EFEKTIFITAS TERAPI KOMBINASI PEDICLE SCREW SUBLAMINARY WIRING (PSSW) DAN OBAT ANTI TUBERKULOSA TERHADAP KOREKSI KIFOSIS DAN PERBAIKAN DEFISIT NEUROLOGIS PADA PASIEN SPONDILITIS TUBERKULOSA DI RSUD DR. ZAINOEL ABIDIN BANDA ACEH
Abstract
Abstrak. Penggunaan obat anti tuberkulostatika sebagai kemoterapi pada pasien spondilitis tuberkulosa (ST) saat ini merupakan pilihan utama, namun hal ini tidak dapat diterapkan pada semua kasus ST terutama pada kasus dengan resiko deformitas, ketidakstabilan fragmen dan yang disertai dengan adanya gangguan neurologis. Terapi kombinasi antara tindakan operatif dan penggunaan obat anti-TB masih merupakan hal yang kontroversi dalam penatalaksanaan ST. Untuk menilai efektifitas terapi kombinasi pedicle screw sublaminary wiring (pssw) dan obat anti tuberkulosa terhadap koreksi kifosis dan perbaikan defisit neurologis pada pasien ST. Penelitian ini merupakan suatu penelitian eksperimen semu yang bertujuan untuk mengevaluasi efektifitas terapi kombinasi PSSW dan anti tuberkulosa terhadap koreksi kifosis dan perbaikan defisit neurologis pada 18 orang pasien spondilitis tuberkulosa di rawat di RSU dr. Zainoel Abidin Banda Aceh selama periode Maret 2005 hingga Maret 2007. Pada penelitian ini didapatkan hasil yang bermakna secara statistik terhadap perbaikan derajat kifosis (t-test, α=0,05) dan defisit neurologis (wilcoxon signed test, α=0,05). setelah diberikan terapi kombinasi antara PSSW dan anti tuberkulosa. Terapi kombinasi antara PSSW dengan anti tuberkulosa selama 6 bulan pada penderita ST, ternyata memberikan hasil yang memuaskan baik secara klinis maupun radiologis.
Abstract. Although anti-TB drugs is now mainstay treatment for spinal TB, it may not applicable to all situations, especially in patients with risk of deformity, instability and progression of neurological deficit. Combine therapy between medical and surgical strategies are still controversies. Determine the efficacy of pedicle screw sublaminary wiring (PSSW) with anti tuberculous drugs to kyphotic correction and improvement of neurological deficits. This study was a quasi-experimental study, to evaluate the effect of combine therapy PSSW with anti tuberculous drugs to kyphotic correction and improvement of neurological deficits in 18 adult patients with tuberculous spondylitis at Zainoel Abidin hospital in Banda Aceh during period of January 2005 – March 2007. There was significant effect of combine therapy pssw with tuberculostatic drugs to kyphosis correction in tuberculous spondylitis (t-test, α=0,05) and there also was significant effect of combine therapy pedicle screw sublaminary wiring (pssw) with tuberculostatic drugs to improvement of neurological deficits in tuberculous spondylitis (wilcoxon signed test, α=0,05). Combination therapy of pssw and anti tuberculous drugs for 6 months has good efficacy to kyphotic correction and improvement of neurological deficits both clinically and radiologically.
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References
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