Microsurgery techniques are useful innovations towards minimizing the insult of canal stenosis. Here, we describe the trumpet laminectomy microdecompression (TLM) technique, advantages and disadvantages. Sixty-two TLM patients with lumbar disc herniation, facet hypertrophy or yellow ligament or intracanal granulation tissue. The symptoms are low back pain, dysesthesia and severe pain on both legs. Spine levels operated Th11-S1; the patients who had trumpet-type fenestration, 62.9% had hypertrophy of the facet joint, 11.3% had intracanal granulation tissue, 79.1% had hypertrophy of the yellow ligament and 64.5% had disc herniation. The average of procedure duration was 68.9 min and intraoperative blood loss was 47.4 mL. Intraoperative complications were found in 3.2% of patients, with dural damage but without cerebrospinal fluid leakage. The TLM can be performed for all ages and all levels of spinal canal stenosis, without the complication of spondilolistesis. The TLM has a shorter duration, with minimal intraoperative blood loss.

AbstrakCedera servikal merupakan salah satu cedera tulang belakang terbanyak pada penderita trauma. Di Amerika Serikat tahun 2008 dari 100.000 kasus cedera tulang belakang, 2/3 merupakan kasus cedera servikal. Penilaian awal dilakukan berdasarkan American Spinal Cord Injury Association (ASIA) Impairment Score, sedangkan hasil setelah penatalaksanaannya sering diabaikan untuk evaluasi keberhasilan ahli di rumah sakit. Tujuan penelitian untuk mengetahui nilai functional independence measure (FIM) penderita cedera servikal dengan manajemen konservatif dan korelasinya dengan usia, jenis kelamin, jenis trauma, onset trauma, abnormalitas tulang servikal, lesi cervical spine, dan ASIA Impairment Score. Dilakukan studi kohor prospektif pada semua pasien cedera servikal yang memenuhi kriteria inklusi di Departemen Bedah Saraf Rumah Sakit (RS) Dr. Hasan Sadikin Bandung. Subjek dikelompokkan berdasarkan usia, jenis kelamin, trauma tunggal/multipel, akut/kronik, abnormalitas tulang servikal, lesi komplet/inkomplet, ASIA Impairment Score, dan komplikasi awal cedera. Pada penderita dilakukan penilaian FIM di Poliklinik Bedah Saraf. Data dianalisis menggunakan uji-t dan uji chi-kuadrat dengan p<0,05. Terdapat 17 penderita cedera servikal yang dirawat di Departemen Bedah Saraf RS Dr. Hasan Sadikin Bandung periode April 2009-April 2010. Observasi kohor prospektif nilai FIM rata-rata penderita cedera servikal adalah 4+1,63. Analisis chi-kuadrat menyatakan bahwa tidak terdapat hubungan usia (p=0,064), jenis kelamin (p=0,144), jenis trauma penyerta (p=0,959), onset cedera (p=0,220), abnormalitas tulang servikal (p=0,869) dengan besarnya nilai FIM pasien cedera servikal. Terdapat hubungan jenis lesi cervical spine (p=0,037), ASIA Impairment Score (p<0,001) dengan besarnya nilai FIM penderita cedera servikal. Simpulan, jenis lesi cervical spine dan ASIA Impairment Score memiliki hubungan bermakna dengan besarnya nilai FIM penderita 3 bulan pascacedera servikal. [MKB. 2013;45(3):180-6] Kata kunci: ASIA Impairment Score, cedera servikal, functional independence measure Functional Independence Measure in Patients with Cervical Spine Injury AbstractCervical spine injury is one of the most common spinal cord injuries in trauma patients. From 100,000 spinal cord injury cases reported in the United States of America (2008), 2/3 involved cervical spine injury. American Spinal Cord Injury Association (ASIA) Impairment Score is used as an initial assessment but further prognostic outcome of these patients is often not paid enough attention. The objective of this study was to find the value of functional independence measure (FIM) cervical spine injury patients with conservative management and correlation with age, sex, type of trauma, onset of trauma, cervical bone abnormalities, type of spinal lesion and ASIA Impairment Score. A prospective cohort study was performed to all patients with cervical spine injury which fullfil the inclusion criteria treated in Neurosurgery Department of Dr. Hasan Sadikin Hospital Bandung. The subjects were cla...

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