referat neuro lbp mutia
TRANSCRIPT
-
8/19/2019 Referat Neuro Lbp Mutia
1/17
PENYEBAB DANPENATALAKSANAAN
LOW BACK PAINMUTIA RIZKI 1102011184FAKULTAS KEDOKTERAN UNIVERSITAS YARSIKEPANITERAAN ILMU PENYAKIT SARAF RSUD ARJAWINANGUN
2015
-
8/19/2019 Referat Neuro Lbp Mutia
2/17
PENDAHULUAN
Low Back Pain (nye! "!n##$n# %e&$'$n# )e!n# *!+,-"$! *$&$- "$'.e' ).e,.$-$ *! ne#$$ne#$$ !n*,).! Te&$/ *!'e.$/,! 3$'.43$'.4 "eny
"$.4)!4&4#! %!4-e'$n!' ")!'4&4#!) *$n 3$'.4 )4)!$& Penye%$% Low B%e-$6$--$6$- *$n -,&.!3$'.4!$&7 %$ny$' y$n# !n#$n n$-,n $*$ +,%e$. y$n# /$,) *!.$n##,&$n#! *en#$n 6e"$. *$n .e"$. Se%$#!$n %e)$
pain *$"$. )e-%,/ *$&$- 8$'., )!n#'$. )e/!n##$ 'e&,/$n !n! )e!n#-en*$"$.'$n "e/$.!$n y$n# 6,'," -en*$&$- O&e/ '$en$ !., 'e-,
"enye%$% y$n# &e%!/ )e!,) .!*$' *!'en$&! )e*!n! -,n#'!n Den#$n $n$-"e-e!')$$n )!' y$n# .e&!.! )e.$ $n$&!)!) "e$)$$n nye! y$n# )e')$-
*!*!$#n4)!) *en#$n .e"$. )e*!n! -,n#'!n
-
8/19/2019 Referat Neuro Lbp Mutia
3/17
ANATOMI DANFISIOLOGI
• Ve.e%$ )e9!6$&!) )e%$ny$' : ,$)• Ve.e%$ ./4$'$&!) )e%$ny$' 12
,$)• Ve.e%$ &,-%$&!) )e%$ny$' 5 ,$)• Ve.e%$ )$6$&!) )e%$ny$' 5 ,$)• Ve.e%$ '4')!#!$&!) )e%$ny$'
)e%$ny$' ; ,$)
-
8/19/2019 Referat Neuro Lbp Mutia
4/17
L
KORPUS
ELEMENPOSTERIOR
-
8/19/2019 Referat Neuro Lbp Mutia
5/17
• Medula spinalis -e,"$'$n +$!n#$n )$$3 %e%en.,' '4&,- 9e.!6$& y$n# .e%*$)$ 4.$' 'e&,$ *$! 4n##$ '$n!,- -e&$&,! 34$-en 466!"!.$& -$#n,- -$))$-"$! )e.!n##! )e#-en &,-%$&2 -e*,&&$ )"!n$&!) .e*!! *$!
-
8/19/2019 Referat Neuro Lbp Mutia
6/17
DEFINISI
Low Back Pain $*$&$/ nye! y$n# *!$)$'$n *$e$/ ",n##,n# %$8$/-enye,"$! nye! &4'$& -$,",n nye! $*!',&e $.$, 'e*,$ny$ Nye! !n
*!$n.$$ ),*,. !#$ .e%$8$/ )$-"$! &!"$. %4'4n# %$8$/ y$!., *! *$e$/ &,&,-%4)$'$& *$n )e!n# *!)e.$! *en#$n "en+$&$$n nye! 'e $$/ .,n#'$!
LBP $.$, nye! ",n##,n# %$8$/ .e-$),' )$&$/ )$., *$! #$n##,$n -,)'#$n##,$n ")!'4&4#!) *$n $'!%$. *$! -4%!&!)$)! y$n# )$&$/ LBP $',. $'$
*$&$- 8$'., ',$n# *$! 12 -!n##, )e*$n#'$n LBP '4n!' .e+$*! *$&$-
%,&$n
1 L,-%$ )"!n$& "$!n
2 S$6$& )"!n$& "$!n
-
8/19/2019 Referat Neuro Lbp Mutia
7/17
ETIOLOGI
• Be*$)$'$n 4#$n y$n# -en*$)$! =
1 LBP V!)e4#en!'
2 LBP V$)',&4#en!
LBP -!4#en!'• Ke.e#$n#$n 4.4.
