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INDONESIA
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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SKULL-BASE MENINGOENCEPHALOCELE PRESENTING AS A LABIOGNATOPALATOSCHIZIS AND BILATERAL MACROSTOMIA ON IMPENDING PARTIAL AIRWAY OBSTRUCTION IN A NEONATE Nyoman Golden
Neurologico Spinale Medico Chirurgico Vol 1 No 2 (2018)
Publisher : Indoscholar

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Abstract

A unique skull-base meningoencephalocele presenting as a labiognatopalatoschizis and bilateral macrostomia in a neonate is reported, with impending partial airway obstruction. Surgical management requires neurosurgical intervention and plastic reconstruction. This case report presented a term neonate was noted to have a soft, fxed, 5-cm mass fulled of his mouth with the impending partial airway obstruction. The patient had several episodes of apnea related to partial airway obstruction by the mass. Computed tomography (CT) scan showed a large complex cystic and solid mass on lamina cribrosa of ethmoidal bone. Focal calcifcation was seen within the mass. The mass extended resulting in the complete cleft of lip and palate, and bilaterally macrostomia. The brain on CT scan was normal with no dysmorphic structures. A transcranial approach by the neurosurgeon was performed to excise the cephalocele and close the dura mater. The bone defect on lamina cribrosa of ethmoidal bone was closed using periosteum tissue. The procedure was followed by total excision of the prolapsed brain tissue and osteotomy on the left palate and then nasal airway reconstruction continued with gradual reconstruction with external compression for close loopholes of the palate. Three months after the initial surgery, a defect of the palate was narrowing and without cranial nerve defcits. Skull-base transethmoidal meningoencephalocele with labiognatopalatoschizis and bilateral macrostomia is a rare congenital abnormality. Neurosurgical procedures through transcranial approach are safe and provide excellent results. Moreover, gradual reconstruction will improve a patient’s quality of life and activity of daily living
PEDIATRIC CRANIOFACIAL DISFIGUREMENT WITH AUTOLOGOUS RIBS BONE GRAFT RECONSTRUCTION Anne Saputra; Wayan Niryana; Made Suka Adnyana
Neurologico Spinale Medico Chirurgico Vol 1 No 2 (2018)
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Abstract

Pediatric reconstruction of the cranial defect is a challenging task, the standard reconstruction method has been bone grafting. The reconstruction of complex facial defects should satisfy both aesthetic and functional requirements. In the case of large defects, the use of craniofacial prostheses using autogenous bone is the material of choice because of its potential for revascularization and its osteoconductive properties. A 3-year-old patient has facial disfgurement as result from bone defciency following anterior skull base tumour resection. To minimize the associated functional and cosmetic problems, a number of reconstructive options are available to the surgeon including the use of autogenous and alloplastic implants. A computed tomography (CT) 3-dimensional reconstruction scan showed a large craniofacial defect as residual radical skull base tumour resection. A transcranial approach by a neurosurgeon and plastic surgery was performed to reconstruct the defect using autologous rib bone graft. Six months after the reconstruction surgery, a defect of the craniofacial was narrowing without cranial nerve defcits.Complex reconstructions of extensive defects in craniofacial area can be achieved using autologous bone grafts. They yield reasonable functional and aesthetic outcomes and noticeably improves the qualityof life.
PERCUTANEOUS EPIDURAL NEUROPLASTY (PEN) USING COMBINATION OF HYALURONIDASE AND HYPERTONIC SALINE (NaCl 3%) IN TREATING FAILED BACK SURGERY SYNDROME Wawan Mulyawan; Yudi Yuwono Wiwoho; Syaiful Ichwan
Neurologico Spinale Medico Chirurgico Vol 1 No 1 (2018)
Publisher : Indoscholar

