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Cervical Spine Trauma Management Rully Hanafi Dahlan; Sevline Estethia Ompusunggu; Farid Yudoyono
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
Publisher : Indoscholar

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Abstract

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 (< 72 h) may facilitate a postoperative neurological improvement probably due to the prevention of the secondary mechanisms of damage in acute SCI. In the context of the advanced management of spinal injuries, the main points of the focused assessment, the important waypoints of a full classification of the skeletal and spinal cord injury, the principles of early prioritization and decision making, the outline of the surgical strategy including indications, timing, approaches, technique and post-operative care, and the outline principles of rehabilitation. The authors in this paper try to summarize and create a guideline of management, based on experience in a regional centre.
Cervical Spine Trauma Dahlan, Rully Hanafi; Ompusunggu, Sevline Estethia; Baselim, Ismail M.; G., Yustinus Robby B.
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 1 No. 2 (2019): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhs-j.v1i2.1042

Abstract

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.
The Role of Minimally Invasive Spine Surgery Dahlan, Rully Hanafi; Ompusunggu, Sevline Estethia; Ade, Christian; Raharjo, Ayu Iswandari
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 2 No. 2 (2020): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhsj.v2i2.1043

Abstract

Introduction :In the past half of century, the spinal surgery techniques has advanced significantly. Along with the improvement and various of techniques and technologies in general, there has been a big movement to reduce the morbidity of surgery. Case review : As opposed to open spine surgery, minimally invasive surgical approaches can be faster, safer and require less recovery time. The minimally invasive spine surgery also need to make an efficient target of surgery. The roots in minimally invasive spine surgery (MISS) are based primarily on technique modifications. Discussion: The Williams microdiscectomy, described in 1978, revolutionized MISS by starting the evolution of lumbar discectomy from an open surgery through a 6-inch incision to a microsurgical approach through as small an opening as possible. Conclusion :We don’t use the MISS technique when the extension of tumor is more than 2 levels; extension of the tumor is 20% longer than diameter of largest retractor; the tumor > 3cm for interlaminary approach, the wide durotomy is needed; and also the case with intramedullary tumor with 80% extention, from left to the right side; en bloc as the the goal of surgery for extradural tumor
Principles of Spine Instrumentation Dahlan, Rully Hanafi; Ompusunggu, Sevline Estethia; Utomo, Putra; Choliq, Firman Nur
Asian Australasian Neuro and Health Science Journal (AANHS-J) Vol. 2 No. 1 (2020): AANHS Journal
Publisher : Talenta Universitas Sumatera Utara

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/aanhs-j.v2i1.1044

Abstract

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 vertebrae, so that decreasing the chance of failure at the metal–bone interface.The Luque segmental wiring technique, developed in the early 1970s, was the first of this class of implants to achieve wide clinical application. Subsequent modifications have been used. Conclusion : Further modifications were the forerunners of more complex, currently used systems of universal spinal instrumentation (USI).
Laminectomy Decompression in Radiculopathy Vertebrae L3-L4, L4-L5: A Case Report Priambodo, Radityo; Ompusunggu, Sevline Estethia; Dahlan, Rully Hanafi
Sumatera Medical Journal Vol. 6 No. 3 (2023): Sumatera Medical Journal (SUMEJ)
Publisher : Talenta Publisher

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.32734/sumej.v6i3.9371

Abstract

Background: Spinal tumors are uncommon lesions and affect only a minority of the population. Spinal metastases comprise approximately 97% of masses encountered with spinal imaging and are the most common site of metastasis from breast cancer. The signs and symptoms for metastatic spinal tumors vary from back pain, motoric and sensoric dysfunction, and in advanced disease, spinal cord compression. Objective: To report a case of metastatic spinal tumor in a patient with a history of breast cancer presenting with lower limb weakness. Methods: A 39-year-old female patient with complaints of lower limb weakness and a history of breast cancer underwent a contrast lumbosacral MRI examination, revealing metastatic spine tumors. The patient was planned for laminectomy decompression, tumor resection, and posterior stabilization procedures. Results: The MRI confirmed the presence of metastatic spinal tumors. The patient underwent planned surgical interventions including laminectomy decompression, tumor resection, and posterior stabilization. Conclusion: Spinal tumors are conditions that can arise within the spinal cord itself or from adjacent structures and affect only a minority of the population. The hallmark symptom for spinal metastases is back pain. Surgical techniques such as open decompression and stabilization are used based on the patient's condition, particularly in cases with neurodeficits and compression seen on radiological examination, and they offer a good prognosis.
Hak Asasi Manusia dalam Proses Peradilan Pidana Tindak Pidana oleh Orang dengan Gangguan Jiwa: Tinjauan Keadilan Hukum dan Psikologi Sosial Kusumah, R. Windi Rachmawati; Ravena, Dey; Dahlan, Rully Hanafi; Sambas, Nandang; Nu’mani, Harits; Herniati, Dini Dewi
Jurnal Locus Penelitian dan Pengabdian Vol. 4 No. 6 (2025): JURNAL LOCUS: Penelitian & Pengabdian
Publisher : Riviera Publishing

