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"Latar belakang: Limfadenopati servikal merupakan pembesaran kelenjar getah bening >1 cm di regio servikalis. Etiologi bervariasi, di negara maju 70% merupakan kasus limfadenitis reaktif, sedangkan di negara berkembang 56,67% merupakan infeksi tuberkulosis. Belum ada penelitian di Indonesia tentang hal ini. Tujuan: Mengetahui profil kejadian limfadenopati servikal pada anak di Klinik Rawat Jalan RSCM Kiara, Jakarta. Metode: Desain potong lintang deskriptif pada 6126 subyek usia 1 bulan – 18 tahun, didapatkan 93 subyek mengalami limfadenopati servikal. Subyek kemudian dianamnesis dan diikuti proses diagnosisnya. Hasil: Prevalens limfadenopati servikal adalah 1,5%. Dari 93 subyek, 70% limfadenopati servikal bukan sebagai keluhan utama. Gejala konstitusional tersering adalah demam (43%), malaise (37,6%) dan penurunan berat badan (36,5%). Sebagian besar limfadenopati berukuran 1,1-2 cm, jamak, lokasi di anterior, 25,8% teraba berkonglomerasi dan terfiksasi, nyeri tekan hanya 2,1%. Diagnosis medis terbanyak adalah infeksi tuberkulosis (35,5%), keganasan (20,5%) dan hanya 2,1% yang merupakan kasus limfadenitis servikal akut. Biopsi dilakukan pada 28 subyek (FNAB/biopsi jaringan), 35,7% merupakan infeksi tuberkulosis, 25% kasus keganasan dan 14,2% merupakan radang kronik non-spesifik. Kesimpulan: Prevalens limfadenopati servikal pada anak sebesar 1,5% dengan diagnosis medis dan hasil biopsi terbanyak adalah kasus infeksi tuberkulosis.

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Background: Cervical lymphadenopathy is an enlargement of lymph node > 1 cm in the cervical region. Etiology varies, in developed countries 70% are reactive lymphadenitis, whereas in developing countries 56.67% are tuberculosis infections. No studies in Indonesia about this topic.

Aim: To know the profile children with cervical lymphadenopathy in Outpatient Clinic, RSCM Kiara, Jakarta.

Method: Descriptive cross-sectional design on 6126 subjects aged 1 month – 18 years, found 93 subjects experiencing cervical lymphadenopathy. These subjects underwent interviews and the diagnosis process observed.

Result: Prevalence of cervical lymphadenopathy is 1.5%. From 93 subject, 70% cervical lymphadenopathy is not the main complaint. The most often constitutional symptoms are fever (43%), malaise (37.6%) and weight loss (36.5%). Most of the lymphadenopathy are 1.1-2 cm in size, multiple, location in anterior, 25.8% felt to be conglomerated and fixed, only 2.1% are tenderness. Most common medical diagnoses were tuberculosis infections (35.5%), malignancies (20.5%) and only 2.1% are acute cervical lymphadenitis. Biopsy was done to 28 subject (FNAB/open biopsy) 35,7% are tuberculosis infections, 25% are malignancies and 14,2% are non-specific chronic inflammation.

Conclusion: Prevalence of cervical lymphadenopathy in children is 1,5% and the most often medical diagnose and biopsy profile are tuberculous infection."

"Background : Laminoplasty was developed to widen the spinal canal dimensions without permanently removing the dorsal elements of the cervical spine. The retained dorsal elements should aid in the prevention of muscle scarring to the dura and potentially reduce the incidence of postoperative instability.Cervical laminoplasty has been advocated as an alternative procedure to laminectomy for the decompression of the cervical spine. It provides favourable cord decompression and stabilisation of the cervical spine and is a simpler and safer alternative to anterior fusion and laminectomy for myelopathy and myeloradiculopathy, due to degenerative cervical stenosis. Most authors report outcome based on the Japanese Orthopedic Association (JOA) scoring system. Reported results include mean preoperative and postoperative scores for all patients, and a calculated rate of recovery is provided. The mean recovery rate after the Hirabayashi expansive laminoplasty is approximately 60%. To know the outcome, we evaluated 9 patients with degenerative cervical spinal stenosis that had been treated with laminopalsty using JOA score and Oswestry disability index questioner also the correlation between them.Methods : We performed pre and post interventional study on patients with degenerative cervical spinal stenosis with moderate until severe stenosis that had failed non operative treatment from January 2007 -June 2008 at Cipto mangunkusumo Hospital Jakarta. With JOA score as clinicall approach and Oswestri Disability Index (001) questioner by patient approach, we identify the cervical spine function of the patients before and after laminoplasty (1 month, & 6 month post operative)Results: There were significant difference of JOA and 001 score before and after decompression by laminoplasty with p<0.05. The improvement of cervical spine function also significantly increase until 6 months after surgery compare to the 1$ month post operative JOA and 001 score (p=0.028, p=0.035 respectically). There is strong correlation between them (r=0.804).Conclusion : Laminoplasty decompression technique can improve the cervical spine clinically (increase the JOA score) and quality of life (decrease the 001 score) of patient with degenerative cevical spinal stenosis."

