The Differences Effect Of Giving Snags And Mc Kenzie With Manual Traction And Mc Kenzie For Pain Reduction And Lumbal Disability In HNP Conditions

Latar Belakang : Herniated Nucleus Pulposus adalah kondisi penonjolan discus intervertebralis yang dapat menekan akar saraf yang keluar dari foramen intervertebralis sehingga menimbulkan nyeri radikular, dan pada akhirnya menyebabkan disabilitas lumbal. Metode Desain randomized two group pre test – post test dan menggunakan tehnik pulposive sampling bertujuan untuk mengetahui beda pengaruh pada intervensi SNAGs dan Mc kenzie dibandingkan dengan Manual Traction dan Mc.Kenzie terhadap penurunan nyeri dan disabilitas lumbal pada penderita HNP lumbal. Penelitian ini dilaksanakan di RSAD Tk. II Pelamonia Makassar dengan sampel adalah penderita HNP lumbal yang sesuai dengan kriteria inklusi. Jumlah sampel adalah 16 orang yang dibagi secara acak kedalam 2 kelompok yaitu kelompok perlakuan 1 yang diberikan SNAGs dan Mc kenzie sebanyak 8 orang dan kelompok perlakuan 2 yang diberikan Manual Traction dan Mc Kenzie sebanyak 8 orang. Alat ukur yang digunakan adalah Oswetry Disability Index (ODI). Hasil : Berdasarkan analisis uji paired sample t pada kelompok perlakuan I diperoleh nilai (p = 0.000 < 0,05) untuk nilai Oswetry Disability Index yang berarti bahwa pemberian Sustained Apophysial Glides dan Mc Kenzie dapat menghasilkan penurunan nyeri dan disabilitas lumbal yang signifikan. Sedangkan kelompok perlakuan II juga diperoleh nilai (p = 0.000 < 0,05) untuk nilai Oswetry Disability Index yang berarti bahwa pemberian Manual Traction dan Mc Kenzie dapat menghasilkan penurunan nyeri dan disabilitas lumbal yang signifikan. Kemudian berdasarkan uji Indepentent sample t diperoleh nilai (p = 0.000 < 0,05) untuk nilai Oswetry Disability Index yang berarti bahwa pemberian Sustained Apophysial Glides dan Mc Kenzie lebih efektif secara signifikan dibandingkan dengan pemberian Manual Traction dan Mc Kenzie terhadap penurunan nyeri dan disabilitas lumbal. Kesimpulan : Dapat disipulkan bahwa pemberian pemberian SNAGs dan Mc Kenzie lebih efektif dibandingkan dengan Manual Traction dan Mc Kenzie terhadap penurunan nyeri dan disabilitas lumbal pada penderita HNP. Kata kunci : Sustained Natural Apophyseal Glides, Manual traction, Mc Kenzie, ODI, HNP Lumbal

PENATALAKSANAAN FISIOTERAPI PADA GANGGUAN FUNGSIONAL LUMBAL AKIBAT SPONDILOLISTESIS DI RSUP. Dr. WAHIDIN SUDIROHUSODO MAKASSAR

Spondylosis lumbal merupakan gangguan degenerative yang terjadi pada corpus dan discus intervertebralis, yang ditandai dengan pertumbuhan osteofit pada corpus vertebra tepatnya pada tepi inferior dan superior corpus. Dari temuan radiografik 13% pada pria usia 30-an, dan 100% pada pria usia 70-an. Sedangkan pada wanita umur 40-an 5% dan umur 70-an 96%. Penyebabnya yaitu faktor usia, jenis kelamin, pekerjaan dan obesitas. Gejala yang sering muncul yaitu nyeri, spasme otot. Penelitian ini merupaka case study dengan menggunakan sampel tunggal untuk mengetahui perubahan nyeri dan spasme otot setelah diberikan intervensi Micro Wave Diathermy (MWD) dan terapi latihan William Flexion Exercise . alat ukur yang digunakan adalah VAS. Penelitian ini dilakukan di RSUP. Dr. Wahidin Sudirohusodo. Pada kajian kasus ini, hasil pemeriksaan ditemukan problematik yaitu adanya nyeri dan spasme otot m. Erector spine. Penatalaksanaa fisioterapi dengan menggunakan MWD dan William Flexion Exercise mengalami penurunan nyeri mulai dari pre test minggu I sebesar 6,5 sampai terapi minggu ke 4 turun menjadi 4,5, pada nyeri tekan juga terjadi penurunan nyeri mulai dari pre test minggu I sebesar 7 sampai pada terapi minggu ke IV turun menjadi 5. Kata kunci : Spondylosis lumbal, Micro Wave Diathermy (MWD), William Flexion Exercise

