An edible sea cucumber Holothuria atra has been hypothesized to have medicinal benefits against hyperuricemia owing to its bioactive compounds, including mono- and poly-unsaturated fatty acids. Herein, we aimed to investigate the fatty acids-rich extract produced from H. atra to treat hyperuricemic rats (Rattus novergicus). The extraction was carried out using n-hexane solvent and then administered to potassium oxonate-induced hyperuricemic rats, with allopurinol acting as a positive control. The extract (50, 100, 150 mg/kg body weight) and allopurinol (10 mg/kg) were administered QD through an oral route using a nasogastric tube. Serum uric acid, creatinine, aspartate aminotransferase (AST) and alanine aminotransferase (ALT), and blood urea nitrogen of the abdominal aortic blood were investigated. Our results suggested that the extract was rich in polyunsaturated (arachidonic acid) and monounsaturated fatty acids (oleic acid), in which its administration of 150 mg/kg could significantly reduce serum uric acid (p < 0.001), AST (p = 0.001), and ALT (p = 0.0302). The anti-hyperuricemic activity could be associated with the modulation of GLUT9 by the H. atra extract. In conclusion, the n-hexane extract from H. atra is a potential serum uric acid-lowering agent targeting GLUT9, where further investigations are crucially warranted.

Hypoxia-inducible factor-1 alpha (HIF-1α) is a transcription factor that plays a crucial role in cellular responses to hypoxia, such as in the development of intimal hyperplasia, a common complication in arteriovenous fistula (AVF) creation. While the application of umbilical cord mesenchymal stem cells (UC-MSCs) has shown promise in various regenerative medicine applications, including tissue repair and angiogenesis, the effect of UC-MSCs on HIF-1α level in the AVF has not been tested. Therefore, the aim of this study was to evaluate the effect of UC-MSCs administration on HIF-1α levels in the AVF animal model. An experimental study was conducted on 28 local male rabbits (Lepus domestica) using a post-test-only design. The rabbits were divided randomly into four groups: normal rabbit group (negative control), placebo-treated AVF rabbit group (positive control), AVF rabbits treated with in-situ UC-MSCs injection (one dose, 106 UC-MSCs/kg body weight), and AVF rabbits treated with intravenous UC-MSCs (one dose, 106 UC-MSCs/kg body weight (BW). HIF-1α level was measured using ELISA method after 28 days post-treatment. All data were analyzed using the one-way analysis of variance (ANOVA) and continued with the Duncan's post-hoc test. The data indicated that the levels of HIF-1α were different among all four groups (p<0.001). The post-hoc analysis revealed that the HIF-1α levels in both UC-MSC treated groups were significantly lower compared to untreated AVF rabbits (p<0.05). This study suggests that UC-MSCs could be a promising therapy to prevent and reduce intimal hyperplasia in AVF.

BACKGROUND: Congenital muscular torticollis (CMT) is a common pediatric abnormality involving sternocleidomastoid (SCM) muscle. The pathogenesis of CMT has yet to be elucidated, but intrauterine abnormalities seem to be a plausible explanation. This condition, if left untreated, may result in craniofacial asymmetry, neck pain, and limited neck movement. We reported a case of an 11-year-old girl with CMT, which symptoms were first noticed at the age of 4, but were neglected by her parents, the patient was then treated with a complete unipolar SCM release. CASE PRESENTATION: An 11-year-old girl presented with neck stiffness and limited head movement, first noticed at the age of 4, but was neglected. These symptoms worsened within the last few weeks. Physical examination revealed tension and tightness in the left SCM muscle. The patient then underwent complete unipolar release of SCM muscle and proceeded to aggressive physiotherapy for 3 months and put to rigid collar neck for the next 3 weeks. Follow-up was done in the fourth week and a full range of motion (ROM) of the neck was achieved. DISCUSSION: The timing of surgery could yield a good result if performed within 1–4 years of age. However, another literature stated that surgical intervention in the older patient with CMT could still result in better outcomes. Therefore, in this case, we proceeded to perform a complete unipolar release on the left SCM muscle. Post-operative results were satisfying, with significant improvement in neck ROM. CONCLUSION: Surgical approach in adolescents with CMT may still carry a favorable outcome, in terms of better ROM and neck motion. Subsequent physiotherapy and brace placement were crucial to maintaining the results of the surgery.

