Puji Tuhan day 10 setelah operasi cervical disc replacement rasanya kayak “lahir baru” lagi.
All the pain is gone 🥲 seneng banget.
Special thanks to @dr.harmantya yang udah mengedukasi dan melakukan CDR ku ini, bener-bener life changing. Also thanks @gatam_ekahospital untuk pelayanannya yang luar biasa dari awal konsul sampe pulang perfect service banget 😍
Thankyouuuu lagi dan lagi buat istriku yang udah nemenin dalam kondisi apapun 😘
Thankyou kak Diana @diana.victory.37 yang sudah bantu proses administrasi dan perasuransian 🙏
Semoga kita semua sehat selalu ❤️
A 60-year-old female patient presented with chronic lower back pain radiating to the right leg.
The condition is not only due to a pinched nerve, but also degenerative scoliosis, a spinal curvature caused by aging and progressive degeneration of spinal structures.
This condition makes the body appear to lean forward as if it is about to collapse, forcing the back muscles to work harder and resulting in increasing pain.
Evaluation shows that the curvature is mainly located in the lumbar (lower back) region.
A corrective scoliosis surgery is planned using a combined approach:
• OLIF (Oblique Lumbar Interbody Fusion) from the side to support and restore disc height
• Followed by posterior instrumentation to correct alignment and stabilize the spine
The goal is to reduce pain, improve posture, and enhance the patient’s functional quality of life.
#DrHarman #SpineEducation #Scoliosis #DegenerativeScoliosis #LumbarSpine
In this case, the patient experienced weakness from the neck down.
The symptoms included weak hands, unsteady walking, and difficulty performing fine motor tasks such as buttoning a shirt. These are classic signs of cervical myelopathy, a condition caused by compression of the spinal cord in the neck.
MRI revealed multiple levels of compression affecting the spinal cord. CT scan also showed bone overgrowth/ossification, indicating a long-standing and progressively worsening degenerative process.
In worsening cervical myelopathy, the main goal of treatment is to relieve the pressure on the spinal cord as soon as possible. Surgery may be performed from the front, the back, or with a combined approach, depending on the location and type of compression.
The earlier it is treated, the greater the chance of improving neurological function.
#DrHarman #SpineEducation #CervicalMyelopathy #CervicalSpine #SpineSurgery
An interesting case of a 76-year-old female patient presenting with progressive weakness on one side of the body over the past 6 months.
Initially, the condition was thought to be due to a pinched nerve in the lumbar spine (L4–L5), and imaging did show significant compression at that level. However, clinically, this finding did not fully explain the patient’s hemibody weakness.
This highlights the importance of a thorough physical examination and detailed history taking, rather than relying solely on imaging such as MRI or CT scans.
On further examination, hyperreflexia was identified, suggesting involvement of the upper motor neuron. This finding indicated that the problem was not limited to the lumbar spine.
Subsequent MRI of the thoracic spine revealed a tumor in the thoracic region compressing the spinal cord.
#DrHarman #SpineEducation #SpineTumor #ThoracicTumor #SpineSurgery
We encountered another case of recurrent disc herniation (HNP). The patient previously underwent surgery for HNP at the L5–S1 level about a year ago, but has now returned with new symptoms. This time, the nerve compression is at the L4–L5 level, where the disc has degenerated and is pressing on the left nerve.
It is important to remember that surgery does not always mark the end of the problem. Lifestyle changes—such as maintaining a healthy weight, strengthening core muscles, and improving work posture—remain essential to help prevent recurrence.
In this case, conservative treatment and physiotherapy had already been attempted without improvement. After discussion with the patient, it was decided to proceed with Lumbar Disc Replacement (LDR) through an anterior approach, aiming to replace the damaged disc while preserving the natural motion of the spine.
#DrHarman #SpineEducation #HNP #LumbarDiscReplacement #SpineSurgery
In some cases of recurrent disc herniation (HNP), the spinal disc that was previously treated by removing the protruding portion can herniate again and compress the nerve. If this condition occurs repeatedly or the disc has already undergone significant damage, one of the treatment options is to replace the damaged disc with an artificial disc.
This procedure is known as Lumbar Disc Replacement (LDR), a surgery that replaces the damaged disc with an artificial one that can still move. The goal is not only to relieve pressure on the nerve but also to preserve the natural motion of the spine.
With proper patient selection, this procedure can be an effective solution to relieve pain while also reducing the risk of recurrence at the same level.