Kesesuaian MRI 1,0 Tesla untuk Membedakan Spondilitis dan Metastasis Vertebra dengan Konfirmasi Hasil Histopatologi

Background: Magnetic Resonance Imaging (MRI) is the most accurate modality imaging to evaluate vertebral abnormality. Infection and metastatic in musculoskeletal is most commonly found in the vertebra. It is often difcult to di?erentiate between spondylitis and metastatic, both clinically and radiographically, mainly on atypical case.Objective: To analyze the precision of MRI 1,0 Tesla in di?erentiation of radiological imaging between spondylitis and vertebral metastatic with histopathological confrmation.Materials and methods: This is an analytic observational study, with cross-sectional research design. Statistical analysis was performed with Mc Neemar test. Samples were selected by consecutive sampling with 35 patients (15 men, 20 women), 22samples of spondylitis and 13 of samples metastatic which were confrmed by histopathological examination.Result: From 22 samples of spondylitis confrmed by histopathology, only 86% (19 samples) were diagnosed as having spondylitis on MRI, whereas 13 metastatic samples 100% was correctly diagnosed on MRI.Conclusion: Statistically there was no signifcant di?erences between radiology diagnostic using 1,0 Tesla MRI with histopathological diagnosis, p=0,250 (p> 0,05), with tendency MRI 1,0 Tesla is more precise in diagnosing metastatic. MR imagesshow typical fndings in spondylitis such as anterior component corpus vertebral and discus intervertebralis involvement, disk signal abnormalities, paravertebral abscesses and involvement of multiple vertebral bodies sequentially. MR images show typical fndings in metastasis such as anterior and posterior corpus vertebral involvement, paravertebral soft tissue mass and skip lesion.

Optimisasi Field of View (FOV) Terhadap Kualitas Citra Pada T2WI FSE MRI Lumbal Sagital

Background : Field of view (FOV) is one of paramaters in MRI that is possibly adjusted by a radiographer. Many various adjusment of FOV that are using for lumbar MR Imaging. This study is to determine the effect of variations in the value of FOV to the image quality and anatomical information.Methods : This is a quasy experimental research. The study was conducted with 1.5 Tesla MRI. Data were collected from three volunteers with 5 variations of FOV (17cm, 22cm, 27cm, 32cm and 37cm) which is totally 15 images acquired. Images were evaluated according to the objective evaluation of SNR and CNR by a software in the MRI machine. Quntitative measurements of SNR were conducted on corpus vertebrae, discus intervertebralis, medulla spinalis, cerebrospinal fluid (CSF) and ligamentum flavum respectively. While CNR measurements were on CSF-corpus vertebra, CSF-discus intervertebralis, CSF-medulla spinalis, medulla spinalis-corpus vertebra, medulla spinalis-discus intervertebralis and corpus vertebra-discus intervertebralis. For conspicuity, overall image contrast and artifacts were evaluated qualitatively by three radiologists scoring on the paper sheet based on the image of corpus vertebrae, discus intervertebralis, medulla spinalis, cerebrospinal fluid, ligamentum flavum. Quantitative data of SNR and CNR value were analyzed using Linier Regression and Correlation Spearman test. While radiologists scoring were analyzed using Friedman test and cross tabulation.Results : The results showed that FOV variations affect the image qualities of T2WI FSE sagital lumbar MR Imaging. FOV variations are significantly corelate to the SNR of corpus vertebra, discus intervertebralis, medulla spinalis, CSF and ligamentum flavum. FOV variations are also significantly correlate to the CNR value of CSF-corpus vertebra, CSF-discus intervertebralis, CSF-medulla spinalis, medulla spinalis-corpus vertebra and medulla spinalis-discus intervertebralis (p values 0,05) with positive correlation. But there is no correlation between FOV variations and CNR at the corpus vertebra-discus intervertebralis (p values = 0,109).Conclusion : Based on these results indicate that overall image and artifacts are relatively similar for all value of FOV variations. Optimal values of FOV for T2WI FSE sagittal lumbar MR Imaging is a FOV of 27 cm.