Objective:Surgical management of giant skull osteomas Osteomas are benign, generally slow growing, bone forming tumors limited to the craniofacial and jaw bones.Materials and Methods:A retrospective review of all cases of osteoma diagnosed from 2009 to 2013 treated in our hospital. The data collected included age at diagnosis, gender, lesion location, size, presenting and duration of symptoms, treatment, complication and outcome.Results:During our study period there were 15 cases that were treated surgically. Their mean age was 42 years (range: 15–65 years) and all of our patients were female. The average duration of symptoms was 3 years and size varying from 4 cm to 12 cm. Eight patients complained of headache, whereas 6 patients complained about esthetics, and 1 patient presented with proptosis. The tumor was excised by cutting the base of the tumor and then residual tumor was grinded using a round head cutting bar. Osteoma was removed with esthetically acceptable appearance.Conclusion:There were no major complications during operative and postoperative period. Although osteomas are usually slow growing but surgery is usually performed due to esthetic reasons. It is important to plan an appropriate surgical approach that minimizes any damage to the adjacent structures.
Background: Spinal tuberculosis (TB) is a common form of extrapulmonary TB. Although the first line of the treatment is anti-TB medications, patients with severe neurological deficits, spinal instability, and/or kyphotic deformity often warrant surgery. Here, we report five cases of spinal TB requiring operative intervention at Hasan Sadikin General Hospital, Bandung, Indonesia. Case Description: We operated on five patients with spinal TB cases from 2019 to October 2021. In addition to appropriate medical management, all five patients successfully underwent laminectomy with or without posterior stabilization. Conclusion: It is essential to establish the diagnosis and surgically manage patients with spinal TB early in the clinical course to minimize residual post-operative neurological deficits.
Surgical site infection (SSI) following spinal surgery is a frequent complication that has been reported and can be devastating for patients and result in higher postoperative mortality, morbidity and healthcare costs. Although exact rates for SSI after instrumented spinal surgery are unavailable the most common organisms causing infection in spinal surgery patients is Staphylococcus aureus. The methicillin-resistant Staphylococcus aureus (MRSA) infection rising quickly caused by resistant bacteria, especially MRSA, and continues to rise providing a difficult challenge for medical community. The evolution and development of spinal instrumentation technology enabled the spine surgeon to achieve spinal stabilization during surgery. There are risks associated with spinal hardware including injury cord and nerve root, failure of instrumentation/migration and infection. Vinegar, from the French word vinaigre, meaning 'sour wine,' made from any fermentable carbohydrate source example apples, grapes, melons, coconut, honey. Recent scientific investigations demonstrate the antimicrobial properties of vinegar. Vinegar liquid that contained acetate acid 0.5% already have some report of its safety for topical therapy. Acetate acid is frequently used for wound care as 0.25 to 1% solution. The effectiveness of closed vacuum drainage system (CVDS) using acetate acid 0.5% in this case believe due to acidity of the liquid. It would be lowering pH and so complex making the environment not suitable for growing and multiplication of MRSA. Acetate acid also destabilize cell membrane integrity. Other mechanism is dilution by normal saline inflow and outflow has been reported decrease bacterial concentration. Closed vacuum drainage system with vinegar liquid that contained acetate acid 0.5% has been reported its effectively as the method for the management of postoperative MRSA spinal infection. It has some beneficial effect and allow us to close the wound primarily.
Latar Belakang dan Tujuan: Nyeri pinggang bawah yang disebabkan oleh penekanan radik saraf tulang belakang maupun thecal sac sering dijumpai dan dapat menimbulkan kecacatan. Percutaneous epidural adhesiolysis (PEA) adalah salah satu tindakan yang dilakukan untuk mengatasi nyeri sehingga penelitian ini bertujuan untuk mengevaluasi efektifitas PEA menggunakan lidokain 2% dalam mengatasi nyeri pinggang bawah. Subyek dan Metode: Penelitian cohort retrospektif dengan lima data pasien diambil dari database bagian Bedah Saraf. Semua pasien dilakukan PEA dengan injeksi anestesi lokal menggunakan 5 mL lidokain 2%, pengukuran luaran menggunakan Visual Analog Score (VAS), Oswestry Disability Index (ODI) dan penggunaan obat opioid yang dianalisa pada bulan ke-3 dan 6 bulan setelah tindakan. Hasil: Usia tertua adalah 60 tahun dengan 80% penderita adalah laki-laki dengan nilai maksimum VAS sebelum tindakan adalah 9, VAS 3 bulan pascatindakan adalah 3 sedangkan VAS 6 bulan pascatindakan adalah 2. Sehingga terdapat perbaikan VAS dan ODI yang signifikan (Friedman test dan post hoc Wilcoxon test) dengan nilai p<0,05. Satu pasien tetap menggunakan opioid hingga 6 bulan pascatindakan PEA. Simpulan: Pengurangan nyeri yang signifikan disertai dengan perbaikan status fungsional terjadi pada pasien yang diberikan PEA dengan menggunakan anestetika lokal lidokain 2%.
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