CASE REPORT

Monitoring neurofisiologis pada Adolescent Idiopathic Scoliosis yang menjalani operasi koreksi deformitas

Teresa Wilfrida Mangkung , Ida Bagus Krisna Jaya Sutawan, Tjok GA Senapathi, I Made Wiryana

Teresa Wilfrida Mangkung
Residen Departemen/KSM Ilmu Anestesi dan Terapi Intensif Fakultas Kedokteran Universitas Udayana. Email: [email protected]

Ida Bagus Krisna Jaya Sutawan
Spesialis Konsultan Departemen/KSM Ilmu Anestesi dan Terapi Intensif Fakultas Kedokteran Universitas Udayana

Tjok GA Senapathi
Spesialis Konsultan Departemen/KSM Ilmu Anestesi dan Terapi Intensif Fakultas Kedokteran Universitas Udayana

I Made Wiryana
Profesor Spesialis Konsultan Departemen/KSM Ilmu Anestesi dan Terapi Intensif Fakultas Kedokteran Universitas Udayana
Online First: April 01, 2021 | Cite this Article
Mangkung, T., Sutawan, I., Senapathi, T., Wiryana, I. 2021. Monitoring neurofisiologis pada Adolescent Idiopathic Scoliosis yang menjalani operasi koreksi deformitas. Medicina 52(1): 1-5. DOI:10.15562/medicina.v52i1.1029


Scoliosis is structure deformity of vertebrae that is diagnosed based on measurement of major curve of the vertebrae. Adolescents Idiopathic Scoliosis (AIS) is the most common type of scoliosis. One of the management of scoliosis is surgery. The main goal of surgery is to prevent progressivity of scoliosis by spinal arthrodesis or fusion of the scoliosis vertebrae. One of the risk of this surgery is nerve damage that need close monitoring intraoperatively to prevent the damage. Female, 17 year old was diagnosed with AIS in thoracolumbal with Cobb angle 800 in the thoracal section and Cobb angle 900 in the lumbal section. She had deformity correction under general anesthesia. Neurophysiologic monitoring during surgery was somatosensory evoked potentials (SSEP) and motor evoked potential (MEP). These monitoring was used to prevent nerve damage due to spinal cord injury. Spinal cord injury could happen when pedicle screw was inserted and during rotation to correct the vertebrae’s angle.

 

 

Skoliosis adalah deformitas struktur dari tulang belakang dengan dasar pengukuran kurva mayor sebagai penentu deformitas. Adolescents Idiopathic Skoliosis (AIS) adalah bentuk paling umum dari skoliosis. Salah satu manajemen dari skoliosis adalah melalui tindakan pembedahan. Tujuan utama pembedahan pada skoliosis adalah untuk mencegah progresivitas dari skoliosis dengan artrodesis spinal atau fusi dari regio tulang belakang yang mengalami skoliosis, sedangkan tindakan pembedahan sendiri memiliki risiko terjadinya kerusakan saraf. Oleh karena itu dibutuhkan suatu monitoring yang dapat digunakan untuk mendeteksi kerusakan tersebut intraoperative sehingga dapat dicegah kerusakan yang lebih lanjut atau permanen. Perempuan, 17 tahun dengan diagnosis Adolescence Idiopathic Scoliosis torakolumbal dengan sudut Cobb torakalis 800 dan sudut Cobb lumbalis 900 dilakukan tindakan koreksi deformitas dengan pembiusan umum. Durante operasi dilakukan monitoring neurofisiologis dengan somatosensory  evoked potentials (SSEP) dan motor evoked potential (MEP). Kedua monitoring ini bertujuan mencegah terjadinya kerusakan saraf akibat cedera pada medula spinalis saat dilakukan pemasangan pedicle screw dan rotasi untuk mengkoreksi sudut dari tulang belakang.

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