Keberhasilan Fusi Tulang Belakang pada Spondilitis Tuberkulosis

Agus Rahadian Rahim, Bambang Tiksnadi, Nucki N. Hidayat, Ahmad Ramdan

Abstract


Fusi tulang belakang pada spondilitis tuberkulosis bertujuan untuk menghilangkan sumber infeksi, koreksi deformitas, dan mengatasi komplikasi neurologis. Data tingkat keberhasilan fusi ini masih belum tersedia. Kendala lain adalah harga instrumentasi bermerek untuk operasi fusi tulang belakang sangat mahal. Penelitian studi kohort retrospektif ini untuk evaluasi keberhasilan fusi tulang belakang pada spondilitis tuberkulosis di Rumah Sakit Dr. Hasan Sadikin, Bandung tahun 2005–2009. Didapatkan 115 kasus spondilitis tuberkulosis yang dioperasi terdiri atas 34 (29,3%) kasus anterior decompresion spinal fusion (ADSF) dan 81 (70,7%) kasus dengan menggunakan instrumentasi posterior. Dari 81 kasus tersebut, terdapat 3, 27, 26, dan 19 orang berturut-turut mengalami fusi tulang belakang setelah 4, 3, 2, dan 1 tahun pascaoperasi. Hanya 6 kasus yang belum mengalami fusi. Tingkat keberhasilan fusi tulang belakang pada kasus spondilitis tuberkulosis terbukti tinggi, 93%. Selain itu, instrumentasi lokal dapat digunakan sebagai alternatif instrumentasi yang bersifat cost effective untuk tindakan operasi fusi tulang belakang pada kasus spondilitis tuberkulosis dengan p=0,63. Sebagai kesimpulan, kasus spondilitis tuberkulosis yang memerlukan tindakan operasi fusi tulang belakang dapat ditangani dengan baik di RS Dr. Hasan Sadikin, dengan tingkat keberhasilan tinggi dan cost effective. [MKB. 2011;43(3):134–9].

Kata kunci: Fusi tulang belakang, spondilitis tuberkulosis


Successful Rate of Spinal Fusion in Spondylitis Tuberculosis

Spinal fusion for spondylitis tuberculosis is performed to diminish infection source, correct deformity and overcome neurologic complication. Data of spinal fusion rate has not been available yet. The other problem is that branded instrumentation price is very expensive. The aim of this retrospective cohort study was to evaluate successful rate of spinal fusion in spondylitis tuberculosis performed in Dr. Hasan Sadikin General Hospital, Bandung year 2005–2009. There were 115 cases of spondylitis tuberculosis which treated by operations, 34 cases (29.3%) with anterior decompresion spinal fusion (ADSF) and 81 cases (70.7%) using posterior instrumentation. From those 81 cases, 3, 27, 26, and 19 patients after surgery 4, 3, 2, dan 1 year had spinal fusion, consecutively. Only 6 cases who had not fused yet. The successful rate of spinal fusion in spondylitis tuberculosis, Bandung was proved to be high, 93%, and local instrument product could be used as a costly effective and good alternative treatment in operative management of spondylitis tuberculosis with p=0.63. As a conclusion, spondylitis tuberculosis cases which need spinal fusion can be well treated in Dr. Hasan Sadikin Hospital with high successful rate and cost effective. [MKB. 2011;43(3):134–9].

Key words: Spinal fusion, spondylitis tuberculosis

 

DOI:  http://dx.doi.org/10.15395/mkb.v43n3.59


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