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Abstract

Background: Following surgical treatments for low back pain, lower extremity pain or neurologic symptoms would last or recur, this is defined as failed sack surgery syndrome (FBSS). FBSS usually occurs in 5-40% of these surgical patients. The most common cause is an epidural scar adhesion. Percutaneous epidural neuroplasty is the non-mechanical treatment for this condition. Previously, the use of hyaluronidase and hypertonic saline separately is commonly used for epidurolysis but the combination of hyaluronidase and hypertonic saline 3% has not been explored.Objective: To investigate the two-year outcomes of percutaneous epidural neuroplasty using a combination of hyaluronidase and hypertonic saline 3% in patients with FBSS.Methods: Twelve patients who experience low back pain, with or without radiculopathy, who have underwent lumbar spine surgery previously were assigned to the study. Parameters, such as the visual analogue scale scores for the back (VAS-B) and legs (VAS-L), and the Oswestry disability index (ODI), were recorded and compared between pretreatment, 1 week, 1 month, 3 months, 1 year and 2 years follow-up.Results: For all 12 patients, the postoperative VAS-B, VAS-L, and ODI were significantly different from the preoperative values in all follow-up periods: 1 month, 3 months, 1 year, and 2 years.Conclusion: Based off this study group, percutaneous epidural neuroplasty using a combination of hyaluronidase and hypertonic saline 3% has a favourable outcome in the 2 years follow-up
Modified Laminoplasty After Excision of Cervical Schwannoma with Large Extravertebral Extension Muhammad Faris; Abdul Hafid Bajamal; Zaky Bajamal; Krisna Tsaniadi Prihastomo
Neurologico Spinale Medico Chirurgico Vol 1 No 1 (2018)
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Abstract

Tumour excision and laminoplasty are commonly performed as surgical treatment of extra vertebral extension of cervical schwannoma. It is worth knowing that the conventional technique of multilevel laminectomy may hinder younger patients in the long-term. This article reports a 30-year old man with an intradural-extramedullary tumour which extended from C4 to T1 that underwent modified laminoplasty. This modified technique is preferable in maintaining the anteroposterior diameter of spinal canal as well as reducing the displacement of guttered laminae
Resection of Ulnar Nerve Giant Cell Neurinoma Tjokorda Gde Bagus Mahadewa
Neurologico Spinale Medico Chirurgico Vol 1 No 1 (2018)
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Abstract

Giant cellular ulnar nerve neurinoma is a very rare condition. According to the literature, the author reports the first case while only two other reports of the cellular neurinoma can be found in English literature in different locations. The author presents the case of large size cellular neurinoma of the ulnar nerve, where the primary tumour was resected using the shelled out technique, without neurolysis and any nerve repair. Histopathologic characteristics, radiological findings and clinical data on these tumours were reviewed, and the proposed chosen surgical technique, which differs from that used in the previous cases and taking into account the rate of recurrence after total resection.
Kyphoplasty Technique for Thoraco-Lumbar Compression Fracture Alfred Sutrisno Sim
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Abstract

Osteoporotic vertebral compression fracture (VCF) is a significant causeof morbidity and mortality among elderly patients. Fractures canhappen because of osteoporosis, tumors, or other conditions.In the past two decades, kyphoplasty has emerged as surgicaloptions that play a central role in the treatment of vertebralcompression fractures. Before the common use of kyphoplasty, theprincipal surgical option for treatment of compression fractures wasdecompression and fusion. However, surgical fixation frequentlyfailed in elderly patients because of osteopenia. Kyphoplastyhas expanded to include treatment of osteoporotic compressionfractures, traumatic compression fractures, and metastaticcompression fractures. Osteoporotic compression fractures are nowthe most common indication for this procedure.Kyphoplasty utilizes an inflatable balloon to create a cavityfor the cement with the additional potential goals of restoringheight and reducing kyphosis. Kyphoplasty is an effectivetreatment options for the reduction of pain associated withvertebral body compression fractures. Biomechanical studiesdemonstrate that kyphoplasty is initially superior for increasingvertebral body height and reducing kyphosis, but these gainsare lost with repetitive loading. Complications secondaryto extravasation of cement include compression of neuralelements and venous embolism. These complications are rarebut more common with vertebroplasty. Kyphoplasty is a safeand effective procedure for the treatment of vertebral bodycompression fractures.
Supraclavicular Approach on Thoracic Outlet Syndrome Amiril Mu’imin
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Abstract

