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Tumor Tulang Belakang – Salah Satu Penyebab Sakit Pinggang

November 1, 2017 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

Tumor Tulang Belakang - Salah Satu Penyebab Sakit Pinggang

Pernahkan anda mengalami sakit pinggang?

Kebanyakan kita menyepelekan sakit pinggang yang sebagian besar akan sembuh sendiri jika beristirahat. Padahal, bisa jadi itu bukan sakit pinggang biasa. Untuk sakit pinggang yang berhubungan dengan masalah otot dan degenerative memang tidak serius. Tapi, sakit pinggang ini bisa menjadi masalah serius jika disebabkan oleh tumor.

Berikut ini adalah contoh kasus tumor tulang belakang. 

Ibu Maria (bukan nama sebenarnya), 42 tahun, mengeluh sakit pinggang selama 3 bulan. Berat badan turun 5 kg. Dua hari sebelum ke dokter, secara tiba-tiba beliau tidak bisa jalan karena kaki merasa sangat lemah. Hasil pemeriksaan lengkap menunjukkan ibu Maria menderita tumor tulang belakang yang menjepit saraf. Tumor ini menyebar dari usus besar (tumor primari). Saraf yang terjepit menyebabkan kelemahan di otot kaki  sampai pasien tidak kuat berjalan. Beliau menjalani operasi untuk mengambil tumor, membebaskan saraf dan menstabilkan tulang belakang. Setelah operasi ibu Maria bisa berjalan kembali dengan normal. Pasien menjalani chemotherapy dan radiotherapy untuk membasmi tumor lebih lanjut.

Tumor di tulang belakang adalah penyebab sakit pinggang yang berbahaya yang memerlukan penanganan segera. Tumor ini dapat membesar secara cepat dan tiba-tiba. Jika menjepit saraf, pasien bisa mengalami kelumpuhan secara tiba-tiba. Sering kali tumor di tulang belakang terjadi karena penyebaran sel tumor dari tempat lain seperti di usus, prostat, payudara dan lain-lain. Banyak sekali pasien yang mengeluh sakit pinggang tanpa keluhan lain seperti kasus Ibu Maria. Dengan pemeriksaan lengkap, tumor di tulang belakang  dan asal tumor (tumor primari) bisa ditemukan dan ditangani secara keseluruhan. Jika pasien mengabaikan keluhan sakit pinggang, tumor ini tidak akan terdeteksi atau mungkin akan terdeteksi dalam kondisi yang lebih parah.

Jenis sakit pinggang seperti apa yang tidak boleh diabaikan?

Sebagian besar sakit pinggang tidak berbahaya. Jika sakit pinggang disertai berat badan menurun secara drastis, sakit pinggang lebih parah saat beristirahat, atau sakit pinggang yang terus menerus dan tidak pulih lebih dari satu bulan, pasien perlu segera periksa ke dokter untuk menegakkan diagnosa apakah hal ini berhubungan dengan tumor.

Mengapa tumor tulang belakang mengakibatkan sakit pinggang?

Tumor tulang belakang dapat menyebabkan sakit pinggang karena beberapa hal.

  • Tumor membuat tulang belakang menjadi tidak stabil.
  • Tumor membuat tulang belakang rapuh dan gampang patah. Sakit pinggang meningkat secara tiba-tiba jika ada patah tulang di punggung.
  • Tumor bisa menjepit saraf. Hal ini menyebabkan sakit pinggang terkadang menjalar ke kaki atau ke perut dan dada.

Apakah pentingnya untuk mendeteksi tumor tulang belakang secara dini?

Dengan berjalan waktu tumor bisa makin membesar, jika masih berukuran kecil tentu saja lebih gampang dioperasi dari pada sudah berukuran besar. Lebih baik lagi dioperasi sebelum tumor menjepit saraf dan mengakibatkan kelumpuhan.