Introduction: AVF is the best option for hemodialysis access, but its patency rate drops after one year. UC-MSCs were used to reduce inflammation and promote vascular tissue repair in AVF rabbit models. Methods: In this study, 28 male domestic rabbits (Lepus Domestica) were divided into four groups: KN as a negative control, KP as a positive control with placebo therapy, P1 as the treatment group with in situ UC-MSCs, and P2 as the treatment group with intravenous UC-MSCs. The UC-MSCs dose administered was 1,000,000 cells per kilogram of body weight. After 28 days, all groups of rabbit models with AVF were sacrificed. HIF-1α, eNOS, and MMP-2 levels were measured using ELISA Sandwich methods and analyzed using a one-way ANOVA test followed by post hoc Duncan test. Results: The study found significant differences in HIF-1α, eNOS, and MMP-2 levels among the treatment groups. P3 and P4 treatments did not significantly differ in HIF-1α levels, but P3 had a lower average HIF-1α level than P4. The KP group had the highest concentration of eNOS, significantly higher than P1, P2, and KN. ENOs concentration decreased in P1 and P2 and was significantly lower than KP. The level of MMP-2 in AVF rabbits that received intravenous UC-MSCs was significantly higher than that of healthy rabbits (KN), but significantly lower than the AVF rabbit group that received a placebo. The MMP-2 level in AVF rabbits receiving in situ UC-MSCs was significantly lower than in the placebo and intravenous UC-MSC groups. Conclusion. This study suggests that local delivery of in situ UC-MSCs targeting HIF-1α, eNOS, and MMP-2 levels can effectively reduce intimal hyperplasia (IH) in rabbit models of AVF, potentially preventing early AVF failure and serving as a promising therapy to prevent and reduce IH in AVF.

Introduction. Surgical site infection (SSI) is one of the most important causes of morbidity and mortality in postoperative patients, but it is preventable in some cases. Our aim is to study the prevalence of surgical site infections and to determine the risk factors that influence the rate of SSI in a tertiary care hospital. Materials and Methods. This is an observational study conducted in the department of general surgery, Mayo Institute of Medical Sciences, Barabanki, Uttar Pradesh, from July 2021 to June 2022. Results. The present study includes 59 men and 34 women. Out of 93 patients, most patients were in the age group of 40-50 years. In our study, there was a 3.722-fold higher probability of developing SSI in patients with comorbidities. Emergency surgery also has a 7.187 times higher risk of developing SSI than elective surgery. The prevalence in this study of SSI was 8.60%; of 8 patients, only 1 developed SSI on deep incision. Conclusion. The following conclusions/ recommendations emerged from this study: reducing the duration of surgical procedures by adopting appropriate techniques and early resumption of patient mobilization. Judicious use of drains is also recommended, paying more attention in emergency operations and/or with a high risk of contamination.

Background: Thoracic trauma is defined as a trauma that hits the chest wall directly or indirectly, either as a result of blunt or penetrating trauma. Thoracic trauma can occurred in any age or genders, and become a life-threatening if the treatment isn’t immediate and appropriate. Methods: This research was an observational study with a cohort retrospective design using secondary data in the form of thoracic trauma patients at The Zainoel Abidin General Hospital, Banda Aceh, Indonesia in the period January 2019- December 2020. The statistical analysis used were chi square for bivariate and multivariate analysis, spesifically logistic regression analysis was conducted to know which risk factor influences the most. Result: There were 141 medical records used in this study, thoracic trauma was more common in men compared to women. The age group of 46-55 is the age group with the highest percentage of thoracic trauma patients, road traffic are the leading cause of thoracic trauma where the most common diagnosis is rib fractures. Significant factors that associated with the short outcome of thoracic trauma are thoracic trauma diagnosis (p=0,00), management of thoracic trauma (p=0,00), ventilator (p=0,04), duration of ventilator (p=0.01), sepsis (p=0,00), qSOFA score (p=0,00) and injury severity score (p=0,00). Conclusions: Motorbike accidents contributed to a considerable number of traumatic chest injuries in this study. Diagnosis, management of trauma, days of ventilation, qSOFA score, injury severity score, and development of sepsis were associated with the short-term outcome among thoracic trauma patients. Injury severity score seems to be the most influential variable in this study, the lower the better it is. Road safety intervention is urgently needed to control the underlying problems in this study.

