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Yudistira Prama Tirta
Korelasi antara luaran parameter sagital spinopelvik dan luaran ido pada pasien pasca operasi fusi dan stabilisasi tulang belakang torakal dan lumbal di Rumah Sakit dr. Cipto Mangunkusumo Jakarta pada tahun 2012-2014 = Correlation between sagittal spinopelvic parameters outcome and ido outcome of post thoracal and lumbar vertebrae stabilization and fusion patient in dr. Cipto Mangunkusumo Hospital Jakarta 2012-2014
"ABSTRAK
Pendahuluan. Parameter spinopelvik merupakan parameter untuk mengukur
keseimbangan poros tulang belakang terhadap ekstrimitas bawah pada penampang
sagital. Parameter ini terdiri dari sagittal vertical axis (SVA), pelvic incidence
(PI), pelvic tilt (PT), pelvic incidence (PI) dan diukur melalui X-ray whole spine
lateral view dalam keadaan berdiri. Pengukuran parameter ini penting sebagai
dasar analisa keseimbangan sagital dalam operasi rekonstruktif tulang belakang,
karena dengan tidak adanya keseimbangan pada penampang sagital ini akan
berakibat timbulnya adjacent segment degeneration yang akan memengaruhi
luaran klinis. Hingga saat ini belum ada studi yang mengevaluasi hubungan antara
luaran parameter spinopelvik dengan luaran klinis di indonesia.
Metode Penelitian. Penelitian ini adalah penelitian analitik potong lintang dengan
subyek 19 pasien dewasa pasca operasi stabilisasi dan fusi tulang belakang torakal
dan lumbal di Rumah Sakit Dr. Ciptomangunkusumo (RSCM) Jakarta pada tahun
2012-2014. Pasien tersebut dilakukan evaluasi X-ray parameter spinopelvik SVA,
PI, PT, dan SS dilakukan penilaian skor Indeks Disabilitas Oswestry (IDO) pada
saat 1 tahun pasca operasi. Lalu dilakukan analisis statistik dengan menggunakan
uji hipotesis komparatif numerik dengan menggunakan pearson dimana
dibandingkan luaran parameter spinopelvik SVA, PI, PT, dan SS dengan luaran
fungsional skor IDO.
Temuan dan Diskusi Penelitian. Didapatkan hasil korelasi antara IDO dan SVA
(p<0,001) (r=0,866). Korelasi antara IDO dan PI (p=0,006) (r=0,603). Korelasi
antara IDO dan PT (p=0,107) (r=0,382). Korelasi IDO dan SS (p=0,051)
(r=0,454).
Simpulan. Didapatkan korelasi kuat antara IDO dan SVA serta IDO dan PI.
Tidak didapatkan korelasi antara IDO dan PT serta IDO dan SS. SVA dan PI
merupakan parameter spinopelvik yang berpengaruh pada luaran pasca operasi fusi tulang belakang torakal dan lumbal.
ABSTRACT
Introduction. Spinopelvic parameter is a parameter that used to measure the
sagital balance of vertebrae in congruency with lower extrimity in sagital plane.
This parametr is consist of sagittal vertical axis (SVA), pelvic incidence (PI),
pelvic tilt (PT), pelvic incidence (PI) dan diukur melalui X-ray whole spine lateral
view in standing position. Measurement of this parameter is important as basic
analysis for achieve sagital balance in reconstructive operation of the vertebrae,
because if the sagital balance is interupted will cause the adjacent segment
degeneration that will influence the clinical outcomes. Up until now, there is no
study that evaluate the spinopelvic parameter with the clinical outcomes in
Indonesia.
Methods. This study is a cross-sectional analytic with 19 subject of adult patient
that had undergo thoracal and lumbar fusion and stabilization in Rumah Sakit Dr.
Ciptomangunkusumo (RSCM) Jakarta in 2012-2014. The subject was underwent
x-ray evaluation of SVA, PI, PT, and SS. The patient also underwent evaluation
of Indeks Disabilitas Oswestry (IDO) score in 1 year after operation. Then the
statistical work was done with numeric comparative pearson test analysis to
determine whether there is correlation between SVA, PI, PT, and SS with IDO
score.
Result and Discussion. There is strong correlation between IDO and SVA
(p<0,001) (r=0,866). Strong correlation between IDO and PI (p=0,006) (r=0,603).
No correlation between IDO and PT (p=0,107) (r=0,382). No correlation between
IDO and SS (p=0,051) (r=0,454).
Conclusion. Strong correlation is indicated in IDO and SVA, also in IDO and PI.
There is no correlation between IDO and PT, also in IDO and SS. SVA and PI are
the important spinopelvic parameter that have influence on clinical outcome in
post thoracal and lumbar fusion and stabilization patient.