Jadi jangan menyepelekan sakit pinggang yang tidak kunjung membaik apalagi jika berat badan menurun dan sakit pinggang memburuk saat istirahat. Segera periksalah ke dokter untuk mencari penyebabnya. 

Tumor Tulang Belakang - Salah Satu Penyebab Sakit Pinggang

Dr Tony Setiobudi adalah spesialis bedah tulang dan super-spesialis bedah tulang belakang di Mount Elizabeth Hospital (Orchard), Singapore. Dr Tony menangani masalah tulang, sendi, saraf, otot dan ligamen pada orang dewasa dan anak. Dr Tony mempunyai keahlian khusus dalam penanganan saraf terjepit (HNP & spinal stenosis) & masalah tulang belakang seperti nyeri punggung & leher, scoliosis, postur bungkuk (kyphosis), tumor & infeksi tulang belakang, cedera saraf besar (spinal cord) & patah tulang osteoporosis.

 

 

Filed Under: Back Pain, Spine, Spine Surgery Tagged With: Back Pain, nerve compression, Paralysis, spine surgery, spine tumor

Operasi Postur Bungkuk Dapat Menambah Tinggi Badan

August 18, 2017 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

Operasi Postur Bungkuk Dapat Menambah Tinggi Badan

Postur bungkuk adalah masalah medis dan masalah estetika. Orang dengan postur bungkuk sering jatuh karena pandangan ke depan terganggu.

Postur bungkuk bisa disebabkan oleh bermacam-macam masalah medis:

  • Ankylosing spondylitis
  • Scheuermann’s disease
  • Proses penuaan (ageing)
  • Patah tulang belakang
  • TBC tulang belakang.

Postur bungkuk yang disebabakan oleh ankylosing spondylitis, Scheuermann’s disease dan TBC tulang belakang sering kali parah. Karena terlalu parah, sering kali pasien tidak dapat beraktifitas dengan baik. Operasi untuk menegakkan postur bungkuk ini perlu dilakukan. Dengan teknologi modern, operasi tulang belakang untuk menegakkan postur bungkuk menjadi jauh lebih aman.

Postur bungkuk ini memerlukan pemeriksaan yang menyeluruh. Ada beberapa kriteria untuk operasi terutama untuk postur bungkuk yang parah. Operasi dilakukan dengan bius total. Tulang belakang ditegakkan dengan menggunakan rods dan screws. Selain pandangan ke depan lebih normal, setelah postur lebih tegak pasien juga akan lebih tinggi. Secara estetika, pasien juga terlihat lebih tegap dan percaya diri.

Operasi menegakkan postur bungkuk ini lebih baik dilakukan secara dini semasa pasien masih muda dan sehat. Terkadang untuk pasien manula, operasi ini tidak mungkin untuk dilakukan terutama jika pasien menderita banyak penyakit kronis lain seperti diabetes, tekanan darah tinggi, sakit jantung dan lain-lain yang membuat resiko operasi lebih tinggi.

Pasien perlu tinggal di rumah sakit selama 5-7 hari. Setelah operasi pasien dirawat di ICU atau high dependency unit selama 1 malam. 2 hari setelah operasi pasien melakukan fisioterapi untuk berjalan. Setelah operasi, rasa nyeri dihilangkan dengan obat analgesik sehingga pasien tetap merasa nyaman.

 

Operasi Postur Bungkuk Dapat Menambah Tinggi Badan

Dr Tony Setiobudi adalah spesialis bedah tulang dan super-spesialis bedah tulang belakang di Mount Elizabeth Hospital (Orchard), Singapore. Dr Tony menangani masalah tulang, sendi, saraf, otot dan ligamen pada orang dewasa dan anak. Dr Tony mempunyai keahlian khusus dalam penanganan saraf terjepit (HNP & spinal stenosis) & masalah tulang belakang seperti nyeri punggung & leher, scoliosis, postur bungkuk (kyphosis), tumor & infeksi tulang belakang, cedera saraf besar (spinal cord) & patah tulang osteoporosis.