Little is known about traditional bone setting (TBS) practise in Aceh, Indonesia despite of its common utilisation. The aim of this study was to explore the characteristics of TBS practise in Aceh, Indonesia. Thirty-nine participants from ten regencies in Aceh were interviewed from January to December 2019. Most of the participants were male (82.1%), and aged between 31-50 years old (79,5%). Half of the participants were elementary school graduates (51,3%). More than half (59%) of participants had been practicing bone setting for 5-10 years, and many of them (48.7%) used traditional massages combined with splints and herbal mixtures. None (0%) of the participant obtained legal permission to practice bone setting. More than half (71.8%) obtained the knowledge of TBS from their ancestral heritage, only one participant obtained it through apprenticeships. We concluded that TBS practices in Aceh were unregistered, and the practitioners were mostly untrained. There is a need to provide training and permits for TBS practise to ensure patients’ safety.

Background: The pathogenesis of herniated nucleus pulposus (HNP) is complex and may involve the wide variety of gene polymorphism. However, the reports from the existing studies are inconclusive. The objective of this study was to determine the role of single nucleotide polymorphisms (SNPs) in interleukin 1 alpha (IL-1A), tumor necrosis factor-alpha (TNF-A), and vitamin D receptor (VDR) genes on the susceptibility to herniated nucleus pulposus (HNP). Methods: Four databases (PubMed, Embase, Cochrane, and Web of Science) were searched as of April 1 st, 2021. Authors, publication year, targeted genes, genotype and allele frequency in each case and control groups were collected. Newcastle-Ottawa scale was used to evaluate the publication quality. The pooled estimates of association of IL-1A -889C>T (rs1800587), TNF-A -238G>A (rs361525), and VDR TaqI (rs731236) and susceptibility to HNP were assessed using Z test. Results: We screened 3,067 unique studies for eligibility and three, two and nine case-control studies on IL-1A -889C>T, TNF-A -238G>A, and VDR TaqI were included, respectively, in our meta-analysis. The studies consisting 369 HNP cases and 433 controls for IL-1A -889C>T, 252 cases and 259 controls for TNF-A -238G>A and 1130 cases and 2096 controls for VDR TaqI. Our pooled estimates indicated that there was no significant association of those SNPs with the susceptibility to HNP in any genotype, dominant model, recessive model, or allele comparations. Conclusion: Although individual studies suggested the important role of gene expression dysregulation associated with SNPs in IL-1A, TNF-A, and VDR, our data indicated that IL-1A -889C>T, TNF-A -238G>A, and VDR TaqI had weak association with HNP susceptibility in both genotypes and allele distributions. However, since heterogeneity was identified among studies included in this meta-analysis, further meta-analysis with a larger population and subgroup analysis on specific population are warranted to support this finding.