;Introduction. Spinopelvic parameter is a parameter that used to measure the
sagital balance of vertebrae in congruency with lower extrimity in sagital plane.
This parametr is consist of sagittal vertical axis (SVA), pelvic incidence (PI),
pelvic tilt (PT), pelvic incidence (PI) dan diukur melalui X-ray whole spine lateral
view in standing position. Measurement of this parameter is important as basic
analysis for achieve sagital balance in reconstructive operation of the vertebrae,
because if the sagital balance is interupted will cause the adjacent segment
degeneration that will influence the clinical outcomes. Up until now, there is no
study that evaluate the spinopelvic parameter with the clinical outcomes in
Indonesia.
Methods. This study is a cross-sectional analytic with 19 subject of adult patient
that had undergo thoracal and lumbar fusion and stabilization in Rumah Sakit Dr.
Ciptomangunkusumo (RSCM) Jakarta in 2012-2014. The subject was underwent
x-ray evaluation of SVA, PI, PT, and SS. The patient also underwent evaluation
of Indeks Disabilitas Oswestry (IDO) score in 1 year after operation. Then the
statistical work was done with numeric comparative pearson test analysis to
determine whether there is correlation between SVA, PI, PT, and SS with IDO
score.
Result and Discussion. There is strong correlation between IDO and SVA
(p<0,001) (r=0,866). Strong correlation between IDO and PI (p=0,006) (r=0,603).
No correlation between IDO and PT (p=0,107) (r=0,382). No correlation between
IDO and SS (p=0,051) (r=0,454).
Conclusion. Strong correlation is indicated in IDO and SVA, also in IDO and PI.
There is no correlation between IDO and PT, also in IDO and SS. SVA and PI are
the important spinopelvic parameter that have influence on clinical outcome in
post thoracal and lumbar fusion and stabilization patient.
"
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Erick Wonggokusuma
Efek suntikan intra articular recombinant human growth hormone dibandingkan dengan asam hyaluronat dan placebo terhadap degenerasi tulang rawan kelinci selandia baru mocel osteoarthritis = Effect of intraarticular injection of recombinant human growth hormone compared with hyaluronic acid and placebo in cartilage degeneration process of osteoarthritic model in white new zealand rabbit
"ABSTRAK
Pendahuluan. Osteoarthritis (OA) adalah sebuah penyakit sendi degeneratif yang
menyebabkan disabilitas dengan prevalensi yang terus meningkat. Hormon
pertumbuhan memiliki efek regenerasi tulang rawan secara langsung melalui
stimulasi sel kondroblas dan proses morphoangiogenesis juga melalui faktor
pertumbuhan secara sistemik. Penelitian ini bertujuan untuk mengetahui manfaat
suntikan sendi dengan hormon pertumbuhan pada kasus Osteoarthritis.
Metode Penelitian. Penelitian dilakukan di Rumah Sakit Hewan Institut
Pertanian Bogor pada bulan Mei hingga September 2015. Desain penelitian adalah
randomized post test only control group. Sejumlah 21 ekor kelinci Selandia Baru
putih, berat 1.9-2.6kg, usia 7-8 bulan. Kelinci dibagi secara acak menjadi
kelompok kontrol (NaCl 0.9%), suntikan hormon pertumbuhan (4iu), dan suntikan
asam hyaluronat (6mg) . Dengan metode acak tersamar dilakukan suntikan
kolagenase tipe II C. Histolyticum pada hari 1 dan ke 4 pada lutut kiri, kemudian
tindakan penyuntikan dilakukan sebanyak tiga kali dengan selang waktu 1
minggu. Evaluasi dengan periode kepincangan, skoring makroskopis, histologis
dilakukan pada minggu ke-8 pasca penyuntikan pertama.
Temuan Penelitian. Berdasarkan hasil penelitian ditemukan periode kepincangan
pada grup yang diberikan hormon pertumbuhan lebih singkat, dan bermakna
secara statistik dibandingkan dengan grup kontrol (p<0.001), grup asam
hyaluronat (p<0.03), dan grup hormon pertumbuhan (p<0.001). Evaluasi skor
makroskopik dengan skor yoshimi menunjukan bahwa kelompok hormon
pertumbuhan memiliki kerusakan tulang rawan yang lebih ringan jika
dibandingkan dengan grup kontrol (p=0.001) dan grup asam hyaluronat (p=0.04).
Skoring histopatologis menggunakan skor modifikasi Mankin menunjukan pada
kelompok dengan hormon pertumbuhan memiliki angka terendah dibandingkan
grup lainnya (p=0.001), grup kontrol (p=0.001), grup asam hyaluronat (p=0.015).
Kesimpulan. Suntikan hormon pertumbuhan ke dalam sendi memiliki efektifitas
yang lebih baik dibandingkan dengan Asam hyaluronat pada model osteoarthritis.