#DrHarman #SpineEducation #HNP #LumbarDiscReplacement #SpineSurgery
An interesting case: a 37-year-old man with pain radiating to his left leg for the past 6 months. The patient previously underwent surgery at the L4–L5 level about a year ago, but now presents with a recurrent disc herniation, where the disc has protruded again and is compressing the nerve.
The challenge is determining the most appropriate surgical approach. Operating from the back carries the risk of encountering scar tissue from the previous surgery, while an anterior approach allows for disc replacement. However, the difficulty lies in the position of the herniated disc, which has migrated downward, making it harder to retrieve from the front.
So, what would be the best strategy for this case?
We’ll discuss the answer in the next video.
#DrHarman #SpineEducation #HNP #RecurrentDiscHerniation #SpineSurgery
What a remarkable week in spine surgery!
8 levels of Cervical Disc Replacement.
10 levels of Lumbar Disc Replacement.
Eighteen disc levels treated, each with its own story, symptoms, and surgical challenges.
Disc replacement is not simply about removing pain. It is about preserving motion, maintaining balance, and restoring quality of life. Every level requires careful evaluation, precise execution, and thoughtful decision-making.
Grateful for the trust from each patient, and for the team who shows up ready for every case.
#drharman #lumbardisc #cervicaldisc #discreplacement
Today, we managed a case of a 61-year-old woman with nerve compression in two areas at once: the thoracic spine (upper back) and the lumbar spine (lower back). In this case, surgical decompression was performed in both the upper and lower regions to prevent further deterioration and preserve nerve function.
In the thoracic region (T10–T12), the spinal cord was compressed from both the front and the back due to ligament thickening, creating an hourglass-like narrowing. This condition is far more dangerous because it involves the central nervous system (spinal cord) and, if left untreated, can lead to paralysis from the waist down.
In addition, the patient also had nerve compression at the lumbar level L4–L5, which is commonly caused by a bulging disc pressing on the nerve from behind.
It is important to understand that the characteristics and risks of thoracic nerve compression are very different from those in the lumbar spine. Once symptoms such as weakness appear, thoracic compression should never be ignored.
#DrHarman #SpineEducation #ThoracicSpine #LumbarSpine #SpineSurgery
A 41-year-old man presented with lower back pain that had persisted for nearly two years. Although he is still relatively young, his tall and large body build places greater stress on the intervertebral discs, increasing the risk of degeneration.
Evaluation revealed degeneration of two discs at the L4–L5 and L5–S1 levels, along with nerve compression radiating to the right leg. The patient had undergone various conservative treatments—including lifestyle modification, core muscle strengthening, and physiotherapy—but the pain persisted and significantly affected his quality of life.
Given the patient’s relatively young age, the goal of treatment is not only pain relief but also preservation of the spine’s natural motion. Therefore, a two-level lumbar disc replacement at L4–L5 and L5–S1 was planned.
#DrHarman #SpineEducation #LowBackPain #LumbarDiscReplacement #SpineSurgery
Today, a procedure was performed for a case of thoracic myelopathy, a condition caused by spinal cord compression in the thoracic (upper back) region. Unlike nerve compression in the lower back, which affects peripheral nerves, compression in the thoracic spine involves the central spinal cord, making it significantly more dangerous if left untreated.
In this patient, the condition had been neglected for a long time, leading to weakness from the waist down and difficulty walking. Imaging revealed compression at the T10–T11 level with signs of myelomalacia, indicating prolonged spinal cord compression.
The causes of thoracic spinal cord compression vary, ranging from disc herniation to ossification of the posterior longitudinal ligament (OPLL). In this case, the ligament that should normally be flexible had thickened and hardened, resulting in spinal cord compression.
As signs of paralysis were already present, surgical intervention was necessary to decompress the spinal cord—either through an endoscopic approach or open surgery—with the goal of preventing further deterioration and preserving neurological function.
#DrHarman #SpineEducation #ThoracicMyelopathy #SpinalCordCompression #SpineSurgery
In a single day, multiple spine procedures can be performed—each with a different indication, yet guided by the same core principles:
relieving pain, protecting nerve function, and improving quality of life.
• Transforaminal endoscopy to release a pinched nerve through a minimally invasive approach
• Tumor removal with nerve decompression to preserve neurological function
• Spinal disc replacement for chronic pain that interferes with daily activities
• Cervical spine surgery to treat conditions affecting the neck region
Not all neck or lower back pain requires surgery.
But when symptoms persist, worsen, or begin to threaten nerve function, surgical intervention may become the most appropriate option.
In spine care, what matters most is not the number of procedures performed,
but the accuracy of the indication and the safety of the patient.
#DrHarman #SpineEducation #SpineSurgery #PinchedNerve #BackPain #NeckPain
