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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 134 Documents
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Diagnostic validity of Thoracic trauma severity score in patient with blunt thoracic trauma for predicting mortality rate Ngakan Gede Dwija Hermawan; I Nyoman Semadi; I Gede Raka Widiana; Desy Permatasari; Christopher Ryalino
Neurologico Spinale Medico Chirurgico Vol 2 No 1 (2019)
Publisher : Indoscholar

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Abstract

Introduction: The high incidence of blunt thoracic trauma is still a serious concern in emergency services. Mild to severe cases of blunt thoracic trauma that come to the emergency department are not those that can be considered simple but need to be reviewed for the possibility that can lead to the occurrence of advanced complications. This study aims to predict mortality in patient with blunt thoracic trauma with TTS (Thoracic trauma severity) score. Patients and Methods: This is a retrospective study with 52 subjects of blunt thoracic trauma patients treated at our University Hospital from January 2016 to May 2017. Eligible data were collected from medical record analyzed by receiver operating characteristics curve and cross tabulation. Results: The age of the subjects are 48.03±15.62, with male 42 subjects (80.8%) and female ten subjects (19.2%). The mean point of Thoracic trauma severity score (TTSS) was 8.32 ± SD: 2.69. The outcome was three patients dead (5.8%) and 49 patients discharged (94,2%). The sensitivity of TTSS 100 %, specificity 89.7%, positive predictive value (PPV) 37.5%, negative predictive value (NPV) 100%, and accuracy rate 90.3%. Highly sensitivity and specificity results for Thoracic Trauma Severity Score is valid for the screening of Blunt Thoracic Trauma. Conclusion: At 11.5 cut-off point, the TTSS was an excellent tool to predict the mortality rate of patients with blunt thoracic trauma. It has a 100% sensitivity and 89.7% specificity, as well as 37.5% PPV and 100% NPV.
Palliative treatment for multiple spinal metastasis in patient with ovarian cancer Rully Hanafi Dahlan; Sevline Estethia Ompusunggu; Muhammad Kusdiansah; Ismail Baselim
Neurologico Spinale Medico Chirurgico Vol 2 No 1 (2019)
Publisher : Indoscholar

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Abstract

Ovarian cancer is the fourth most common type of female cancer and the fifth leading cause of cancer death in women. It is the fourth most common malignancy in women. Management varies depending on the patient condition, so one patient can undergo aggressive decompression and stabilization followed by adjuvant therapy, while others may respond to medication and supportive care. The decision to pursue radical surgical treatment is complex, but the indications are becoming clearer. These include radioresistant tumors, obvious spinal instability, clinically significant neural compression secondary to retropulsed bone or from spinal deformity, intractable pain unresponsive to nonoperative measures, and radiation failure.
DISTRIBUTION AND CHARACTERISTICS OF HEAD INJURY AND REFERRAL NUMBER AT DR H. ANDI ABDURRAHMAN NOOR GENERAL HOSPITAL, TANAH BUMBU, SOUTH BORNEO, INDONESIA Komang Werdhi Sentosa; Ani Rahmawati; Daldy Arianda; Ardik Lahdimawan; Agus Suhendar
Neurologico Spinale Medico Chirurgico Vol 1 No 3 (2018)
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Abstract

Background: Head injury (HI) has been one among leading causes of morbidity and mortality worldwide especially in the peripheries area. In South Borneo, 9.4% of trauma cases was a head injury. Especially, Tanah Bumbu Regency, one of peripheries area in South Borneo ranks third for head injuries after Tabalong and Tanah Laut Regency in 2007. Objective: The aim of this study was to describe the characteristics of head injury patient and referral number at Dr. H. Andi Abdurrahman Noor general hospital. Methods: All head injury patients admitted to the emergency department (ED) of Dr. H. Andi Abdurrahman Noor general Hospital in a one-year period (2017) were registered in this retrospective study. Using the total population sampling method,413 cases of head injury during the period were included as a subject of study. Result: This study showed that mild head injury was the most cases of head injury with 325 cases (78.2%). 61 patients were referred to a higher trauma center in 2017. Head injury was most common in 11‑20 years old age group. Men also had higher incident rate compared to women (2:1). Most of the patients were a nonstate employee. Head injury is commonly caused by traffic accident. Conclusion: This study shows that characteristics of HI in the peripheries area such Tanah Bumbu regency are no different from other countries. Our findings suggest that several prevention steps should be taken to reduce the number of head injury based on the distribution and characteristics of head injury sustainers.
A PRELIMINARY STUDY ON THE EXTRAVASATION OF INTRAVENOUS CHEMOTHERAPY IN SANGLAH GENERAL HOSPITAL, BALI – INDONESIA Inge Kurniawati; Putu Anda Tusta Adiputra
Neurologico Spinale Medico Chirurgico Vol 1 No 3 (2018)
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Abstract

