan yang terlibat. Dalam artikel ini kami melaporkan kasus seorang pasien berusia 65 tahun dengan crush injury tungkai bawah dan suspek covid-19. Pasien direncanakan untuk menjalani CITO debridemen dan amputasi di atas lutut. Artikel ini kemudian membahas pertimbangan perioperatif dan teknis yang penting untuk menangani pasien COVID-19 yang membutuhkan perawatan darurat, tanpa mengesampingkan hasil klinis sembari memastikan keselamatan staf yang ada

The CERVICOTHORACIC SPINAL TUBERCULOSIS TREATED WITH A COMBINED SINGLE STAGE SURGERY: Spinal Tuberculosis Ermawan, Rieva; jiwandono, bayu sakti jiwandono; Utomo, Pamudji
JAMBI MEDICAL JOURNAL "Jurnal Kedokteran dan Kesehatan" Vol. 8 No. 2 (2020): JAMBI MEDICAL JOURNAL Jurnal Kedokteran Dan Kesehatan
Publisher : FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN UNIVERSITAS JAMBI

Introduction Tuberculosis of the cervical spine is rare, comprising only 3-5% of cases of tuberculosis of the spine. TB spine is the most common form of skeletal TB. It is the most dangerous manifestation of TB due to the involvement of the spinal cord and the resultant neurologic impairment. Objective The objective of this paper is to present our experience with a rare case of cervical spine spondylitis. This case stresses the usefulness of a single-stage anterior and posterior approach with posterior instrumentation. Method We present a case report based on our internal documents. We report a case of spondylitis tuberculosis of the C6-C7 cervical spine associated with retropharyngeal abscess in a 15-year-old Indonesian female. Neck pain and weakness of both upper and lower extremities were the main features. There was a history of weight loss, fever, and excessive night sweats. No antecedent history of trauma to the head and neck region. Results We did a single-stage anterior and posterior approach with posterior instrumentation. Anterior approach was done to evacuate and debridement of the retropharyngeal abscess. The posterior approach was done for posterior instrumentation with pedicle screw and dual rod. We did posterior stabilization on Cervical 5-6 and Thoracal 3-4. One week after surgery we found remarkable improvement of the pain and extremities functions. Conclusion In the surgical treatment of cervicothoracic spinal tuberculosis, a single-stage cervical combined anterior-posterior approach with posterior instrumentation is capable of complete debridement for tuberculosis lesions. Operative management in our patient resulted in remarkable improvement. Keywords: Cervicothoracic spondylitis, tuberculosis, retropharyngeal abscess

Bovine nucleus pulposus decellularization using freeze drying technique to form a biological scaffold Romaniyanto; Prijosedjati, Raden Andhi; Ermawan, Rieva; Hakim, Fikar Arsyad; Saddalqous
Journal of International Surgery and Clinical Medicine Vol. 4 No. 1 (2024): (Available online: 1 June 2024)
Publisher : Surgical Residency Program Syiah Kuala University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.51559/jiscm.v4i1.54

Introduction: As much as 40% of low back pain patients are caused by degenerative disc disease. The current treatments are fusion stabilization and total disc replacement, which have a risk for adjacent segment disease. These suboptimal results have become the beginning of the development of regenerative therapy. The success of this therapy will increase if the scaffold meets the ideal conditions. Biological scaffolds provide a cell growth environment that resembles the original tissue. Bovine intervertebral nucleus pulposus can become promising scaffolds. Objective: This research describes the proper freeze-drying approach for decellularizing bovine nucleus pulposus to create a biological scaffold. Methods: We conducted an experimental post-test control design study using bovine coccygeal nucleus pulposus material. All treatment groups underwent freeze-drying with Buchi Lyovapor™ L-200/L-200 Pro. All groups were evaluated for the level of decellularization using the Quick-DNA™ Miniprep Plus Kit (Zymo Research®) and remaining glycosaminoglycan levels by Alcian Blue staining. Results: Comparison of DNA concentrations obtained p-values respectively <0.0001 (p <0.05), which means that all the treatments showed a decrease in DNA concentration compared to the control group. The comparison of the glycosaminoglycan percentage between the P1 vs. Control group obtained a value of p=0.381 (p>0.05), which means that the glycosaminoglycan percentage results for the P1 group were not significantly different from the control group. Conclusion: This study of group P1 showed that decellularization of the bovine nucleus pulposus by freeze-drying technique can form an excellent biological scaffold.