Hormon pertumbuhan memberikan harapan baru sebagai alternatif dalam terapi
osteoarthritis.ABSTRACT
Introduction. Osteoarthritis is a degenerative joint disorder that cause disability
for patients all over the globe, with an increasing number of patients. Growth
hormone (GH) works trough direct and indirect effect on cartilage regeneration by
chondroblast stimulation, stimulation of growth factors and morphoangiogenesis
process. Further research is needed to know the effects of intra articular joint
injection of growth hormone using validated animal model and reliable outcome
measurement.
Methods. This study was conducted in Animal Hospital of Agricultural Institute
Bogor west Java, from May to September 2015. The design of the study was
randomized posttest only control group. Male white New Zealand rabbit (n=21)
weighted 1.9-2.6kg, age 6-7months were used in this study. The sample was
randomized and divided into three groups. All groups recieved intra articular
injection of type 2 collagenase (Sigma® Missouri) 2mg at the left knee on day 1
and 4. Injections of growth hormone (4iu), hyaluronic acid (HA) (6mg) and saline
(0.6ml) were done at 2 weeks after collagenase injection once a week for
consecutive 3 weeks. Evaluation of weight and lameness periode is done
periodically, histopathological and macroscopic score were done at 8 weeks since
the first injection.
Result. The lameness priode for control group is significantly longer than both of
the experimental groups (p<0.001), HA (p<0.03), and GH (p<0.001).
Macroscopic score evaluation taken from the lateral condyle of the left femur
showed that the GH group received significantly less cartilage damage than the
HA group (P=0.04) and placebo (P=0.01). Histopathological score was also found
lowest at the GH group (p=0.001), with significant difference in control
(p=0.001), and HA group (p=0.015).).
Conclusion. Intraarticular injection of growth hormone is found to be more
effective compared to hyaluronic acid on rabbit osteoarthritis model. This results
showed promising result for intra articular injection of GH as an alternative
treatment for osteoarthritis.;Introduction. Osteoarthritis is a degenerative joint disorder that cause disability
for patients all over the globe, with an increasing number of patients. Growth
hormone (GH) works trough direct and indirect effect on cartilage regeneration by
chondroblast stimulation, stimulation of growth factors and morphoangiogenesis
process. Further research is needed to know the effects of intra articular joint
injection of growth hormone using validated animal model and reliable outcome
measurement.
Methods. This study was conducted in Animal Hospital of Agricultural Institute
Bogor west Java, from May to September 2015. The design of the study was
randomized posttest only control group. Male white New Zealand rabbit (n=21)
weighted 1.9-2.6kg, age 6-7months were used in this study. The sample was
randomized and divided into three groups. All groups recieved intra articular
injection of type 2 collagenase (Sigma® Missouri) 2mg at the left knee on day 1
and 4. Injections of growth hormone (4iu), hyaluronic acid (HA) (6mg) and saline
(0.6ml) were done at 2 weeks after collagenase injection once a week for
consecutive 3 weeks. Evaluation of weight and lameness periode is done
periodically, histopathological and macroscopic score were done at 8 weeks since
the first injection.
Result. The lameness priode for control group is significantly longer than both of
the experimental groups (p<0.001), HA (p<0.03), and GH (p<0.001).
Macroscopic score evaluation taken from the lateral condyle of the left femur
showed that the GH group received significantly less cartilage damage than the
HA group (P=0.04) and placebo (P=0.01). Histopathological score was also found
lowest at the GH group (p=0.001), with significant difference in control
(p=0.001), and HA group (p=0.015).).
Conclusion. Intraarticular injection of growth hormone is found to be more
effective compared to hyaluronic acid on rabbit osteoarthritis model. This results
showed promising result for intra articular injection of GH as an alternative
treatment for osteoarthritis.;Introduction. Osteoarthritis is a degenerative joint disorder that cause disability
for patients all over the globe, with an increasing number of patients. Growth
hormone (GH) works trough direct and indirect effect on cartilage regeneration by
chondroblast stimulation, stimulation of growth factors and morphoangiogenesis
process. Further research is needed to know the effects of intra articular joint
injection of growth hormone using validated animal model and reliable outcome
measurement.
Methods. This study was conducted in Animal Hospital of Agricultural Institute
Bogor west Java, from May to September 2015. The design of the study was
randomized posttest only control group. Male white New Zealand rabbit (n=21)
weighted 1.9-2.6kg, age 6-7months were used in this study. The sample was
randomized and divided into three groups. All groups recieved intra articular
injection of type 2 collagenase (Sigma® Missouri) 2mg at the left knee on day 1
and 4. Injections of growth hormone (4iu), hyaluronic acid (HA) (6mg) and saline
(0.6ml) were done at 2 weeks after collagenase injection once a week for
consecutive 3 weeks. Evaluation of weight and lameness periode is done
periodically, histopathological and macroscopic score were done at 8 weeks since
the first injection.