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.58344/locus.v4i6.4308

Abstract

Penelitian ini mengkaji perlindungan hak asasi manusia dalam proses peradilan pidana terhadap orang dengan gangguan jiwa. Meskipun berbagai peraturan hukum di Indonesia, seperti Kitab Undang-Undang Hukum Pidana (KUHP), Undang-Undang Nomor 18 Tahun 2014 tentang Kesehatan Jiwa, dan prinsip-prinsip HAM internasional telah mengatur hak individu dengan gangguan jiwa, penerapannya di lapangan masih belum optimal. Dalam praktiknya, individu dengan gangguan jiwa yang tersangkut kasus pidana sering mengalami pengabaian hak, seperti tidak mendapatkan pemeriksaan psikologis yang layak, tidak didampingi oleh ahli kesehatan mental, hingga perlakuan diskriminatif selama proses penyidikan, penahanan, dan persidangan. Dengan pendekatan kualitatif melalui studi literatur dan analisis kasus, penelitian ini menemukan bahwa stigma sosial terhadap gangguan jiwa turut memengaruhi penegakan hukum, dan berpotensi menyebabkan pelanggaran hak asasi manusia. Temuan ini menegaskan pentingnya integrasi antara pendekatan psikologis, hukum progresif, dan prinsip HAM dalam sistem peradilan pidana Indonesia. Penelitian ini merekomendasikan adanya reformasi hukum berbasis keadilan inklusif, pelatihan khusus bagi aparat penegak hukum dalam menangani pelaku dengan gangguan jiwa, serta penguatan akses terhadap layanan kesehatan jiwa yang layak. Tujuannya adalah agar proses peradilan tidak hanya menekankan aspek legalistik, tetapi juga menjunjung tinggi martabat dan kondisi psikologis pelaku.
Percutaneous Epidural Adhesiolysis (PEA) untuk Manajemen Nyeri Pinggang Bawah Kronis Yudoyono, Farid; Ompusunggu, Sevline Estethia; Dahlan, Rully Hanafi; Avrina, Rossa; Arifin, Muhammad Zafrullah
Jurnal Neuroanestesi Indonesia Vol 4, No 2 (2015)
Publisher : https://snacc.org/wp-content/uploads/2019/fall/Intl-news3.html

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (2616.655 KB) | DOI: 10.24244/jni.vol4i2.116

Abstract

Latar Belakang dan Tujuan: Nyeri pinggang bawah yang disebabkan oleh penekanan radik saraf tulang belakang maupun thecal sac sering dijumpai dan dapat menimbulkan kecacatan. Percutaneous epidural adhesiolysis (PEA) adalah salah satu tindakan yang dilakukan untuk mengatasi nyeri sehingga penelitian ini bertujuan untuk mengevaluasi efektifitas PEA menggunakan lidokain 2% dalam mengatasi nyeri pinggang bawah. Subyek dan Metode: Penelitian cohort retrospektif dengan lima data pasien diambil dari database bagian Bedah Saraf. Semua pasien dilakukan PEA dengan injeksi anestesi lokal menggunakan 5 mL lidokain 2%, pengukuran luaran menggunakan Visual Analog Score (VAS), Oswestry Disability Index (ODI) dan penggunaan obat opioid yang dianalisa pada bulan ke-3 dan 6 bulan setelah tindakan. Hasil: Usia tertua adalah 60 tahun dengan 80% penderita adalah laki-laki dengan nilai maksimum VAS sebelum tindakan adalah 9, VAS 3 bulan pascatindakan adalah 3 sedangkan VAS 6 bulan pascatindakan adalah 2. Sehingga terdapat perbaikan VAS dan ODI yang signifikan (Friedman test dan post hoc Wilcoxon test) dengan nilai p0,05. Satu pasien tetap menggunakan opioid hingga 6 bulan pascatindakan PEA. Simpulan: Pengurangan nyeri yang signifikan disertai dengan perbaikan status fungsional terjadi pada pasien yang diberikan PEA dengan menggunakan anestetika lokal lidokain 2%.Percutaneous Epidural Adhesiolysis (PEA) for Chronic Low Back Pain ManagementBackground and Objective: Chronic low back pain caused by compression of spinal nerves roots or thecal sac is common and can lead to disability. Percutaneous epidural adhesiolysis (PEA) is an interventional pain management to relieve the pain.This study aims to evaluate the effectiveness of the PEA using lidocaine 2% in relieving lower back pain.Material and Methods: This retrospective cohort study was done using five patients data taken from medical record, with all patients had underwent PEA using 5 mL of 2% lidocaine, outcome measurements were evaluated using Visual Analogue Score (VAS), Oswestry Disability Index (ODI) and the useage of opioid drugs at 3rd and 6th month afterward. Results: The oldest age was 60 years and 80% of patients were male with a maximum value of VAS before procedure was 9, VAS score at 3rd month was 3 and VAS score at 6th month was 2. The maximum value ODI before procedure was 90, ODI at 3rd month was 50, while the 6th month was 25. Friedman test and post hoc Wilcoxon test revealed a significant difference in VAS score between before procedure, 3rd month and 6th month post-procedure (p 0,05).Conclusion: PEA with lidocaine 2%, is an effective treatment for chronic low back pain and can reduce pain thus increase fungsional state significantly.