Functional Outcome Evaluation of Grade III Open Tibial Fracture Treated by External Fixation as Definitive Treatment Soetjahjo, Bintang; Ermawan, Rieva; Saputra, Rhyan Darma; Hancoro, Udi Herunefi; Nugroho, Bagus Jati; Anugra, Jiva Yori
Indonesian Journal of Medicine Vol. 6 No. 4 (2021)
Publisher : Masters Program in Public Health, Sebelas Maret University

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.26911/theijmed.2021.6.4.381

Background: Tibial shaft fractures including open tibial fractures grade III are one of the most common fractures of long bones. There are many methods of conservative and operative treatment, one of them is external fixation. External fixation is more common used temporary in polytraumatized patients with tibial shaft fractures. The study was undertaken to see if the patient can be treated with external fixation as the definitive treatment and evaluate the functional outcome after the treatment.Subjects and Method: A retrospective review of a prospectively-collected database was performed. Data was taken from the Orthopaedic Department of RSUD Dr. Moewardi Hospital patients’ database. The study included all patients who underwent grade III open tibial fracture treatment from May 2018 to May 2019. A total of 8 patients who were included in our study were a patient with open tibial fractures grade III planned for external fixaton as definitive treatment. They were evaluated radiographically and clinically to determine the union rate. The data were reported descriptively.Results: External fixator time ranged in this study around 240 days. In this study, there were a few patients whose progress were remain unknown due to loss of contact. Fractures studied 5 out of 8, no patient were union after 8 months of external fixator used. 4 out of 8 patients were reported non-union after 8 months based on their radiological examination (50%) and 1 out of 8 patients were reported has been performed Removal of External Fixation (ROEF) after 5 months of treatment. The rest of the 3 patients’ results were remain unknown.Conclusion: Open tibial fractures grade III of the leg can be managed with use of external fixator as a definitive treatment. However, the use of external fixation does not provide maximum results in grade III A tibial fractures.Keywords: open tibial fractures, external fixation, union, malunionCorrespondence: Bintang Soetjahjo. Dr. Moewardi General Hospital. Jl. Kolonel Sutarto 132, Jebres, Surakarta, Central Java, Indonesia. 57126. Email: bjortho@yahoo.com. Indonesian Journal of Medicine (2021), 06(04): 452-459https://doi.org/10.26911/theijmed.2021.06.04.11

Correlative Analysis of Radiological Measurements and 1-year SRS-22r in Early and Middle Adolescents with Adolescent Idiopathic Scoliosis: A Retrospective Study Ermawan, Rieva; Jiwandono, Bayu Sakti; Yudistiro, Ibnu; Abdulhamid, Muhammad; Corrigan, Hubertus; Renata, Felicia
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 14 No. 1 (2025): April 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v14i1.2025.26-36

Background: Patient-reported outcomes are increasingly valuable for assessing the effectiveness of clinical interventions from the patient's perspective. This study aims to investigate the differences in the correlation between radiological measurements and 1-year postoperative SRS-22r domain scores in early (EA) and middle adolescence (MA) patients with adolescent idiopathic scoliosis (AIS), as well as analyze the correlation of these outcomes across different Lenke curve types. Methods: We reviewed records of 87 female AIS patients who underwent scoliosis corrective surgery, collecting data on age, body mass index, preoperative and postoperative radiographic measurements, and 1-year postoperative quality of life assessments, including function, pain, self-image, and satisfaction scores from the SRS-22r questionnaire. Patients were categorized into subgroups based on age and the number of curves. The Spearman correlation test evaluated correlations between radiographic measures and SRS-22r domain scores across these subgroups. Results: Significant correlations were found between self-image and preoperative main apical vertebral translation (AVT), Cobb angle, and trunk shift, with stronger associations in EA than MA. Pain had a weak inverse correlation with the postoperative main Cobb angle, notably in the one-curve group and more strongly in EA. Satisfaction scores decreased with age and were lower in the two-curve group and EA. Conclusions: Cobb angle correction in AIS patients strongly correlates to postoperative self-image, particularly in Lenke type 2, 3, and 6. In Lenke type 1 and type 5, greater correction of the Cobb angle is associated with increased postoperative pain.

