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Neurologico Spinale Medico Chirurgico
Published by Universitas Udayana
ISSN : -     EISSN : 26212064     DOI : https://doi.org/10.36444/nsmc
Core Subject : Health, Science,
Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience
Neurologico Spinale Medico Chirurgico (NSMC) is an open-access, single-blind peer-reviewed journal, published by Indonesian Neurospine Society (INSS) under the flag of Indonesian Neurosurgery Society (INS) and Faculty of Medicine, Udayana University. NSMC publishes articles which encompass all aspects of basic research/clinical studies. The journal facilitates, bridge and integrate the intellectual, methodological, and substantive diversity of medical knowledge, especially in the field of surgery, neurology, neurosurgery, spine, neuroanesthesia, medicine, and health. The journal appreciates any contributions which promote the exchange of ideas between practising educators and medical researchers all over the world.
Arjuna Subject : Kedokteran - Kedokteran (Lain-Lain)
Articles 36 Documents
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Search results for , issue "Supplementary Issue - Conference Abstracts" : 36 Documents clear
Spinal Trauma: a case report Nasrullah Mustamir
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Introduction: The incidences of both car accident and sport accident have been increasing lately in Indonesia. One of the big problems is about the trauma of the spine. Cervical spine trauma is the most dangerous case. Herein we report one case of Odontoid Fracture Type II. Methods: A 24-years-old man had an accident after jumping into a shallow swimming pool. The patient bumped his head into the floor and suffered from tetraparesis. After that, he was getting better step-by-step. Approximately 3 months later, the patient bumped his head again on a branch of a tree and regressed to tetraparesis again. We established odontoid fracture type II diagnosis from plain cervical x-ray. We decided to do a surgery by using pedicle screws at CII, lateral mass at CI, and fusion at CI and CII. Result: After the surgery, the patient’s health improved. Six months after the operation, the patient recovered well. Conclusion: We can do this operation without c-arm, we performed this operation by free-hand and anatomy landmark.
Delayed Treatment of Spinal Cord Injury In Young: A Case Report Joshua Sutikno
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Background: Spinal cord injury (SCI), one of the problems caused by traffic accidents, has a high morbidity in developing country like Indonesia. In Indonesia, the use of motorcycles is increasing every year. The epidemiological data from Fatmawati Hospital of spinal cord injury in 2014 was 104 cases both traumatic and non-traumatic SCI. In this case, a young boy with worsening of SCI, delayed the treatment for about 3 months. Case: A 19 years-old male complained of limbs paralysis for the past two weeks. He felt numbness and tingling in hamstring and calf areas. From past medical history, he had a motorcycle accident 3 months prior. After the accident, he suffered from extreme low back pain, but he could still move his legs. Due to economic restrictions, the patient refused to go to the hospital, and they chose a traditional treatment. For about three months, the pain was decreasing, but he was never pain-free. As the symptoms continued to worsen, the neurosurgeon decided to decompress the spinal cord and performed discectomy. After a week of treatment, the pain disappeared, motor muscle got better, and he could feel again the sensation on the dermatome of S1. Conclusion: Early treatment is recommended to get a better outcome. The surgery is not the only treatment, rehabilitation and orthotics using are important too. Delayed treatment increases morbidity rate.
Cervical Spine Trauma Management Rully Hanafi Dahlan; Sevline Estethia Ompusunggu; Farid Yudoyono
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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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.
Lateral Mass Screws, Pitfalls, and Practis Abdul Hafid Bajamal
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Lateral mass screws represent a unique challenge to practising spine surgeons because this technique is still the most appropriate technique for fixation at the subaxial spine from C3 to C7. There is a wide range of indications for lateral mass screws fixation including acute and chronic instability resulting from tumours, infections, posterior element fractures, posterior ligamentous injuries, post-laminectomy instability, and following multilevel corpectomy and pseudarthrosis after anterior cervical fusion. Lateral mass screws may be inadequate in cases with poor bone quality secondary to fracture, neoplasm, or revision surgery. Pitfalls and practice of this technique will be discussed.