Background: Thoracic Outlet Syndrome (TOS) is a clinical syndrome that refers to abnormal compression of the neurovascular in the neck and axilla with signs and symptoms manifesting in the shoulders, neck, arms, hands and sometimes fingers. It may be underdiagnosed because this syndrome is poorly understood. The compression is primarily neurogenic, vascular, or both. As the number of patients undergoing successful treatment increases, TOS is becoming a common diagnosis. In those patients in whom pain is refractory to conservative care, surgery should be considered. The aim of this study is to evaluate the outcome of a supraclavicular approach to treat the thoracic outlet syndrome patients in Dr. Ramelan Navy Hospital Surabaya. Materials and methods: This study is a case series of 16 patients (10 females and 6 males) of 19-50 years old, who underwent neurovascular compression with the supraclavicular approach. Symptoms were evaluated with medical records based on peri-operative anamnesis and physical examination. Results: The follow-up with 16 patients showed excellent results such as decreasing pain, decreasing sensory or motoric symptoms, and complications like pneumothorax hematothorax, and injury of artery, vein or plexus brachialis were not found. Conclusion: Supraclavicular approach is relatively effective and safe for neurovascular decompression of TOS. Excellent outcomes were observed with a small incision, safe and minimal complications.
Neurological Recovery in Traumatic Spinal Cord Injury Patient with Delayed Surgical Intervention Mochamad Targib Alatas
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Abstract

Early surgical treatment for traumatic spinal cord injury (SCI) patients has been proven to yield better improvement on neurological state, and widely practiced among surgeons in this field. However, it is not always affordable in every clinical setting. It is undeniable that surgery for chronic SCI has more challenges as the malunion of vertebral bones might have initiated, thus requires more complex operating techniques. In this case series, we report 7 patients with traumatic SCI whose surgical intervention is delayed due to several reasons. Initial motoric scores vary from 0 to 3, all have their interval periods supervised between outpatient clinic visits. On follow up they demonstrate significant neurological development defined by at least 2 grades motoric score improvement. Physical rehabilitation also began before surgery was conducted. These results should encourage surgeons to keep striving for the patient’s best interest, even when the injury has taken place weeks or even months before surgery is feasible because clinical improvement for these patients is not impossible.
Decision Making in Peripheral Nerve Injury Ferry Senjaya
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Abstract

The decision making process during diagnosis and treatment of a peripheral nerve injury can be complex at times. The nature and cause of nerve injury, its location, and its severity require very distinct decisions with regards to timing and intervention chosen. For good decision-making, a good knowledge of the pathophysiological conditions of peripheral nerve and its response to injury is paramount. In this article, the decision-making process related to pre-operative, intra-operative, and post-operative periods are discussed.
Our Surgical Strategy for Thoracic Outlet Syndrome Yasuhiro Nakajima
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Abstract

Surgical treatment for thoracic outlet syndrome (TOS) is a very controversial surgery because objective diagnosis, such as image and electrophysiological examination, is very difficult. Clinical provocation tests including brachial plexus compression tests, such as Morley and Roos, and vascular compression tests, such as Wright and Eden, are not high in specificity and are likely to be positive even in healthy persons and patients with carpal tunnel syndrome. We place emphasis on the laterality of latency and amplitude in the sensory neural action potential (SNAP) of the medial antebrachial cutaneous nerve and ulnar nerve. After enough stretching exercises of scapular stabilizers and brachial plexus block, we always select surgery. In this presentation, I would like to show our diagnosis method and treatment strategy including surgery.

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