Filed Under: Ankylosing Spondylitis, Spine, Uncategorised

Anak Saya Pendek | Apa Yang Bisa Dilakukan?

July 22, 2017 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)
Anak Saya Pendek | Apa Yang Bisa Dilakukan?

Orang tua kuatir kalau anaknya tergolong pendek di kelas. Secara medis definisi tubuh pendek adalah ketinggian di bawah 3 percentile dibanding dengan anak dengan umur dan jenis kelamin yang sama. Secara awam artinya jika ada 100 anak dengan umur dan jenis kelamin yang sama, 3 orang terpendek, secara medis tergolong mempunyai tubuh pendek (short stature). Tetapi bukan berarti anak itu mempunyai masalah medis. Asal anak itu bertumbuh secara parallel, hal ini secara medis dianggap normal.

Apa yang mempengaruhi tinggi badan anak? 

  • Genetik – Ketinggian anak juga tergantung ketinggian orang tuanya. Tinggi tubuh kita dipengaruhi genetik.
  • Late Bloomer – Kadang anak mengalami pertumbuhan terlambat. Anak ini terlihat kecil dibanding dengan teman-teman sekelasnya. Tapi saat dewasa anak dengan pertumbuhan terlambat sering kali lebih tinggi dibanding dengan mereka yang mengalami pertumbuhan lebih cepat. Ini terjadi karena anak ini masih bertumbuh tinggi di saat anak lain sudah berhenti bertumbuh tinggi.
  • Medical Problems – anak susah makan atau makan tidak bergizi, masalah pencernaan, masalah hormon, syndrome genetik, penyakit kronis.

Apa yang bisa dilakukan supaya pertumbuhan maximal?

  • Makan yang bergizi, olahraga yang teratur dan tidur yang cukup dapat membantu pertumbuhan secara maximal
  • Jika ada masalah medis, hal ini harus ditangani dengan baik supaya dampak terhadap pertumbuhan badan minimal.

Anak Saya Pendek | Apa Yang Bisa Dilakukan?

Dr Tony Setiobudi adalah spesialis bedah tulang dan super-spesialis bedah tulang belakang di Mount Elizabeth Hospital (Orchard), Singapore. Dr Tony menangani masalah tulang, sendi, saraf, otot dan ligamen pada orang dewasa dan anak. Dr Tony mempunyai keahlian khusus dalam penanganan saraf terjepit (HNP & spinal stenosis) & masalah tulang belakang seperti nyeri punggung & leher, scoliosis, postur bungkuk (kyphosis), tumor & infeksi tulang belakang, cedera saraf besar (spinal cord) & patah tulang osteoporosis.

Filed Under: General Orthopaedic, Pediatric Orthopaedic Tagged With: pediatric, short stature

Vertebroplasty | Injection of Cement in Osteoporotic Spine Fracture

April 1, 2017 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

Vertebroplasty | Injection of Cement in Osteoporotic Spine Fracture

Spine Fracture in elderly occurs because of osteoporosis. Normal activities or minor fall can cause spine fracture if the bone is very soft. The fracture can be very painful that sitting and standing can be very uncomfortable. The back pain exists because of the injury and spinal instability in the fractured bone.

Vertebroplasty – injection of cement in the fractured bone – can provide significant pain relief almost immediately. This can provide stability of the fractured bone. Therefore, the back pain can reduce significantly. This procedure can be done as day surgery procedure under local anesthesia or general anesthesia.

The patient is lying prone on the operating table. Under local anesthesia the needle is directed towards the fractured bone with Xray as a guide. Once the tip of the needle reaches the desired position, the cement is injected slowly. The flow of the cement can be seen from the Xray.

If you have osteoporosis or osteoporosis fracture or you to check if you have osteoporosis, do not hesitate to contact us.