Background: The pathogenesis of herniated nucleus pulposus (HNP) is complex and may involve the wide variety of gene polymorphism. However, the reports from the existing studies are inconclusive. The objective of this study was to determine the role of single nucleotide polymorphisms (SNPs) in interleukin 1 alpha (IL-1A), tumor necrosis factor-alpha (TNF-A), and vitamin D receptor (VDR) genes on the susceptibility to herniated nucleus pulposus (HNP). Methods: Four databases (PubMed, Embase, Cochrane, and Web of Science) were searched as of April 1 st, 2021. Authors, publication year, targeted genes, genotype and allele frequency in each case and control groups were collected. Newcastle-Ottawa scale was used to evaluate the publication quality. The pooled estimates of association of IL-1A -889C>T (rs1800587), TNF-A -238G>A (rs361525), and VDR TaqI (rs731236) and susceptibility to HNP were assessed using Z test. Results: We screened 3,067 unique studies for eligibility and three, two and nine case-control studies on IL-1A -889C>T, TNF-A -238G>A, and VDR TaqI were included, respectively, in our meta-analysis. The studies consisting 369 HNP cases and 433 controls for IL-1A -889C>T, 252 cases and 259 controls for TNF-A -238G>A and 1130 cases and 2096 controls for VDR TaqI. Our pooled estimates indicated that there was no significant association of those SNPs with the susceptibility to HNP in any genotype, dominant model, recessive model, or allele comparations. Conclusion: Although individual studies suggested the important role of gene expression dysregulation associated with SNPs in IL-1A, TNF-A, and VDR, our data indicated that IL-1A -889C>T, TNF-A -238G>A, and VDR TaqI had weak association with HNP susceptibility in both genotypes and allele distributions. However, since heterogeneity was identified among studies included in this meta-analysis, further meta-analysis with a larger population and subgroup analysis on specific population are warranted to support this finding.

An acute spinal cord injury (SCI) early management is one of the most challenging tasks in trauma cases. The outcome of its cases depends upon the accuracy, adequacy, and speed of first aid management, diagnosis, and treatment within the “Golden Hours Periods.” Rapid and safe transport of the spinal injury patient allows for early medical stabilization designed to preserve and potentially improve the neurological outcome. The complications that arise from spinal instability or neurological must be prevented immediately and involves all members of the multidisciplinary team. Specialized assessment of people with new spinal cord injuries must take place immediately after an injury. The diagnosis of SCI should include the level and severity of the damage of the spinal cord, type of fracture or/and dislocation of the injured vertebrae, and the stability of the spinal column. Imaging begins from plain radiograph and should include a multi-slice CT protocol of the entire spine to delineate the known injury and to exclude non-contiguous damages. The outcome SCI treatment depends on the number of axons that survived – the higher the number of surviving axons, the restoration of neurological functions might be higher. The management of SCI begins before the patient admitted to the hospital. The principles of treatments include early reduction and fixation, combined extramedullary and intramedullary decompression, cell transplantation, early rehabilitation treatment, and complication prevention. The surgical treatment sometimes needed to evaluate, stabilize the spine, decompress the area that injured, and managed any other injuries that may have been associated with the accident. Once a patient was stabilized, care, and treatment focus on supportive care and rehabilitation.

INTRODUCTION: Thoracic spinal psammomatous meningioma is a rare subtype of meningioma. Surgery is the definitive treatment for symptomatic spinal meningiomas and offers a substantial possibility for complete resection and cure. PRESENTATION OF CASE: A 42-year-old female complaining of back pain for one year and progressive weakness and numbness of both lower limbs with urinary incontinence and constipation for two months. Magnetic resonance imaging showed an intramedullary spinal mass at D3-D4 level. The patient underwent laminectomy at D3-D5 level, revealing dural bulge. A midline durotomy performed. Intraoperative findings showed firmed, greyish to white and moderately vascular mass. A clear margin was identifiable between cord and tumor. Simpson grade 3 resection was performed. Pedicle screw and rod was placed for posterior stabilization. Histopathological examination demonstrated a psammomatous spinal meningioma. Despite the pain and the sensory sensation was improved, the motoric and autonomic function still showed no significant improvement in the early postoperative period. DISCUSSION: The preferred approach or procedure must be tailored case by case based on preoperative surgical grading of the tumor and its associated factors. Meanwhile, the prognosis for recovery depends mainly on two factors: the severity of the neurological deficit and the duration of the deficit before decompression. CONCLUSION: Surgical resection of the tumor may relieve the spinal cord compression in a neglected case. Even though the neurologic function after surgery rarely returns to the functional stage due to chronic neural tissue damage. (C) 2019 The Authors. Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.