Result. The lameness priode for control group is significantly longer than both of
the experimental groups (p<0.001), HA (p<0.03), and GH (p<0.001).
Macroscopic score evaluation taken from the lateral condyle of the left femur
showed that the GH group received significantly less cartilage damage than the
HA group (P=0.04) and placebo (P=0.01). Histopathological score was also found
lowest at the GH group (p=0.001), with significant difference in control
(p=0.001), and HA group (p=0.015).).
Conclusion. Intraarticular injection of growth hormone is found to be more
effective compared to hyaluronic acid on rabbit osteoarthritis model. This results
showed promising result for intra articular injection of GH as an alternative
treatment for osteoarthritis."
Fakultas Kedokteran Universitas Indonesia, 2015
SP-PDF
UI - Tugas Akhir  Universitas Indonesia Library
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Muh Tri Nugroho Fahrudhin
Perbandingan Luaran Klinis antara Penggunaan Panduan Ultrasonografi dengan Panduan Floroskopi pada Tindakan Selective Nerve Root Block Lumbar: Sebuah Uji Klinis Acak Tidak Tersamar = Comparison of Clinical Outcomes between the Use of Ultrasound Guidance and Fluoroscopy Guidance in Lumbar Selective Nerve Root Block: A Randomized Controlled Trial
"Lumbar canal stenosis merupakan penyebab utama disabilitas pasien. Selective Nerve Root Block (SNRB) pada area lumbar adalah salah satu metode terapi untuk mengatasi nyeri akibat radikulopati lumbar yang bertujuan mengurangi kebutuhan operasi. Ultrasonografi (USG) muncul sebagai alternatif dengan kelebihan seperti tanpa radiasi, mobilitas tinggi, kemampuan pencitraan jaringan lunak, dan penetrasi jarum real-time jika dibandinagkan menggunakan Floroskopi. Penelitian ini merupakan studi uji klinis acak non-inferiority tersamar tunggal yang dilakukan di 2 Rumah Sakit. 52 subjek penelitian yang terdiri dari 26 subjek yang dilakukan tindakan SNRB dengan panduan fluoroskopi dan 26 subjek yang dilakukan tindakan SNRB dengan panduan USG. Tidak ada perbedaan karakteristik dasar antara kedua kelompok berdasarkan usia, jenis kelamin, IMT, durasi gejala. level lumbar VAS, maupun ODI pre operasi (p > 0,05). Penelitian ini menunjukkan penurunan signifikan pada nilai VAS di kelompok floroskopi dan USG pada 30 menit, 2 minggu, dan 12 minggu setelah tindakan dibandingkan dengan baseline (p < 0,01). Kendati demikian, tidak ada perbedaan VAS dan ODI yang signifikan antara kedua metode panduan pada setiap titik waktu (p > 0,05). Tidak terdapat perbedaan dalam pengurangan nyeri radikular lumbal, skor ODI, dan kejadian komplikasi antara tindakan SNRB dengan panduan fluoroskopi maupun USG. Penggunaan panduan USG pada SNRB terbukti lebih efisien dengan durasi yang lebih singkat dan sama efektifnya dengan fluoroskopi.
Lumbar canal stenosis is a leading cause of patient disability. Selective Nerve Root Block (SNRB) in the lumbar area is a therapeutic method aimed at alleviating pain from lumbar radiculopathy to reduce disability and surgical needs. SNRB typically employs fluoroscopy but has drawbacks such as radiation exposure. Ultrasonography (USG) has emerged as an alternative offering benefits. This was a randomized single-blind non-inferiority clinical trial conducted at 2 Hospitals. There were 52 subjects, with 26 undergoing SNRB with fluoroscopy guidance and 26 with USG guidance. No baseline characteristic differences were found between the groups in terms of age, gender, BMI, symptom duration, preoperative lumbar level VAS, or ODI (p > 0.05). The study demonstrated significant reductions in VAS scores in both fluoroscopy and USG groups at 30 minutes, 2 weeks, and 12 weeks post-procedure compared to baseline (p < 0.01). However, no significant differences in VAS and ODI were observed between the two guidance methods at any time point (p > 0.05). There was no difference in the reduction of lumbar radicular pain, ODI scores, and complication rates between SNRB procedures guided by fluoroscopy and USG. USG guidance in SNRB proves to be more efficient with shorter duration and equally effective as fluoroscopy."
Jakarta: Fakultas Kedokteran Universitas Indonesia, 2024
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UI - Disertasi Membership  Universitas Indonesia Library