• S"$)-e $.$, 'e+$n# 4.4.• De)!en)! 4.4.• O.4. y$n# /!"e)en)!.!3
-
8/19/2019 Referat Neuro Lbp Mutia
8/17
ETIOLOGI
• Be*$)$'$n -e'$n!)-e "$.4&4#!)ny$ =
1 T$,-$
2 In3e')!
-
8/19/2019 Referat Neuro Lbp Mutia
9/17
FAKTOR RESIKO
FAKTORRESIKO
USIA
JENISKELA
IN
IMT
PEKERJAAN
AKTIVI
TASOLAHR
AGA
LAINLAIN
-
8/19/2019 Referat Neuro Lbp Mutia
10/17
P$.4)4&4#!• Men#$n#'$. %e%$n %e$. "$*$ "4)!)! -e-%,n#',' -eny$-"!n# -enye%
4.4. .!*$' -$-", -e-"e.$/$n'$n "4)!)! .,&$n# %e&$'$n# ./4$'$& *$n )e/!n##$ "$*$ )$$. facet joint &e"$) *$n *!)e.$! .$!'$n *$! )$-"!n# .e
#e)e'$n "$*$ 'e*,$ "e-,'$$n 3$6e. +4!n. -enye%$%'$n 'e.e#$n#$n 4.*$e$/ .e)e%,. y$n# $'/!ny$ -en!-%,&'$n 'e.e%$.$)$n #e)e'$n "$*$%e&$'$n#
• Diskus intervertebralis $'$n -en#$&$-! "e,%$/$n )!3$. 'e.!'$ ,)!$ %e.$
P$*$ 4$n# -,*$ *!)',) .e,.$-$ .e),),n $.$) %4'$.!&$#4 *en#$n -#e&$.!n,) P$*$ &$n)!$ $'$n -en+$*! %4'$.!&$#4 y$n# "$*$. *$n .$' .e
• D!)',) &,-%$& %$8$/ L;L5 *$n L5S1 -en*e!.$ ).e)) -e'$n!) "$&!n# "e,%$/$n *e#ene$)! .e%e$. Pen4n+4&$n 3$)e. $'$n -en#$'!%$.'$n "e"$*$ $'$ )$$3 'e.!'$ 'e&,$ *$! '$n$&!) )"!n$&!) y$n# -enye%$%'$n ny-enye%$ )e"$n+$n# )$$3 .e)e%,.
-
8/19/2019 Referat Neuro Lbp Mutia
11/17
DIAGNOSIS
1. ANAMNESIS
•. Nye! = L4'$& !!.$)! $*!') ,+,'$n )4-$.!) ,+,'$n 9!)e4)4-$.!) !)'e-!$ ")!
•. On)e.
•. Pe'e+$$n @ 'e#!$.$n y$n# -en*$/,&,!
•. F,n#)! -4.4!' )en)4!' 4.4n4-
2. PEMERIKSAAN ISIK
•. In)"e')!
•. P$&"$)!
•. Pe-e!')$$n -4.4!6
•. Pe-e!')$$n )en)4!'
•. Ree') = L$)e,e Ken!# P$.!6' *$n K4n.$ P$.!6' N$C!#e V$&)$9$ S"$)-G$en)e&en
-
8/19/2019 Referat Neuro Lbp Mutia
12/17
-
8/19/2019 Referat Neuro Lbp Mutia
13/17
DIAGNOSIS
• PEMERIKSAAN PENUN!ANG
1 L$%4$.4!,-
2 L,-%$& ",n#)!
-
8/19/2019 Referat Neuro Lbp Mutia
14/17
-
8/19/2019 Referat Neuro Lbp Mutia
15/17
PENATALAKSANAAN
• A"#i$i#as= &$','$n $'.!9!.$) n4-$& Pen.!n# ,n.,' -e&$n+,.'$n 'e+$ )e"e.! %!
• Ti%a& 'a%in(= .!*$' *!$n+,'$n )e%$#$! .e$"! .e.$"! "$*$ %e%e$"$ '*!&$','$n .!$/ %$!n# 2< /$! "e.$-$ ,n.,' -en#,$n#! nye!
• Medi"asi= 4%$. $n.!nye! *!%e!'$n *en#$n !n.e9$& %!$)$ *$n *!#,n$'$n*!"e&,'$n M,&$! *en#$n "$$)e.$-4& $.$, NSAID J!'$ .!*$' $*$ "e%$6$-",$n "$$)e.$-4& *en#$n 4"!4!* Pe.!-%$n#'$n .$-%$/$n muscle rela/$ny$ ,n.,' +$n#'$ "en*e' -en#!n#$. %$/$y$ 'e.e#$n.,n#$n
• Ola&%a(a = /$,) *!e9$&,$)! &e%!/ &$n+,. +!'$ "$)!en .!*$' 'e-%$&! 'e $'.!9/$!ny$ *$&$- ;? -!n##,
• Manipulasi= *!"e.!-%$n#'$n ,n.,' '$),)'$),) y$n# -e-%,.,/'$n 4%$. nye! e').$ *$n %e&,- *$"$. 'e-%$&! %e'e+$ *$&$- 12 -!n##,
• Te%api dan in#e%$ensi lain= %e&,- $*$ "ene&!.!$n -en#en$! .e$"! *en#$n .ultrasoun! $',",n., )$%,' "eny$n##$ $.$,",n "!+$.$n
-
8/19/2019 Referat Neuro Lbp Mutia
16/17
PENATALAKSANAAN
-
8/19/2019 Referat Neuro Lbp Mutia
17/17
KESIMPULAN
LBP (&48 %$6' "$!n $.$, nye! ",n##,n# %$8$/ $*$&$/ #e+$&$ y$n# "$.!-%,& *! -$)y$$'$. '!.$ H$-"! )e.!$" 4$n# "en$/ -en#$&$-! e"",n##,n# %$8$/ *! )e"$n+$n# /!*,"ny$ Nye! *$"$. %e9$!$)! *$! %e&$n#),n# &$-$ )$-"$! )e*$n# *$n )e%en.$ In! $'$n -e-%$!' *$&$--!n##, %$#! 'e%$ny$'$n 4$n#
An$-ne)$ *$n "e-e!')$$n )!' -e-e#$n# "e$n$n "en.!n# ,n.,' %!)$ -"enye%$% *$! .e+$*!ny$ nye! ",n##,n# %$8$/ !n! )e"e.! !8$y$. .$,-
!8$y$. '$n'e "en##,n$$n ).e4!* y$n# &$-$ *$n &$!n&$!n