The objective of this research was to analyze the interaction of the active ingredients in Labisia pumila (kaempferol, rutin, apigenin, caffeic acid, pyrogallol and gallic acid) against RANK–RANKL–OPG system in context of osteoporosis. This is an in silico research. The three-dimensional structure in .sdf file is converted to PDB format using the Open Babel 2.3.1 software. The three-dimensional structure model of RCSB RANK–RANKL and RANKL–OPG was obtained from http://www.rcsb.org/pdb. The ligand–protein docking and visualization analysis was carried out with Hex8.0 and Discovery Studio Client 3.5 software. RANK–RANKL or RANKL–OPG complex has the easiest interaction with rutin. In conclusion, flavonoid compounds (rutin, apigenin, kaempferol) more easily interact with RANK–RANKL and RANKL–OPG systems than isofavonoid groups (caffeic acid, pyrogallol, gallic acid). This opens the opportunity for the utilization of flavonoid from L. pumila as antiosteoporosis.

Background: Several studies have reported hip geometry to predict the femoral neck fractures. However, they showed inconsistency. Objectives: To determine the association between hip geometry and femoral neck fractures. Methods: Published literature from PubMed and Embase databases (until May 25th, 2017) was searched for eligible publications. The information related to (1) name of first author; (2) year of publication; (3) country of origin; (4) sample size of cases and controls and (5) mean and standard deviation of cases and controls were extracted. The pooled odds ratios (ORs) and 95% confidence intervals (95% CIs) for the association between hip geometry and femoral neck fractures were assessed using random or fixed effect model. A Comprehensive Meta-analysis software, version 2.0, was used to analyse the data. Results: A total of 11 studies were included in this study. Our results showed that increase in hip axis length (OR 95% CI = 1.53 [1.06-2.21], p = 0.025), femoral neck angle (OR 95% CI = 1.47 [1.01-2.15], p = 0.044) and neck width (OR 95% CI = 2.68 [1.84-3.91], p < 0.001) was associated with the risk of femoral neck fractures, whereas we could not find the correlation between femoral neck axis length and the risk of femoral neck fractures. Conclusion: There is strong evidence that elevated hip axis length, femoral neck angle and neck width are the risk factor for femoral neck fractures. The Translational Potential of this Article: Determining the hip axis length, femoral neck angle and neck width that are most highly associated with femoral neck fracture may allow clinicians to more accurately predict which individuals are likely to experience femoral neck fractures in the future. (C) 2017 The Authors. Published by Elsevier (Singapore) Pte Ltd on behalf of Chinese Speaking Orthopaedic Society.

Corresponding author: Muhammad Bayu Zohari Hutagalung, MD, Department of Orthopaedic and Traumatology, Faculty of Medicine, Syiah Kuala University/Dr. Zainoel Abidin Hospital, JL. T Daud Beureueh No 108, Banda Aceh 23124, Indonesia. Tel: +6282364622502, email: bayuzohari@gmail.com ABSTRACT A 16-years old girl presented to the orthopaedic outpatient clinic of Dr. Zainoel Abidin Hospital, Banda Aceh, Indonesia with a progressive growing mass around the left knee since 12 months ago. Diagnostic assesment includes clinical, radiological and fine needle aspiration cytology of the mass confirmed an osteosarcoma. Patients undergo above knee amputation procedure as definitive treatment. Neglected osteosarcoma is a primary malignant bone tumor with more than 3 months delayed from the original time of signs and symptoms occurrence to first presentation for medical care. The combination of unawareness, low socio-economic level and inability to access healthcare facilities are major factors contributing to delayed presentation in this case. Management of neglected osteosarcoma in our region faced a variety of issues such as lack of funding, inadequate diagnostic facilities and limited access to advanced treatment options combined with patient’s cultural and socio-economic preferences with regards to management and treatment options.