  • HP/Whatsapp: +65 9145 5793
  • Email: orthopaedic@spring-hope.com

Vertebroplasty | Injection of Cement in Osteoporotic Spine Fracture

Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore. He treats bone, joint, muscle and ligament problems in adults and children. He has a special interest in nerve compression and spine problems such as back & neck pain, scoliosis, kyphosis, spine tumor & infection, spinal cord injury, osteoporosis fracture, spinal stenosis and slipped disc.

Filed Under: Uncategorised

Paralysis | Can It Recover with Surgery?

March 31, 2017 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

Paralysis | Can It Recover with Surgery?

Paralysis is a very devastating medical problem. The nerves supplying the arms and legs stop working resulting inability to move. People who suffer from paralysis are longing to regain the ability to move. They are desperate and are willing to try anything that can improve the chance of moving or walking again.

The brain gives instruction to move. The instruction is delivered to the muscles through the spinal cord and the nerves. Any interruption in this pathway causes difficulty or inability to move.

There are medical problems that can cause paralysis:

  1. Spinal cord injury from spine fracture. The paralysis occurs immediately. But not all spine fractures cause spinal cord injury
  2. Spinal cord compression from tumor or infection.  Rapid expanding spine tumor or infection can cause spinal cord to stop working.
  3. Spinal cord compression from degeneration. Spinal cord compression from spine degeneration alone rarely cause paralysis. But patients with spinal cord compression are prone to fall. Injury to the spinal cord can occur after a fall can can cause paralysis.
  4. Spinal cord compression from spontaneous bleeding in the spinal canal. People who are on blood thinning are prone to have spontaneous bleeding.
  5. Stroke

When paralysis has occurred, can it be treated with surgery?

When paralysis is caused by physical compression of the spinal cord, emergency surgery is required. This is to free up the spinal cord from compression and to stabilise the spine when there is fracture. The prognosis depends on how bad the spinal cord compression or injury is and how soon the surgery is done. Surgery needs to be done as soon as possible. There is a chance of getting better with surgery but it is not predictable in this case.

Is there any sign before paralysis occurs?

The sign of spinal cord compression are difficulty walking with unsteady gait, weakness and numbness in the hands or legs. Do not ignore this signs and symptoms. You need to see your doctor.

Does spinal cord compression need surgery?

Yes. spinal cord compression can only be treated with surgery. There is no other way. Surgery to free up the spinal cord before the paralysis has a much better outcome than if the surgery is done after paralysis has occurred.

If you have any inquiry about this problem, please do not hesitate to contact us.

Paralysis | Can It Recover with Surgery?

Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore. He treats bone, joint, muscle and ligament problems in adults and children. He has a special interest in nerve compression and spine problems such as back & neck pain, scoliosis, kyphosis, spine tumor & infection, spinal cord injury, osteoporosis fracture, spinal stenosis and slipped disc.

Filed Under: Uncategorised

Osteoporotic Spine Fracture

February 21, 2017 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

When the bone is soft or osteoporotic, it can fracture with trivial injury or even without injury. Spine bone is one of the most commonly affected bones in osteoporotic fracture. It can be debilitating. But it doesn’t need to affect you. You can prevent osteoporosis by having regular screening and early treatment.

Mild fracture can heal by itself. The pain may not be too bad.

In severe fracture,  the back pain can be very excruciating to the extent that the patient is unable to sit, stand and walk for a period of time. If the pain prevents the patient from  getting out of bed, surgical treatment is required. The surgery depends on the stability of the spinal column. If the spine is stable, the patient needs cement injection (vertebroplasty) to strengthen the bone. If the spine is not stable, bigger surgery is required with the use of spinal implants. Surgical treatment for severe fracture has a high success rate. Immediate stability of the spinal column after surgery will result in significant reduction of pain.

Osteoporotic treatment to strengthen the bone is important regardless whether surgery is required. This is to reduce the risk of having another osteoporotic fracture.

Osteoporotic Spine Fracture

Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore. He treats bone, joint, muscle and ligament problems in adults and children. He has a special interest in nerve compression and spine problems such as back & neck pain, scoliosis, kyphosis, spine tumor & infection, spinal cord injury, osteoporosis fracture, spinal stenosis and slipped disc.