""ABSTRAK"Latar Belakang : Gambaran foramen neuralis servikal pada potongan aksial memiliki keterbatasan dan tidak memperlihatkan foramen secara en face. Pemeriksaan MRI servikal dengan menggunakan potongan sagital oblik memberikan visualisasi dan diagnosis stenosis foraminal yang lebih optimal karena pengambilan potongan tegak lurus terhadap foramen neuralis. Saat ini prosedur operasional standar pemeriksaan MRI servikal di RSCM belum menggunakan potongan sagital oblik, sehingga masih belum dapat memberikan visualisasi langsung yang jelas dari foramen neuralis servikal dikarenakan anatomi dari foramen neuralis servikal tersebut.Metode : Pada penelitian ini, dievaluasi 23 subjek penelitian 5 orang laki-laki, 18 orang perempuan, dengan rerata usia 57 tahun yang menjalani pemeriksaan MRI servikal di RSCM. Sebanyak total 138 foramen dianalisis dari C4-5 sampai C6-7 untuk mengetahui perbedaan diagnosis derajat stenosis foraminal servikal pada potongan aksial dengan potongan sagital oblik MRI servikal. Uji hipotesis dilakukan dengan uji nonparametrik Mc Nemar dan hubungan diagnostik antara kedua potongan dinilai dengan analisis Cohen rsquo;s Kappa.Hasil : Terdapat perbedaan bermakna antara diagnosis kategori stenosis berdasarkan potongan sagital oblik dengan aksial MRI servikal dengan nilai p=0,001. Pada analisis Cohen rsquo;s Kappa didapatkan nilai r = 0,248 dengan nilai p=0,000.Kesimpulan : Terdapat perbedaan diagnosis stenosis yang siginifikan pada potongan sagital oblik dengan aksial MRI servikal dengan tidak adanya kesesuaian diagnostik antara kedua potongan tersebut. "

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""ABSTRACT"Background Axial images in cervical MRI examination has limitations in evaluating neural foramen and do not directly visualized it. Oblique sagittal images cervical MRI, that perpendicular to the neural foramen in axial images, provides optimal visualization and better diagnosis of foraminal stenosis grading. Currently, the standard operating procedures of the cervical MRI examination in RSCM are not yet using oblique sagittal images, so it still can not provide direct visualization of the cervical neural foramen due to the anatomy of the cervical foraminal.Method In this study, we evaluated 23 people 5 males and 18 females, mean age 57 years who visited RSCM and underwent cervical MRI. A total of 138 foramina were analysed from C4 5 to C6 7 both sides, based on axial images and oblique sagittal images to determine the diagnostic differences in cervical foraminal stenosis. Hypothesis testing was done with Mc Nemar nonparametric test and diagnostic association between the two images was assessed by Cohen rsquo s Kappa analysis.Result There is significant diagnostic differences p 0,001 of stenosis grading using axial images and oblique sagittal images cervical MRI. In the analysis of Cohen rsquo s Kappa, obtained r 0,248 with p 0,000Conclusions There is significant differences in the diagnosis of cervical foraminal stenosis between the oblique sagittal images and axial images and also there is no diagnsotic association between oblique sagittal and axial images. "

"ABSTRAKLatar belakang dan tujuan: Gambaran foramen neuralis servikal pada potongan aksial memiliki keterbatasan dan tidak memperlihatkan foramen secara en face. Pemeriksaan MRI servikal dengan menggunakan potongan sagital oblik memberikan visualisasi dan diagnosis stenosis foraminal yang lebih optimal karena pengambilan potongan tegak lurus terhadap foramen neuralis. Saat ini prosedur operasional standar pemeriksaan MRI servikal di RSCM belum menggunakan potongan sagital oblik, sehingga masih belum dapat memberikan visualisasi langsung yang jelas dari foramen neuralis servikal dikarenakan anatomi dari foramen neuralis servikal tersebut. Metode: Uji hipotesis dilakukan dengan uji nonparametrik Mc Nemar dan hubungan diagnostik antara kedua potongan dinilai dengan analisis Cohen rsquo;s Kappa. Hasil : Terdapat perbedaan bermakna antara diagnosis kategori stenosis berdasarkan potongan sagital oblik dengan aksial MRI servikal dengan nilai p=0,001. Pada analisis Cohen rsquo;s Kappa didapatkan nilai r = 0,248 dengan nilai p=0,000. Kesimpulan : Terdapat perbedaan diagnosis stenosis yang siginifikan pada potongan sagital oblik dengan aksial MRI servikal dengan tidak adanya kesesuaian diagnostik antara kedua potongan tersebut.