Objective: Surgical site infection (SSI) is an important cause of surgical wound healing disorders. Although SSI is uncommon in open posterior spine surgery, it is potentially correlated with serious morbidity, increased resource utilization and mortality. To evaluate the association between several spinal disorders treated with open posterior spine surgery and the risk of SSI. Materials and Methods: A retrospective study was conducted in Dr. Zainoel Abidin General Hospital included data during January 2012 to December 2015. The data of the spinal disorders treated with open posterior spine surgery and the risk of SSI were extracted from medical record. A chi-square was employed to assess the association between spinal disorders treated with open posterior spine surgery and the incidence of SSI. Results: A total of seven (2.4%) SSIs of 289 patients treated with open posterior spine surgery were analyzed. Spinal tuberculosis was associated with 5.9 fold increased the risk of SSI [odds ratio 95% confidence interval= 5.99 (1.14-31.51), p=0.034[. While, other spinal disorders including spinal stenosis (p=0.311), spine fracture (p=0.759), herniated nucleus pulposus (p=0.484), spinal dislocations (p=0.806), spondylolisthesis (p=0.925), spinal tumor (p=0491), and scoliosis (p=0/07) had no significant association with the risk of SSI. Conclusion: In our population, spinal tuberculosis is indicated to be correlated with the risk of SSI.

Introduction: Several studies have reported the incidence of herniated nucleus pulposus (HNP) in some hospitals. Surgery is one of the options in HNP management. HNP surgery results in Aceh have not been reported yet. Therefore, this study reported the HNP surgery in Zainoel Abidin General Hospital, Banda Aceh period 2010-2012. Methods: This was a descriptive retrospective survey conducted in Zainoel Abidin General Hospital Banda Aceh at August-September 2012. Results: The incidence of HNP who underwent surgery was 28 patients. There was no HNP case in the age group I (0-18 years), seven patients (25%) were age group II (19-40 years), and 21 patients (75%) were age group III (over 40 years). Based on HNP location, no HNP located in the L1-L2 and L3-L4, one patient (3.57%) was L2-L3, 20 patients (71.42%) were L4-L5, three patients (10.71%) were L5-S1, and there were four HNP patients in multiple lumbar (14.28%). Laminectomy was the most common type of surgery performed (27 patients or 96.42%), followed by laminotomy (one patients or 3.57%). Conclusion: There was significant association between the incidence of HNP with age, but not with gender. In summary, the most common lumbar disc herniation was in L4-L5. Laminectomy was the most common procedure performed in HNP patient in Aceh.

Efficacy of the use of hip geometry to predict femoral neck fracture is controversial and it is influenced by the particular race. Studies on the use of hip geometry in Aceh's population have never been done. To determine the association of hip geometry with femoral neck fracture in elderly women in Dr. Zainoel Abidin Teaching Hospital. This study was an observational analysis. The design of this study was cross-sectional. The study was conducted in Dr. Zainoel Abidin Teaching Hospital from May to August 2013. Hip geometry measurements were done, such as the following: hip axis length (HAL), femoral neck axis length (FNAL), femoral neck angle (FNA), and neck width (NW). Statistical analysis used was logistic regression test. A total of 32 patients with femoral neck fractures and 32 control patients were followed in this study. The average value of hip geometry measurements in femoral neck fracture was HAL = 90.2 ± 8.6, FNAL = 77.2 ± 7.3, FNA = 131.7 ± 6.2, NW = 32.3 ± 3.4; and in nonfemoral neck fracture, it was HAL = 88.4 ± 9.4, FNAL = 76.2 ± 7.9, FNA = 131.5 ± 7.3, NW = 29.8 ± 3.3. Measurement HAL, FNAL, and FNA did not have a significant association with the incidence of femoral neck fracture (P > 0.05). However, NW measurement had a significant association with the incidence of femoral neck fracture (P < 0.05). Only NW measurement had a significant association with femoral neck fracture in older women in Dr. Zainoel Abidin Teaching Hospital.

