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    List Pertanyaan

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    List Pertanyaan

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    Andre Prawiradinata
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    Andre Prawiradinata
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    compliList Pertanyaan

    1. Definisi Scoliosis

    Scoliosis is defined as a complex, three-dimensional deformity of the spine characterized by a lateral


    curvature greater than 10 degrees, as measured by the Cobb angle on a radiograph. The condition
    involves not only a sideways curvature but also a rotational deformity of the vertebrae, leading to an
    abnormal spinal alignment in the coronal, sagittal, and axial planes. This deformity can occur at any
    level of the spine, including the cervical, thoracic, and lumbar regions, often resulting in a visible
    asymmetry of the shoulders, waist, or hips.

    Reference:

    1. Bridwell KH, DeWald RL. The Textbook of Spinal Surgery. 3rd ed. Philadelphia: Lippincott
    Williams & Wilkins; 2011.
    2. Morrissy RT, Weinstein SL, editors. Lovell and Winter's Pediatric Orthopaedics. 6th ed.
    Philadelphia: Lippincott Williams & Wilkins; 2006.

    2. Definisi severe scoliosis

    Severe scoliosis is generally defined as a spinal curvature with a Cobb angle of 40 degrees or more in
    adolescents and 50 degrees or more in adults. The Cobb angle is a measurement used to quantify
    the degree of spinal deformity, with larger angles indicating more significant curvature. In clinical
    practice, severe scoliosis is not only defined by the degree of curvature but also by the impact on the
    patient's physical function and overall health.

    Reference:

    Weinstein SL, Dolan LA, Wright JG, Dobbs MB. Effects of bracing in adolescents with idiopathic
    scoliosis. N Engl J Med. 2013 Oct 17;369(16):1512-21.

    3. Komplikasi dari severe scoliosis


    Severe scoliosis can lead to complications such as respiratory issues due to reduced lung
    capacity, cardiovascular problems from increased heart pressure, and chronic back pain
    caused by muscle imbalances, disc strain, and nerve compression. It also results in visible
    physical deformities, including uneven shoulders and rib hump, which affect balance and
    gait. Additionally, scoliosis can cause digestive issues like acid reflux and constipation due to
    internal organ compression, and it has significant psychological and social impacts, including
    body image concerns, low self-esteem, and social anxiety, which may lead to depression and
    anxiety. Furthermore, it reduces mobility and functionality, making physical activity and daily
    tasks more challenging.

    Reference:
    1. Pehrsson K, Larsson S, Oksuz S, Nachemson A. Long-term follow-up of patients with
    untreated scoliosis. A study of mortality, causes of death, and symptoms. Spine (Phila Pa
    1976). 2008 Jan 1;33(1):46-57.
    2. Glassman SD, Berven S, Kostuik J, Dimar JR, Horton WC, Bridwell K. Nonsurgical resource
    utllization in adult spinal deformity: a prospective, multicenter, 5-year analysis. Spine
    (Phila Pa 1976). 2006 Sep 15;31(20):2238-43.
    3. Weinstein SL, Zavala DC, Ponseti IV. Idiopathic scoliosis: long-term follow-up and
    prognosis in untreated patients. J Bone Joint Surg Am. 2008 Feb;90(2):294-7.
    4. Smith JS, Fu KM, Urban P, Shaffrey CI. Neurological dysfunction after adult spinal
    deformity surgery: correlation of radiographic and clinical factors. Spine (Phila Pa 1976).
    2013 Apr 1;38(7)

    5. Yang ingin diktahui di RSHS penanganan seperti apa dan hasil seperti apa

    6. Case data collected from medical record


    Sudah ditambahkan

    6. 9 pasien itu rata rata berapa persen curvenya

    Sudah di introduction

    7. Result

    a. Rata-rata sudut berapa, Pre op dan post op, Sudut tertinggi dan terendah

    The average pre-operative Cobb angle of the thoracic curvature from these 9 patients was 86.56°.
    The average pre-operative Cobb angle of the lumbar curvature from 6 patients was 72.17°. The
    average post-operative Cobb angle of the thoracic curvature was 39.22°, and the average post-
    operative Cobb angle of the lumbar curvature was 31.33°. In the case report, the lowest pre-
    operative Cobb angle recorded was 72° in the thoracic region (Case 6), while the highest pre-
    operative Cobb angle was 110° in the thoracic region (Case 1). After surgical intervention, the lowest
    post-operative Cobb angle was reduced to 25° (thoracic, Case 6), and the highest post-operative
    Cobb angle was 50° (thoracic, observed in both Cases 1 and 2).

    d. Keluhan saat follow up setelah operasi

    Selesai

    e. Evaluasi xray

    f. Komplikasi post op ada atau tidak

    sudah, tidak ada


    8. Discussion

    a. Bandingkan dengan serial kasus jurnal lain apakah hasilnya sama

    When comparing these results to similar studies, the findings are consistent. For example, Tsirikos et
    al. (2018) analyzed adolescent patients with idiopathic scoliosis and comorbidities, reporting similar
    preoperative Cobb angles exceeding 70 degrees. Their postoperative outcomes also showed a
    reduction in Cobb angles to around 40-50 degrees, though they noted a slightly higher incidence of
    complications, including rod breakage in single-rod cases, which contrasts with the absence of
    complications in the Hasan Sadikin series.

    In a study by Wang et al. (2008), which compared anterior and posterior spinal fusion for moderate
    to severe scoliosis, the preoperative Cobb angles ranged from 60 to 90 degrees. The postoperative
    outcomes were similar to those observed in the Hasan Sadikin series, with Cobb angles reduced to
    about 30-40 degrees and minimal complications reported, aligning closely with the successful
    outcomes seen in your series.

    Similarly, Tambe et al. (2018) reported on adolescents with idiopathic scoliosis, where preoperative
    Cobb angles exceeded 50 degrees. Their postoperative corrections typically resulted in Cobb angles
    of 30-40 degrees, with only minor complications such as wound infections and transient neurological
    symptoms, none of which were observed in the Hasan Sadikin series.

    Overall, the outcomes from the Hasan Sadikin General Hospital case series are consistent with those
    reported in other studies, demonstrating significant Cobb angle reductions and a notably low
    complication rate, highlighting the effectiveness of the surgical interventions performed at your
    institution.

    9. Conclusion

    a. The patient underwent successful surgery

    In this case series from Hasan Sadikin General Hospital, nine patients with severe adolescent
    idiopathic scoliosis underwent surgical correction using posterior spinal fusion with instrumentation.
    The surgeries were successful, with significant reductions in Cobb angles, averaging from 86.56
    degrees preoperatively to 39.22 degrees postoperatively for thoracic curvatures, and from 72.17
    degrees to 31.33 degrees for lumbar curvatures. The procedures were performed without significant
    complications, demonstrating the effectiveness of posterior spinal fusion in managing severe
    scoliosis in this patient population.

    10. Clinical epidemiology itu apa

    11. Clinical result post severe scoliosis

    Sudah di conclusion

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