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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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Unilateral Laminotomy for Bilateral Microsurgical Decompression in Treating Multiple Spinal Stenosis Wawan Mulyawan; Yudi Yuwono Wiwoho
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
Publisher : Indoscholar

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Abstract

Multiple spinal stenosis with significant signs and symptoms is one of the complex problems in spine pathology. For a simple reason, many spine surgeons do conservative decompressions, such as decompressive laminectomy or bilateral laminotomy and flavectomy, with one incision (preservation of lamina). Unilateral laminotomy in the lumbar area for bilateral access in spinal canal is quite rare and is performed for the treatment of multiple spinal stenosis. With this technique, microsurgical decompression is done with partial resection of the ipsilateral facet, the medial part of the laminar arch, and the partial contralateral facet, with the complete removal of the ligamentum flavum. By this methods, the aim for complete bilateral flavectomy and partial bilateral facetectomy are the key for the success of clinical improvements in treating multiple spinal stenosis.
Biomechanics Among Various Techniques of the Cervical Laminoplasty Dewa Putu Wisnu Wardhana; Tjokorda Gde Bagus Mahadewa; Sri Maliawan
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Abstract

The nature of cervical spine motions consists of multiple components of the cervical spine, intervertebral disc, ligaments, and adjacent facet joints. Cervical spinal stenosis is disabling and this chronic degenerative disorder commonly occurs in middle age-elderly persons. Surgical options for those spinal cord disorders generally are the anterior or posterior approach. Historically, a conventional multi-level laminectomy was performed to decompress the spinal cord but there is a high rate of late biomechanical complications such as segmental instability, and kyphosis. Laminoplasty was developed to relieve the spinal cord compression and maintain the posterior elements. Lately, there are various techniques of the cervical laminoplasty, the biomechanical impact of these techniques will be described.
Saving Good Quality of Sleep for Cervical Herniated Nucleus Pulposus Patients Ridha Dharmajaya
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Abstract

Background: Cervical herniated nucleus pulposus compresses the nerve roots with clinical pain manifestation and causes sleeping disturbances. The aim of this study was to determine the difference in the quality of sleep before and after surgery. Method: This is a retrospective cohort study. Patients were asked to complete the Pittsburgh Sleep Quality Index (PSQI) and all data was analyzed with the McNemar Test.Result: The outcome revealed that in 98 patients, 72 (73.4%) patients had increased their quality of sleep after surgery. Conclusion: There was a significant difference in the quality of sleep pre- and post-surgery.
Anterior Approach to Thoracic and Thoraco-Lumbar Spine Sahat Edison Sitorus
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Abstract

Anterior surgery approaches have been used for thoracic and upper lumbar spine. These approaches provided a very good exposure to the anterior part of vertebrae and allows for decompression of the spinal canal that help to improves neurological status in patients with neurological deficits The primary indications for the anterior approach in vertebral surgery are the conditions with the destruction of corpus vertebrae and disk diseases caused by several diseases. The aim of surgery is to decompress the neural element, reduction and stabilize the anterior part of the vertebra with and without posterior stabilization. Specifically, it could know the underlying disease and eradication of the disease. Access route is determined by the spinal and the length of the procedure, the location of the more prominent lesion, with special attention for the anatomy of the vessel, visceral, nerve, diaphragm for thoracic-lumbar approach and avoid injuring artery between T4-L4 that critical for spinal cord injury. A multidisciplinary team effort with thoracic and urologic surgeon increases the likelihood of the outcome.
Surgery of Intramedullary Tumours Julius July
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Abstract

Surgery still offers a cure to the majority of intramedullary tumours. The challenge of the surgery is taking out the tumour while preserving the function. Very often the patient has a huge tumour with very minimal symptoms, such as mild numbness. The slow growth of the tumour nature provides enough time for the cord fibres to adapt accordingly. Usually, the motor function is preserved and most of the pathologies are benign. For this reasons, the majority of cases have good long-term tumour control. The functional outcome is depending on the preoperative functional state, especially for motor function. The patient should be educated prior to surgery, especially to anticipate the post-surgical rehabilitation period. The surgical technique should preserve the motor function, but the fine movement usually gets worst for several months after surgery and slowly recover within 6 months. We share our experience of 45 surgical cases with intramedullary tumour (14F;31M), the pathologies distributions are 20 ependymomas, 8 astrocytomas (1/8 anaplastic astrocytoma), 7 cavernomas, 8 hemangioblastomas, 1 glioblastoma multiforme, and 1 tuberculoma. The location distribution varied from 27 at the cervical cord, 11 thoracal, 4 thoracolumbal, and 3 MO-upper cervical. The surgical outcome for all cases experienced sensory changes and recovered over 6 months. Almost all cases experienced some degree of spasticity and fine movement difficulty and they are improving over 6 months. Motor strength is usually preserved. One case of GBM, improve gradually for the first two months then followed by the disease course regardless of the treatment. The tuberculoma case required one year to recover her neurological function with adequate treatment.
Spinal Dural Arteriovenous Fistula: Diagnosis and Treatment Nur Setiawan Suroto
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Abstract