Solitary Neurofibroma Mimicking Giant Cell Tumor of The Upper Cervical Spine: A Case Report Ermawan, Rieva; Renata, Felicia; Muzakkiyafi, Mohammad; Corrigan, Hubertus
(JOINTS) Journal Orthopaedi and Traumatology Surabaya Vol. 14 No. 2 (2025): October 2025
Publisher : Universitas Airlangga

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.20473/joints.v14i2.2025.105-111

Background: Spinal neurofibromas are benign peripheral nerve sheath tumors typically occurring in the thoracic region. Involvement of the C2 vertebra is particularly rare. Atypical presentations of solitary neurofibromas can pose diagnostic challenges when their radiological features resemble other neoplastic entities. Case Report: A 35-year-old male presented with a 3-month history of neck pain and no history of trauma. Physical examination revealed mild bulging and localized tenderness in the posterior neck, with restricted neck extension to 30 degrees. Plain radiography showed a round, expansile lytic lesion with well-defined, nonsclerotic borders on the C2 spinous process, while MRI confirmed enhancing solid components and extensive bone involvement, indicative of a giant cell tumor. The histopathology from the core needle biopsy was inconclusive, showing few inflammatory cells and no evidence of malignancy. The lesion was marginally resected from a posterior approach, achieving only subtotal resection to preserve the vertebral artery. Histopathological analysis from the open biopsy confirmed the diagnosis of neurofibroma. At the 3-month follow-up, postoperative imaging showed the residual tumor. Despite this, the patient reported significant neck pain relief.Discussion: Radiography is insufficient for differentiating spinal tumors; therefore, histopathological biopsy is necessary for an accurate diagnosis. Open biopsy offers higher diagnostic accuracy than core needle biopsy.Conclusion: Neurofibroma should be considered in differential diagnosis for patients initially suspected of giant cell tumors based on radiological findings.

Complete Neurological Recovery Following 360-Degree Decompression and Fusion for T11 Giant Cell Tumor: A Case Report Ermawan, Rieva; Bayu Sakti Jiwandono; Denny Firdaus
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 11 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i11.1114

Background: Giant cell tumors (GCTs) are benign but locally aggressive bone tumors that rarely affect the spine. The thoracic spine is an even rarer location for GCTs, and their presentation with paraplegia poses a significant challenge. This case report describes the successful surgical management of a T11 GCT-causing paraplegia, highlighting the importance of early diagnosis and aggressive surgical intervention. Case presentation: A 27-year-old female presented with acute paraplegia and a history of chronic lower back pain. Imaging revealed a destructive lesion in the T11 vertebral body with spinal cord compression. The patient underwent a 360-degree decompression, en bloc tumor resection, and posterior spinal fusion. Histopathological analysis confirmed the diagnosis of GCT. The patient experienced complete neurological recovery within five days postoperatively and remained symptom-free at the 5-year follow-up. Conclusion: This case demonstrates the feasibility of achieving complete neurological recovery in patients with T11 GCT and paraplegia through aggressive surgical intervention. Early diagnosis and complete tumor resection followed by spinal stabilization are crucial for optimal outcomes.

Complete Neurological Recovery Following 360-Degree Decompression and Fusion for T11 Giant Cell Tumor: A Case Report Ermawan, Rieva; Bayu Sakti Jiwandono; Denny Firdaus
Bioscientia Medicina : Journal of Biomedicine and Translational Research Vol. 8 No. 11 (2024): Bioscientia Medicina: Journal of Biomedicine & Translational Research
Publisher : HM Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.37275/bsm.v8i11.1114

Background: Giant cell tumors (GCTs) are benign but locally aggressive bone tumors that rarely affect the spine. The thoracic spine is an even rarer location for GCTs, and their presentation with paraplegia poses a significant challenge. This case report describes the successful surgical management of a T11 GCT-causing paraplegia, highlighting the importance of early diagnosis and aggressive surgical intervention. Case presentation: A 27-year-old female presented with acute paraplegia and a history of chronic lower back pain. Imaging revealed a destructive lesion in the T11 vertebral body with spinal cord compression. The patient underwent a 360-degree decompression, en bloc tumor resection, and posterior spinal fusion. Histopathological analysis confirmed the diagnosis of GCT. The patient experienced complete neurological recovery within five days postoperatively and remained symptom-free at the 5-year follow-up. Conclusion: This case demonstrates the feasibility of achieving complete neurological recovery in patients with T11 GCT and paraplegia through aggressive surgical intervention. Early diagnosis and complete tumor resection followed by spinal stabilization are crucial for optimal outcomes.

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