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ABSTRACTBackground and Objective Axial images in cervical MRI examination has limitations in evaluating neural foramen and do not directly visualized it. Oblique sagittal images cervical MRI, that perpendicular to the neural foramen in axial images, provides optimal visualization and better diagnosis of foraminal stenosis grading. Currently, the standard operating procedures of the cervical MRI examination in RSCM are not yet using oblique sagittal images, so it still can not provide direct visualization of the cervical neural foramen due to the anatomy of the cervical foraminal. Method Hypothesis testing was done with Mc Nemar nonparametric test and diagnostic association between the two images was assessed by Cohen rsquo s Kappa analysis. Result There is significant diagnostic differences p 0,001 of stenosis grading using axial images and oblique sagittal images cervical MRI. In the analysis of Cohen rsquo s Kappa, obtained r 0,248 with p 0,000. Conclusions There is significant differences in the diagnosis of cervical foraminal stenosis between the oblique sagittal images and axial images and also there is no diagnsotic association between oblique sagittal and axial images."

"ABSTRAK Latar Belakang: Keterlibatan vertebra servikal akibat trauma, penyakit degeneratif dan neoplasma sering diperlukan tindakan intervensi pembedahan. Pengetahuan anatomis yang detail tentang vertebra servikal sangat dibutuhkan akan tetapi terdapat perbedaan pada dimensi vertebra pada beberapa ras. Pengetahuan dimensi elemen vertebra sangat penting untuk perkembangan instrumentasi pada tulang belakang servikal. Tujuan dari penelitian ini adalah untuk mendapatkan data mengenai morfometrik vertebra servikal pada populasi orang IndonesiaMetode Penelitian. Penelitian ini dilakukan pada 66 spesimen kering vertebra servikal dimana 33 berjenis kelamin laki-laki dan 33 perempuan yang didapatkan dari Departemen Anatomi pada enam fakultas kedokteran. Hanya vertebra yang intak, tanpa osteofit atau metastasis tumor diperiksa pada penelitian ini. Semua parameter linear diukur dengan menggunakan caliper digital vernier dengan akurasi 0,01 mm, caliper tersebut mempunyai depth gauge yang digunakan untuk mengukur dimensi vertebra servikal. Pengukuran angular dengan menggunakan goniometri standard. Semua pengukuran vertebra servikal dilakukan oleh tiga orang. Semua struktur yang simetris diukur secara bilateralHasil Penelitian. Secara umum tidak terdapat perbedaan signifikan pada beberapa komponen vertebra servikal. Vertebra servikal pada spesimen laki-laki secara umum mempunyai ukuran rerata yang lebih besar meskipunpada beberapa komponen pada perempuan lebih tinggi. Perbedaan yang signifikan ditemukan pada lebar pedikel pada C3, 4, 5 dan 7 untuk pedikel sisi kanan dan kiri.Kesimpulan. Penelitian morfometrik ini yang dilakukan pada populasi orang Indonesia akan sangat berarti untuk instrumentasi yang baik pada tulang belakang servikal dimana dimensi berukuran kecil pada vertebra servikal mempunyai tantangan tersendiri pada ahli bedah selama pemasangan plate dan screw.

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ABSTRACTIntroduction. The predilection of the cervical spine to a wide array of traumatic, degenerative and neoplastic disease necessitates frequent surgical intervention. A detailed anatomical knowledge of the cervical spine is required but variability in vertebral dimension exists amongst different races. Knowing the dimensions of the vertebral elements is very important for the development of instrumentation to the cervical spine. The aim of the study was to present a morphometric reference database for cervical vertebra of the Indonesian population.Methods. The study was conducted on 66 dried human cervical vertebra of 33 males and 33 females collected from the Department Anatomy of six medical colleges were examined. Only intact vertebrae, free from any osteophytes or metastatic tumors were excluded in the study. All linear parameter were measured using a digital vernier caliper accurate to 0.01 mm, the caliper had a depth gauge which was used to measured the dimensions of cervical vertebra. The angular measurements were made using a standard goniometer. All measurements were made by three observers. All symmetrical structure were measured bilaterally.Results. Generally we find no significant difference between measurement components. Men cervical specimen generally had higher number of mean, although for several components women were higher. Significance difference were found for pedicle width C3, 4, 5 and 7, for both right and left pedicles .Conclusions. The present morphometric study in Indonesian population would be valuable for the successful instrumentation of the cervical spine as smaller dimension of the cervical vertebrae pose a challenge to the surgeon during application of plates and screw"