Background: Extravasation of intravenous chemotherapeutic agents is one of the most devastating complications, which unacceptable condition neither to patient nor to medical services. Many healthcare providers realize that even one extravasation injury is too many since this injury is preventable. Published incidence rates of chemotherapy extravasation range from 0,01% to 6%, but in our institution, chemotherapy extravasation was not well recorded, so the incidencerate is unclear and the number of injuries is underestimated. Method: We observed chemotherapy extravasation occurrence during a 6 months period in our institution, from September 2013 until March 2014. We recorded the chemotherapy agents, patient’s clinical presentations, and extravasation management. Result: During our observation, 1374 chemotherapies administered, and 10 cases of chemotherapy extravasation occur, particularly doxorubicine was the main chemotherapy agent. Almost all treated conservatively, only 10% handled with surgical management. Eventually, 20% of cases have implanted port placed. Conclusion: Extravasation of cytotoxic agents is a serious problem, it causes tissue damage, prolongs the length of stay, increases hospital cost and psychological damage to cancer patients who under chemotherapy. It preventable but always underestimate by some clinicians, the use of central venous access device is one of the solutions to minimize the damage.
CASE REPORT: SURGICAL MANAGEMENT OF LUMBAR COMPRESSION FRACTURE Yustinus Robby Budiman Gondowardojo; Tjokorda Gde Bagus Mahadewa
Neurologico Spinale Medico Chirurgico Vol 1 No 3 (2018)
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Abstract

The lumbar vertebrae are the most common site for fracture incident because of its high mobility. The spinal cord injury usually happened as a result of a direct traumatic blow to the spine causing fractured and compressed spinal cord. A 38-year-old man presented with lumbar spine’s compression fracture at L2 level. In this patient, decompression laminectomy, stabilization, and fusion were done by posterior approach. The operation was successful, according to the X-Ray and patient’s early mobilization. Pneumothorax of the right lung and pleural effusion of the left lung occurred in this patient, so consultation was made to a cardiothoracic surgeon. Chest tube and WSD insertion were performed to treat the comorbidities. Although the patient had multiple trauma that threat a patient’s life, the management was done quickly, so the problems could be solved thus saving the patient’s life. After two months follow up, the patient could already walk and do daily activities independently.
EXCISION OF GIANT CELL TUMOR FOLLOWED BY RECONSTRUCTION OF DISTAL RADIUS USING FREE VASCULARIZED FIBULAR GRAFT Prisca Oriana Sutanto; Agus Roy Rusli Hamid; Adinda Putra Pradhana
Neurologico Spinale Medico Chirurgico Vol 1 No 3 (2018)
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Abstract

Giant cell tumor (GCT) of the distal radius is a rare and unpredictable lesion. The aim of treatment is complete removal of the tumor and preservation of the maximum function of the extremity. Lower rates of local recurrence have been noted after wide resection of the diseased bone. Its standard treatment has ranged from surgical curettage to wide resection. One method for closing the defect is using the head of the fibula as a substitute for the distal radius. The healing of vascularized fibular graft is very quick and without bone resorption. Thus, in the procedure for reconstruction and limb salvage after bone tumor resection of the distal radius, the free vascularized fibular graft with the fibular head is an ideal substitute. This case report will show a patient with GCT that successfully treated by an excision of GCT followed by reconstruction of distal radius using free vascularized fibular graft.
PRE-OPERATIVE DIAGNOSTIC CHALLENGE OF TORSION OF THE GALLBLADDER Inge Kurniawati; . Jimmy; Wayan Periadijaya
Neurologico Spinale Medico Chirurgico Vol 1 No 3 (2018)
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Abstract

Gallbladder torsion is a very rare clinical entity and a difficult condition to diagnose preoperatively. Since its first description in 1898 by Wendel, there have been over 500 documented cases in the literature. The pathophysiology is that of mechanical organo-axial torsion along the gallbladder’s longitudinal axis involving the cystic duct and cystic artery, and with a pre-requisite of local mesenteric redundancy. Gallbladder torsion typically presents as an acute abdomen requiringemergency surgery but the preoperative diagnosis of gallbladder torsion is difficult and most cases are found as a surprise at surgery. Consequently, a delay in diagnosis can have devastating patient outcomes. Herein we report a case of acute gallbladder torsion in an elderly Balinese woman and treated surgically. To our knowledge, this is the first reported case in Bali with a subsequent literature review on the management of this uncommon condition.
RISK FACTORS OF HIGH INTRACRANIAL PRESSURE AND THE RELATED OUTCOMES IN SUBJECTS WITH SEVERE HEAD INJURY IN SANGLAH GENERAL HOSPITAL DENPASAR Wayan Niryana
Neurologico Spinale Medico Chirurgico Vol 1 No 2 (2018)
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Abstract