Fear-Avoidance Beliefs in Chronic Cervical Zygapophyseal Joint Pain Relieve With Medial Branch Block Farid Yudoyono
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Background: Chronic posterior neck pain is common, affecting 50–75% of people for 1 year or longer. The zygapophyseal joint is reported to be one of most common causative factors. The fearavoidance is a model that describes how individuals develop chronic pain as a result of avoidant behaviour based on fear. Previous studies shown that medial branch block (MBB) and radio frequency neurotomy were effective for intractable pain. Material And Method: Case 1, TMK, Male, 57 yo, left posterior neck pain, VAS neck 7-8, NDI 46 %, no radiating pain, no neurological deficit. FABQ-PA score showed high fear (60%). Physical examination provokes facet joint pain. Neuroimaging revealed facet degeneration on T1WI and T2WI MRI. Case 2, RDW, Male, 45 yo, left posterior neck pain, VAS neck 8-9, NDI 40 %, no radiating pain, no neurological deficit. FABQPA score showed high fear (63%). Physical examination provokes facet joint pain. Neuroimaging revealed facet degeneration on T1WI and T2WI MRI. Case 3, TAY, Female, 52 yo, bilateral posterior neck pain, VAS neck 8-9, NDI 52 %, no radiating pain, no neurological deficit. FABQ-PA score showed high fear (60%). Physical examination provokes facet joint pain. Neuroimaging revealed facet degeneration on T1WI and T2WI MRI. Results: Our study reveals that C-MBB might ensure pain relief and decrease analgesic need. Physical activity at 1-, 3- and 6-months post-CMBB intervention were 65%, 60% and 68% of patients, respectively, gained > 50% pain relief. Conclusion: Therapeutic MBB may provide an option for chronic high fear-avoidance beliefs pain of zygapophyseal joint.
Back Pain and Sciatica are not the Signs of HNP (Nerve Compression) Ali Shahab Shahab
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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We used to think that back pain and sciatica were the signs of HNP. In fact, each of them has distinct clinical manifestations. In the majority of nerve compression cases, back pain and sciatica are not found. Meanwhile, most of back pain and sciatica are facet syndromes. Thus, the treatment of nerve compression and facet syndrome is different. To treat nerve compression that was progressing to paralyze, about a hundred years ago, Joel Goldthwait performed decompression through laminectomy from L1 to S3. On the other hand, in 1971, Rees, who was the first surgeon to do the procedure, performed facet denervation to cure facet syndrome on 1000 patients by using scalpel and the result was satisfying. Recently, the treatment of back pain and sciatica (facet syndrome) switches over from open surgery to facet denervation by radiofrequency. In patients with back pain whose MRI show signs of HNP but do not experience motor deficit, the choice of management is also facet denervation. Moreover, according to my experience about the treatment of back pain and sciatica, the best results so far are also by facet denervation.
Our Surgical Strategy for Adult Spine Deformity with Osteoporosis Yasuhiro Nakajima
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Osteoporosis is a major social problem in Japan, which is becoming a super-ageing society. Spinal deformity in the elderly causes various symptoms such as neurological deficits, pain, gastroesophageal reflux disease, etc., which impair QOL of the patients. Osteoporosis is one of major etiologies for elderly spinal deformity. At the same time, osteoporosis often causes serious problems in surgical treatment for elderly spinal deformity including instrumentation failure, proximal and distal junctional kyphosis, etc. This presentation will summarize our surgical strategy for prevention of instrument failure, including our original surgical techniques and osteoporosis treatments.
