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"Pendahuluan: Stenosis kanal lumbal (SKL) adalah gangguan yang disebabkan oleh penyempitan kanal spinal. Derajat penyempitan kanal spinal dapat ditentukan oleh kriteria Herzog yang diukur dengan pemeriksaan MRI. Tujuan penelitian ini adalah untuk mengetahui luaran klinis pasien SKL dengan berbagai derajat stenosis setelah dekompresi dan stabilisasi posterior.Metode: Penelitian ini menggunakan studi kohort retrospektif di Rumah Sakit Umum Pusat Nasional Cipto Mangunkusumo dari bulan Agustus hingga September 2017 dengan teknik total sampling. SKL diklasifikasikan berdasarkan kriteria Herzog. Luaran klinis diukur dengan menghitung skor ODI sebelum operasi dan satu tahun setelah operasi.Hasil: 39 subyek penelitian memiliki rerata usia 58,41±5,86 tahun dan terdiri dari 24 perempuan dan 15 laki-laki. Berdasarkan kriteria Herzog, subyek penelitian yang diklasifikasikan dalam derajat medium 12 (30,8%) dan severe 27 (69,2%). Nilai median skor ODI pada kelompok medium 57 dan severe 60. Setelah operasi, nilai median pada kedua grup turun menjadi 6. Secara statistik, terdapat perbedaan bermakna nilai skor ODI pada kelompok medium (p 0,002) dan kelompok severe (p 0,001), sebelum dan setelah operasi. Sementara itu, tidak ada hubungan bermakna antara skor Herzog dan ODI sebelum operasi (p 0,192) dan setelah operasi (p 0,249).Diskusi: Luaran klinis pasien SKL tergolong baik karena skor ODI mengalami penurunan setelah tindakan dekompresi dan stabilisasi posterior sehingga tindakan tersebut mempengaruhi luaran klinis pasien SKL.

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Background: Lumbar canal stenosis (LCS) is a disorder that caused by the narrowing of the spinal canal. The stage of narrowing is based on Herzog criteria measured from MRI examination. The aim of study was to know clinical outcomes of LCS patients in different stage of stenosis after decompression and posterior stabilization.Methods: This research used retrospective cohort study design and carried out at Cipto Mangunkusumo General Hospital from August to September 2017 with total sampling technique. LCS was classified based on Herzog criteria. Clinical outcome was measured by counting The ODI score before the operative procedure, and one year after the operative procedure.Results: All 39 subjects was 58.41±5.86 years old and consisted of 24 females and 15 males. Based on herzog criteria, the subjects are classified into medium 12 (30,8%) and severe stage 27 (69.2%). The median of ODI score at medium group was 57 and severe group 60. After operative procedure, the median of ODI score at each groups was decreased to 6. Statistically, there was a significant corelation bertween of ODI score in medium (p 0,002) and severe group (p 0,001), to pre and postoperative procedure. No significant correlation between herzog and ODI score preoperative (p 0,192) and postoperative (p 0,249).Discussions: The clinical outcome of LCS patients is good because the ODI score decreases after decompression and posterior stabilization so the procedure affects clinical outcomes of LCS patients."

"Latar Belakang: Stenosis kanal lumbal SKL merupakan suatu kondisi yang potensial menimbulkan disabilitas dan seringkali ditemukan seiring meningkatnya usia populasi. Studi bertujuan menganalisa hubungan antara luaran klinis pasien SKL dan klasifikasi stenosis berdasarkan MRI. Metode: Studi kohort prospektif ini dilakukan di Rumah Sakit Cipto Mangunkusumo RSCM pada januari hingga juli 2016 melalui metode consecutive sampling. Tiga puluh delapan sampel didapat dan kesemuanya dilakukan tatalaksana pembedahan yang sama yaitu dekompresi dan stabilisasi posterior. Subjek dikategorikan ke dalam 4 kategori berdasarakan pemeriksaan MRI menggunakan klasifikasi Schizas. Pemeriksaan pra dan pasca operasi 3 bulan dan 6 bulan dilakukan menggunakan Visual Analogue Scale VAS, Oswestry Disability Index ODI, Japanese Orthopaedic Association Score JOA and Roland Morris Disability Questionnaire RMDQ. Analisis statistic dilakukan dengan menggunakan program SPSS v19. Hasil: Rata ndash; rata usia dari 38 sampel yang didapatkan adalah 58.92 tahun rentang 50-70 tahun. Terdapat 16 orang laki ndash; laki dan 22 orang perempuan. Sebagian besar pasien diklasifikasikan pada grade C berdasarkan klasifikasi Schizas. Perbaikan skor klinis pada subjek laki ndash; laki didapatkan lebih tinggi dibanding perempuan dan hasilnya didapatkan bermakna pada pengukuran VAS pascaoperasi 6 bulan p=0.003 dan JOA pascaoperasi 3 bulan p=0.029. Tidak ditemukan perbedaan bermakna antara derajat klasifikasi berdasarkan MRI dengan skor perbaikan klinis preoperasi, 3 bulan dan 6 bulan pasca operasi menurut VAS p=0.451, p=0.738, p=0.448, ODI p=0.143, p=0.929, p=0.796, JOA p=0.157, p=0.876, p=0.961 dan RMDQ p=0.065, p=0.057, p=0.094. Simpulan: Terdapat perbaikan klinis setelah dilakukan operasi dekompresi dan stabilisai posterior yang ditandai dengan perbaikan skor VAS, ODI, JOA dan RMDQ pasca operasi 3 dan 6 bulan. Tidak terdapat hubungan antara derajat SKL dengan skor VAS, ODI, JOA dan RMDQ.

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Background: Lumbar canal stenosis LCS is a condition which can potentially cause disability and often discovered within the increasing age of population. The aim of this study was to analyze the correlation between clinical outcome of postoperative patients and classifications that are based from MRI assesments.

Method: This prospective cohort study was carried out a Cipto Mangunkusumo General Hospital from January till july 2016 obtained using consecutive sampling. Thirty eight samples were obtained and all of them were managed with same surgical technique that was decompression and posterior stabilization. Patients were categorized in 4 types based on MRI examination using Schizas Classification. Pre and post treatment 3 month and 6 month assessment of the patients was done according to Visual Analogue Scale VAS, Oswestry Disability Index ODI, Japanese Orthopaedic Association Score JOA and Roland Morris Disability Questionnaire RMDQ. Statistical analysis was performed using statitiscal program for social science SPSS v.19.

Result: From 38 samples that were obtained average age was 58.92 years old range 50 70 years old. There were 16 males and 22 females. Most of patients are classified in type C 21 subjects based on MRI examination. The improvement of clinical score in male subjects were better dan female subjects and significantly different in 6 month postoperative VAS p 0.003 and 3 month postoperative JOA score p0.029. In this study was found that generally VAS, ODI, JOA and RMDQ score improved along follow up time. There was no statistical differences between MRI based classification and clinical outcome in preoperative, 3 and 6 month postoperative according to VAS p 0.451, p 0.738, p 0.448, ODI p 0.143, p 0.929, p 0.796, JOA p 0.157, p 0.876, p 0.961 dan RMDQ p 0.065, p 0.057, p 0.094.

Conclusion: There was clinical improvement after decompression and posterior stabilization in lumbar canal stenosis which were manifested in 3 and 6 months post operation of VAS ODI, JOA and RMDQ score. There was no association between degree of LCS and VAS, ODI, JOA and RMDQ score. "