Background: Severe head injury management target is to prevent the secondary brain injury characterized by deterioration in the outcome. High intracranial pressure (ICP) and low cerebral perfusion pressure (CPP) could cause unfavourable outcomes which is influenced by many factors, such as hypoxia and haemorrhage lesions pictured on head CT scan. This study analyzes various risk factors that can lead to increased ICP and the influence of high ICP on the outcome. Methods: This study is a prospective cohort, involving 42 consecutive subjects with severe head injury patients from June to October 2016. The subjects underwent examination for blood pressure, blood gas analysis, and head CT scan. ICP monitoring was then performed and the outcome was assessed using the Glasgow Outcome Scale score when the patient was discharged. In this study, risk factors such as hypoxia, hypotension, and subarachnoid haemorrhage (SAH) were analyzed. Statistical analysis was performed with SPSS 27 with a confidence interval of 95%. Result: There were two risk factors that significantly influenced the increase of ICP, which were hypotension (RR 0.27; 95CI 0.095-0.775; p<0.001) and hypoxia (RR 0.125; 95CI 0.034-0.457; p<0.001). High ICP value ≥ 20 mmHg was associated with an unfavourable outcome (RR 2.28; 95CI 1.31-3.98; p<0.001). Conclusion: Hypoxia and hypotension were two risk factors that significantly influenced the increase of ICP, where high ICP caused the unfavourable outcome.
THE TREND AND PROFILE OF THE THORACIC SPINE SURGERY IN NEUROSURGERY DEPARTMENT FACULTY OF MEDICINE UNIVERSITAS INDONESIA – RSUP NASIONAL DR. CIPTO MANGUNKUSUMO 2012 – 2016 Muhammad Saekhu; Bismo Nugroho; Samsul Ashari; Renindra A Aman; Hanif G Tobing; Setyowidi Nugroho
Neurologico Spinale Medico Chirurgico Vol 1 No 2 (2018)
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Abstract

Background: Spinal surgery, in general, is increasing in number. The most frequent pathology is degenerative disease, and the most common segment is cervical and lumbar. However, there is limited information concerning the thoracic spine surgeries.Objective: The aim of this study is to describe the trend and profle of the thoracic spine (T-spine) surgeries in the Department of Neurosurgery Faculty of Medicine Universitas Indonesia – RSUP Dr.Cipto Mangunkusumo from 2012 to 2016.Method: This is a retrospective study including all patients who were undergoing T-spine surgery during the period of study from January 2012 to December 2016. The number of T-spine procedureswas recorded and plotted in the trend graph. The data consisting age, gender, indication and procedure of T-spine surgery, and duration of hospital stay were recorded from medical records.Result: In the last fve years, there was an increasing trend of T-spine surgery. A total of 68 surgeries for T-spine performed with 35 female and 33 male subjects. Majority of subjects were aged 41 to 50 years old (28%), with an indication of surgery due to tumours (68%). As many as 76% T-spine surgery was carried out non-instrumented. Duration of hospital stay was 9-13 days.Conclusion: Productive age is the most common age undergoing T-spine surgeries. A spinal tumour is the most frequent indication of the T-spine surgeries
CERVICAL GUNSHOT INJURY Gede Andry Nicolas; Heru Sutanto Koerniawan; Raka Janitra; Tjokorda Gde Bagus Mahadewa
Neurologico Spinale Medico Chirurgico Vol 1 No 2 (2018)
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Abstract

The incident of cervical spine injury and cervical spinal cord injury is between 2.0% to 5.0%. The advanced trauma life support (ATLS) stated that a patient with multiple traumas should be assumed to have cervical spine injury especially if the patient loses consciousness when present in the ER. It is stressed that cervical spine injury requires continuous immobilization of the patient’s entire body using a semirigid collar as well as a backboard with tape and straps before and during transfer to a defnitive care facility. The understanding of the mechanism of injury is the most important as the forces transferred are signifcantly different causing different injuries. A serial case reported by Walter and Adkins found that there was no signifcant difference between the patients that have a bullet removed from the neck and patients that have a bullet left in the cervical cord. In both cases, there was no improvement to the neurologic outcome. Kupcha recommends doing selective wound management and observation of retained intracanal bullet fragments in a patient with complete lesion. Surgical decompression after the injury is not recommended. We report a case of 14 year old boy who was treated at Sanglah Hospital referred from an out-of-island Type C Hospital with a spinal cord injury - American Spinal Injury Association A (SCI ASIA A) caused by a gunshot wound in the cervical. Surgical decompression and bullet removal was performed as well as fusion stabilization. He is then treated in the intensive care unit for 48 hours with a slight improvement in motoric of upper and lower extremities.

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