Spinal dural arteriovenous (AV) fistulas are the most commonly encountered vascular malformation of the spinal cord and a treatable cause for progressive paraplegia or tetraplegia. They most commonly affected are elderly men and are classically found in the thoracolumbar region. Symptoms gradually progress or decline in a stepwise manner and are commonly associated with pain and sphincter disturbances. Surgical or endovascular disconnection of the fistula has a high success rate with a low rate of morbidity. Motor symptoms are most likely to improve after treatment, followed by sensory disturbances, and lastly sphincter disturbances.
Spinal Arachnoid Cyst in Children Wihasto Suryaningtyas
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Abstract

Spinal arachnoid cyst is rarely seen in children. The presenting features can be mistakenly assumed as myelitis or Guillan-Barre syndrome. Intermittent weaknesses of the leg, progressive ascending weakness of the leg, sensory disturbance, and altered physiological reflexes are the hallmark of the disease. Nabors classified the pathology of the spinal arachnoid cyst into three types: extradural without nerve root involvement; extradural with nerve root; and intradural. It is mostly located in mid- to lower thoracic. The causes and natural history of pediatric arachnoid cysts are unclear. They usually are associated with trauma, surgery, arachnoiditis, and neural tube defects. MRI is a useful diagnostic tool. We present two cases of extradural and intradural arachnoid cysts in children. The follow-up and surgical results are reviewed. The surgical therapy itself is straightforward. However, the wrong conclusion might cause a financial burden and may cause preventable sequel.
Tethered Cord Syndrome Samsul Ashari
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Abstract

Tethered cord syndrome (TCS) is a clinical condition of various origins, which comprises of progressive neurological, urological, and orthopaedic dysfunction, because of congenital fixation or tethering of the distal spinal cord by the terminal filum. It is believed that, if the filum elasticity is compromised by either fatty infiltration or abnormal thickening, the spine movement may cause stress upon the conus, resulting in TCS. Patients with symptomatic TCS can present with a wide variety of signs and symptoms in combination with cutaneous, orthopaedic, spinal, anorectal, and urological abnormalities. The common clinical presentations include the presence of cutaneous signs associated with open septal defects, neurogenic bladder with incontinence or urinary tract infection, leg or foot weakness, numbness and/or spasticity, differences in leg or foot length, deformities of the foot, spinal deformities, and back and leg pain. Neuroimaging is used to confirm when there is suspicion of TCS. Magnetic resonance imaging is the modality of choice in visualizing the level of the conus medullaris and for identifying a thickened and/or fatty filum. The fundamental goals of surgical intervention in TCS are to prevent future deficits in the asymptomatic patient and to improve or stabilize deficits in the symptomatic patient. These two goals are based on the fact that sectioning of the terminal filum can be done safely with minimal risk and a very low rate of morbidity. The reported complications of surgery are cerebrospinal fluid leakage (most common), wound infection, meningitis, bladder dysfunction, and neurological injury.
Controversies in Managing of Thoracic-Lumbar Upper Burst Fractures Sahat Edison Sitorus
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Abstract

Upper burst fracture of Th12-L1 has unique anatomy because it contains lower spinal cord, medullary cone, and diaphragm which separates between the thoracic and lumbar spine. The presence or absence of neurologic deficit is the single most important factor in the decision making. The presence of profound but incomplete neural deficit in association with canal compromise represents an urgent indication of surgical decompression. Antero-lateral direct decompression with trans-thoracic trans-pleural– retroperitoneal approach given the proximity the cord and conus is the most effective method, with inter-vertebral instrumentation with or without lateral fixation or posterior instrumentation.
Delayed Neurological Deficit after Traumatic Odontoid Fracture Yesaya Yunus; Julius July
Neurologico Spinale Medico Chirurgico Supplementary Issue - Conference Abstracts
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Abstract

Fractures of the odontoid process can lead to gross instability of the atlantoaxial complex and present a significant risk for a potentially catastrophic spinal cord injury. Type II odontoid fractures are the most common odontoid fractures and are unstable that may displace anteriorly or posteriorly. If left untreated, the patient may develop atlantoaxial dislocation that causes neurological deficit also progressive myelopathy. We described the surgical management of four patients with a delayed neurological deficit after odontoid fracture with a history of trauma and after triggered by traditional massage. Traction several days before operation applied to achieve reduction of atlantoaxial dislocation. Posterior instrumentation and correction of atlantoaxial dislocation were performed with interarticular screw fixation (Harm technique) in all of the patients. All of the four patients showed a reduction of the atlantoaxial dislocation and also a neurological improvement. Cervical traction followed by posterior instrumented correction may be an effective alternative to treating delayed neurological deficits after traumatic odontoid fracture.

Page 4 of 14 | Total Record : 134

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