Surgical Treatment for Scoliosis Tjokorda Gde Bagus Mahadewa
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Recently, patients with spinal deformities, particularly scoliosis, could be handled well through surgical pathways. Generally, surgery is indicated in patients with scoliosis curve exceeding 45 degrees (COBB angle > 45). The ultimate goal is to reduce the curve as optimally as possible without disturbing spinal cord. Whether the result is straight or not, it also depends on the patient's spine flexibility before surgery. Surgical indications are for improving appearance, preventing increasing degrees of the curve, preventing interference to other organs such as the lungs, and preventing neurological deficits. Correction of Cobb angle below 25 degrees had already makes the patient feel more comfortable. The amount of screw and instrumentation length depends on the number of spines involved. After surgery treatment, 2-4 weeks of rest are required before returning to daily activity. Fusion principle states that the spine will be slightly stiff in order to be corrected but it is believed that patient's activity could still be done with the remaining flexibility. Surgical treatment of scoliosis that does meet the indications is imperative and relatively safe with advances in medical technology today.
Analysis of Clinical Results of Three Different Routes of Percutaneous Endoscopic Transforaminal Lumbar Discectomy for Lumbar Herniated Disk Farid Yudoyono; Rully Hanafi Dalan
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Objective: Percutaneous endoscopic transforaminal lumbar discectomy (PETLD) can be performed by using foraminal, intervertebral, and suprapedicular routes. The aim of this study was to assess clinical results of three different routes of PETLD. Methods: One hundred and eleven patients who underwent PETLD between January 2016 and October 2016 were included in this study. PETLD was performed using the foraminal (group A), intervertebral (group B), and suprapedicular (group C) routes in 32, 46, and 33 patients, respectively. Outcomes were evaluated using the visual analogue scale (VAS), Oswestry Disability Index (ODI), and MacNab criteria. Results: Seventy-one men and 40 were women (mean age 53.33 ± 14.12 years). The mean follow-up period was 6.44 ± 3.26 months. The preoperative VAS score decreased significantly (P < 0.01) in all 3 groups, but the postoperative VAS score was higher for the foraminal route than the intervertebral (P<0.001) and suprapedicular routes (P < 0.001). Excellent outcome grade according to MacNab criteria was less in foraminal route (18.7%) than in intervertebral (52.2%) and suprapedicular (56.7%) routes. ODI improved significantly (P < 0.01) in all 3 groups. Conclusion: All 3 routes of PETLD resulted in good to excellent clinical results. Nevertheless, the postoperative VAS score was higher for the foraminal route than the intervertebral and suprapedicular routes, probably because of the neurologic characteristics of the disk location. The surgeon should consider this problem to alleviate pain postoperatively and to better counsel the patient before surgery.
PEID (Percutaneous Endoscopic Interlaminar Discectomy): Cautionary Points Based on the Evidence Jun Ho Lee
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Background: Percutaneous endoscopic lumbar discectomy (PELD) is one of the most sophisticated operative procedures for the treatment of lumbar disc herniation (LDH). Endoscopic techniques are now becoming standard in many areas due to expanded technical possibilities of fullendoscopic transforaminal or interlaminar resection of herniated lumbar discs as well as stenosis. However conventional percutaneous endoscopic interlaminar discectomy (PEID) disc operations may sometimes result in subsequent untoward complications due to unnoticed iatrogenic trauma to neural structures, which is mostly related to an anatomical limitation during endoscope insertion. Methods: An appropriate operative indication of the PEID without bone removal or laminectomy can be used to treat LDH cases with an enough interlaminar space (at least ≥ 20 mm by bi-facetal distance) from the reported evidences. Otherwise, there might be several indications for requirement of bone removal; a narrow interlaminar space, disappearance of the concave shape of the upper vertebral laminae, high-grade migration of LDH, recurrent LDH, obesity, or an immobile nerve root. Conclusion: The significance of PEID lies also in its minimal damage to surrounding structures such as muscle, bone, and ligaments. A discrete radiographic evaluation from the patient preoperatively is mandatory before choosing a proper endoscopic surgical modality for the sake of optimal clinical outcome after PEID.

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