 

Filed Under: Osteoporosis, Spine fracture, Spine Surgery Tagged With: Osteoporosis, osteoporotic fracture, spine surgery, vertebroplasty

The Danger of Excessive Mobile Use

February 20, 2017 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

The Danger of Excessive Mobile Use

People of all ages are glued to their mobile phones. Other than the social impact, this phenomenon causes serious health issue to the neck.

Neck posture is bending forward for many hours a day, everyday, for many months and years. Can you imagine our teenage children are having this habit from such a young age? The damage to the neck is accumulative and irreversible to some extent.

Excessive mobile use causes upper cross syndrome

The more forward is the neck posture, the harder the neck muscles need to work to maintain the head up.  This cause muscle imbalance and neck pain. This condition is called “Upper Cross Syndrome”. The neck pain does not get better unless the cause is identified and avoided.

Overtime, this causes chronic pain which is even more difficult to treat.

 

Excessive mobile use causes premature degeneration on the discs in the neck 

Forward neck posture exerts excessive amount of pressure to the discs in the neck. This causes premature degeneration on the discs. The discs become thin and bulging. Sometimes, it causes narrowing of the spinal canal and nerve compression.

 

The symptoms do not appear immediately. It may take years to manifest. But sure it will. Thus, it is important to limit mobile use.

There are some tips that you can do to reduce the damage to the neck when you need to use your mobile excessively

  1. Read your mobile at the eye level so that you neck posture is still upright.
  2. Do regular exercises
  3. Do strengthening of the inner neck muscles to balance up

The Danger of Excessive Mobile Use

Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore. He treats bone, joint, muscle and ligament problems in adults and children. He has a special interest in nerve compression and spine problems such as back & neck pain, scoliosis, kyphosis, spine tumor & infection, spinal cord injury, osteoporosis fracture, spinal stenosis and slipped disc.

Filed Under: Cervical Spondylosis, Neck Pain Tagged With: Mobile use, muscle imbalance, neck pain, nerve compression, upper cross syndrome

The Danger of Spinal Cord Compression

February 19, 2017 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

The Danger of Spinal Cord Compression

 

Spinal cord is a big nerve that connection the brain with the arms and legs. External compression to the spinal cord can interfere with the normal function of the nerves. People with spinal cord compression do not necessarily complain of neck pain or back pain. Spinal cord compression can occur in a few situations:

  1. Slowly because of wear and tear or degenerative process.
  2. Rapidly because of tumor or infection.
  3. Suddenly due to fracture

Whatever the cause is, the treatment of spinal cord compression is surgery to free up the spinal cord. Spinal cord compression from slow process results in difficulty walking and difficulty using the hands. Patients with this condition rarely becomes paralysed. The surgery does not need to be done urgently. However, when the spinal cord compression occurs rapidly or suddenly, the patient may become paralysed. This requires urgent surgery to free up the spinal cord.

Spinal cord compression should not be left untreated.

The Danger of Spinal Cord Compression

Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore. He treats bone, joint, muscle and ligament problems in adults and children. He has a special interest in nerve compression and spine problems such as back & neck pain, scoliosis, kyphosis, spine tumor & infection, spinal cord injury, osteoporosis fracture, spinal stenosis and slipped disc.

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Filed Under: Spinal cord compression Tagged With: Spinal cord compression, Spinal fracture, Spinal Infection, Spinal tumor, spine surgery

Why Fuse the Spine?

February 18, 2017 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

Why Fuse the Spine? Spine stabilization

Spinal fusion surgery is indicated when the spine is expected to be unstable after the index operation. In general if there is a sign of instability before surgery, spinal fusion is indicated.