Objectives: This study aimed to investigate the association between the IL6 - 174 G/C gene polymorphism and the risk of osteoporosis by performing a meta-analysis.Methods: Published literature from PubMed and Embase databases was searched for eligible publications. The following information was extracted from each study: Name of first author, year of publication, country of origin, sample size of cases and controls, and size of each allele. The combined odds ratio (ORs) and 95% confidence intervals (95%CIs) for the association between the IL6 -174 G/C gene polymorphism and the risk of osteoporosis were assessed using a random or fixed effects model. A comprehensive meta-analysis (CMA) 2.0 was used to analyse the data.Results: Twelve studies (4923 cases/3431 controls) were included in this meta-analysis. The results indicated that IL6 -174 G/C gene polymorphism was associated with an increased (G vs C, OR 95%CI = 1.29 [1.03-1.62], p = 0.029) and decreased risk of osteoporosis (C vs G, OR 95%CI = 0.77 [0.62-0.97], p = 0.029; CC vs GG + GC, OR 95%CI = 0.58 [0.39-0.88], p = 0.010).Conclusion: The IL6 -174 G/C gene polymorphism was shown to be positively correlated with osteoporosis risk.

Abstrak . Pembedahan adalah salah satu opsi didalam penanganan HNP Lumbal apabila penanganan secara konservatif mengalami kegagalan. Hasil pengobatan HNPL di Rumah Sakit Umum dr. Zainoel Abidin Banda Aceh belum pernah dilaporkan sebelum,nya. Oleh karena itu penelitian ini melaporkan hasil operasi pada HNPL periode tahun 2010-2012. Penelitian ini dilakukan secara retrospektif. Operasi HNPL dalam periode tersebut adalah pada 28 pasien. Tidak ditemukan HNPL pada kelompok umur group 1 (1-18 tahun), pada kelompok umur group II (19-40 tahun) didapatkan 7 pasien (25%), dan pada kelompok group III (usia lebih 40 tahun) didapatkan pada 21 pasien (75%). Berdasarkan lokasi, L2-L3 didapatkan pada 1 pasien (3.57%), L4L5 pada 20 pasien (71,42%), L5-S1 pada 3 pasien(10,71%), dan 4 pasien pasien HNPL dengan lokasi ganda. Kesimpulannya, lokasi tersering dari HNPL adalah di L4-5. Opsi pembedahan pada HNPL perlu dipertimbangkan apabila pengobatan secara konservatif mengalami kegagalan (dicoba secara konservatif dalam kurun waktu 6 minggu-6 bulan). Hemilaminektomi dan disektomi adalah prosedur tersering pada pembedahan HNPL di Rumah Sakit umum dr. Zinoel Abidin, Banda Aceh. Abstract. Surgery is one of the options in HNPL management if standar conservative treatment failed. HNP surgery results in Aceh have not been reported yet. Therefore, this study reported the HNPL surgery in Zainoel Abidin General Hospital, Banda Aceh period 2010-2012. This research was a descriptive retrospective.The incidence of HNPL who underwent surgery was 28 patients. There was no HNPL case in the age group I (0-18 years), age group II (19-40 years) was 7 patients (25%), and age group III (over 40 years) was 21 patients (75%). Based on HNPL location, no HNPL located in the L1-L2 and L3-L4, L2-L3 was 1 patient (3.57%), L4-L5 was 20 patients (71.42%), L5-S1 was 3 patients (10.71%), and there were 4 patients HNPL in multiple lumbar (14.28%). Hemilaminectomy was the most common type of surgery performed (27 patients or 96.42%), followed by laminotomy (1 patients or 3.57%). In summary, the most common lumbar disc herniation was in L4-L5. The surgical option is only for the patients that failed conservative treatment (in six weeks- six months period). Hemilaminectomy was the most common procedure performed in HNP patient in Aceh.