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Monitoring neurofisiologis pada Adolescent Idiopathic Scoliosis yang menjalani operasi koreksi deformitas



Abstract

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.

Keywords: skoliosis idiopatik koreksi deformitas monitoring neurofisiologis

References

  1. Cheng JC, Castelein RM, Chu WC, et.al. Adoloscent Idiopathic Scoliosis. In: Disease Primer Volume 1. Macmillan Publisher. 2015
  2. Miguel FRJ, Marcelino LC. Complications in Scoliosis Surgery. In : Grivas T. Recent Advances in Scoliosis. Croatia: Intech; 2012
  3. Abjeco AS, Soto JD, Castoro C, et al. Profound Obstructive Hypotensio from Prone Positioning Documented by Transesophageal Echocardiography in Patient with Scoliosis: A Case Report. A&A Case Report. 2017 February 7; DOI : 10.1213/XAA.0000000000000534
  4. Crabb I. Anesthesia for Spinal Surgery. In : Anesthesia and Intensive Care Medicine. The Medicine Publishing Company Ltd. 2003
  5. Gambrall MA. Anesthetic Implications for Surgical Correction of Scoliosis. AANA Journal. 2007 August; 75 (4): 277-285
  6. Kundnami VK, Xhu L, Tak H, Wong HK. Multimodal intraoperative neuromonitoring in corrective surgery for adolescent idiopathic scoliosis: Evaluation of 354 consecutive cases. Indian Journal of Orthopaedics. 2010 January; 44 (1): 64-72.
  7. Laratta JL, Ha A, Shillingford JN, et.al. Neuromonitoring in Spinal Deformity Surgery: A Multimodality Approach. Global Spine Journal. 2018; 8(I); 68-77
  8. Ibrahim T, Mrowczynski O, Zalatimo O, et al. The Impact of Neurophysiological Intraoperative Monitoring during Spinal Cord and Spine Surgery: A Critical Analysis of 121 Cases. Cureus. 2017 November 19; 9(11): e1861

How to Cite

Mangkung, T. W., Sutawan, I. B. K. J., Senapathi, T. G., & Wiryana, I. M. (2021). Monitoring neurofisiologis pada Adolescent Idiopathic Scoliosis yang menjalani operasi koreksi deformitas. Medicina, 52(1), 1–5. https://doi.org/10.15562/medicina.v52i1.1029
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Teresa Wilfrida Mangkung
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Medicina Journal

Ida Bagus Krisna Jaya Sutawan
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Tjok GA Senapathi
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I Made Wiryana
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Medicina Journal