Spinal fusion for nerve compression

Spinal fusion surgery is often performed when the spine shows abnormal movement. Freeing up the nerve from compression (spinal stenosis) often requires removal of bones, ligaments and disc materials. This created further instability in the spine. If the spine is unstable prior to surgery, the spine will become more unstable after the surgery. Thus, spinal fusion is required

 

Spinal fusion for deformity (abnormal posture) correction

Scoliosis or kyphosis (hunched back) often requires surgery to correct the deformity. This requires spinal fusion surgery to maintain the correction and to provide immediate stability after major postural correction.

 

Spinal fusion for spinal tumor surgery  

In spinal tumor, the normal bone is replaced by tumor tissue which causes weakness in the spine. Removal of spinal tumor creates void in the spinal segment which makes the spine very unstable. This void is often replaced by metal implant. Spinal fusion surgery is required to hold the metal implant in place and to provide immediate stability.

 

It is important to know the reason why spinal fusion surgery is required. If you have any questions about why you need spinal fusion surgery, you can approach your doctor for further clarification.

Why Fuse the Spine?

Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore. He treats bone, joint, muscle and ligament problems in adults and children. He has a special interest in nerve compression and spine problems such as back & neck pain, scoliosis, kyphosis, spine tumor & infection, spinal cord injury, osteoporosis fracture, spinal stenosis and slipped disc.

 

Filed Under: Ankylosing Spondylitis, kyphosis, Scoliosis, Spinal Stenosis, Spine Surgery Tagged With: kyphosis, nerve compression, scoliosis, spinal deformity, Spinal fusion surgery, Spinal Stenosis, Spinal tumor

Total Knee Replacement | The Best Operation for Knee Osteoarthritis

February 18, 2017 by Tony Setiobudi

By Dr Tony Setiobudi BMedSci, MBBS, MRCS, MMed (Ortho), FRCS (Ortho)

Total Knee Replacement | The Best Operation for Knee Osteoarthritis

Mr Wong is a 65 year old gentleman. He is complaining of knee pain on both sides, right side worse than left. The pain is gradually getting worse. He cant walk more than 50 metres. He has difficulty climbing stairs and squatting

Mr Wong is suffering from osteoarthritis of the knee. Knee pain from osteoarthritis commonly affect elderly. It interferes with the daily activities. Mild cases of knee osteoarthritis can be treated with medication and activity modification. Severe arthritis is best treated with operation (total knee replacement).

Total knee replacement is the best operation ever invented for osteoarthritis of the knee. In osteoarthritis, the cartilage slowly becomes degenerated and thin. Normal joints do not produce pain when moving because the healthy cartilage protects the nerve endings from being rubbed. In osteoarthritis, the nerve endings become exposed. When the knee moves, the nerve endings get rubbed and become painful. Initially, the pain is minimal. Over time, the pain is getting worse and worse. It interferes with walking and stairs climbing. The walking ability becomes limited. Total knee replacement is an operation to take away the pain generators. The damaged cartilage is removed. The bone is covered with metal. The nerve endings are no longer rubbing when walking. Instead, the metal is rubbing against plastic implant. As a result, after total knee replacement the knee becomes significantly less painful.

Total knee replacement is indicated for patients who are disabled from osteoarthritis of the knee. This is one of the most commonly performed elective orthopaedic operation. The patients need to stay in the hospital for a few days after the operation. The patients are expected to walk one or two days after the surgery. Post-operatively, the patients can walk further and more comfortable.

If you need more info about total knee replacement, do not hesitate to contact us or contact your doctor.

Total Knee Replacement | The Best Operation for Knee Osteoarthritis

Dr Tony Setiobudi is an Orthopaedic & Spine Surgeon at Mount Elizabeth Hospital (Orchard), Singapore. He treats bone, joint, muscle and ligament problems in adults and children. He has a special interest in nerve compression and spine problems such as back & neck pain, scoliosis, kyphosis, spine tumor & infection, spinal cord injury, osteoporosis fracture, spinal stenosis and slipped disc.

Filed Under: Knee osteoarthritis, Uncategorised Tagged With: OA knee, osteoarthritis, TKR, Total knee replacement

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