Korelasi antara abnormalitas rontgen servikal terhadap disabilitas leher pada pasien cervicogenic headache

Abstract

Secondary headache that is often found is cervicogenic headache (CH), which is one type of secondary headache due to abnormalities of the cervical vertebrae. Headache can occur together with neck pain which causes neck disability. Cervical x-ray examination is the first diagnostic test that is often performend in patients with complaints of neck pain. Functional disability of neck pain can be evaluated by using Neck Pain Disability Index (NPDI). There were no prior studies using NPDI in CH patients at Sardjito Hospital.
This study aims to determine the correlation between cervical x-ray abnormalities and neck disability in CH patients.
This was a cross-sectional study. Subjects were recruited by consecutive sampling. The research subjects were patients who came to the Outpatient Department of Neurology at Sardjito Hospital with a diagnosis of CH that was confirmed by NPDI measurement and AP/lateral/oblique cervical x-ray examination.
Sixty-nine subjects with the basic characteristics of 48(69.6%) women, 21(30.4%) men, 38(55.1%) subjects with mild cervical x-ray abnormalities, 10(14.5%) moderate, 21(30.4%) severe, with NPDI mean score of 22.2±15.4. The results of bivariate analysis between NPDI and independent variables, significant in duration of illness (p =0.007;r =0.320), history of head trauma (p =0.002;r =-0.365), Numeric Pain Scale (NPS) (p =0.000;r =0.558), Range of Motion (p =0.000;r =0.558), trigger point (p =0.004;r =-0.342). Multivariate analysis was significant in body weight (p =0.041; B =0.580; 95%CI -1.097–(-0.035)) and NPS (p =0.000; B =4.176; 95%CI 2.720–5.633) with R2 =0.534.
This study suggests that there is no correlation between cervical x-ray abnormalities and neck disability in CH patients.

ABSTRAK

Nyeri kepala sekunder yang banyak dijumpai adalah cervicogenic headache (CH), yaitu salah satu tipe nyeri kepala sekunder akibat kelainan dari vertebra servikal. Nyeri kepala dapat muncul bersamaan dengan nyeri leher yang menyebabkan disabilitas leher. Pemeriksaan foto polos servikal menjadi tes diagnostik pertama yang sering dilakukan pada pasien dengan keluhan nyeri leher. Disabilitas fungsional dari nyeri leher dapat dievaluasi salah satunya dengan neck pain disability index (NPDI). Belum pernah dilakukan penelitian sebelumnya pada pasien CH di RSUP Dr. Sardjito yang menggunakan alat ukur NPDI.
Penelitian ini bertujuan untuk mengetahui korelasi antara abnormalitas rontgen servikal terhadap disabilitas leher pada pasien cervicogenic headache.
Rancangan penelitian menggunakan metode potong lintang. Subjek direkrut secara consecutive sampling. Subjek penelitian adalah pasien yang datang ke poli Saraf RSUP Dr. Sardjito dengan diagnosis cervicogenic headache dilakukan pemeriksaan menggunakan instrumen NPDI dan pemeriksaan rontgen servikal posisi AP/lateral/oblik.
Subjek penelitian sebanyak 69 yang memenuhi kriteria dengan karakteristik dasar wanita 48(69,6%), laki-laki 21(30,4%), subjek derajat abnormalitas rontgen servikal ringan 38(55,1%), sedang 10(14,5%), berat 21(30,4%), dengan skor NPDI rata-rata 22,2±15,4. Hasil analisis bivariat antara NPDI dengan variabel bebas, signifikan pada lama menderita (p =0,007;r
=0,320), riwayat trauma kepala (p =0,002;r =-0,365), numeric pain scale (NPS) (p =0,000;r=0,558), range of motion (ROM) (p =0,000;r =0,558), trigger point (p =0,004;r =-0,342). Analisis multivariat signifikan pada berat badan (p =0,041; B =0,580; 95%CI -1,097–(-0,035)) dan NPS (p =0,000; B =4,176; 95%CI 2,720–5,633) dengan R2 =0,534.
Penelitian ini menunjukkan tidak terdapat korelasi antara abnormalitas rontgen servikal dengan disabilitas leher pada pasien cervicogenic headache.