1.Robotic Neurosurgery: A Preliminary Study Using an Active Vision-Guided Robotic Arm for Bone Drilling and Endoscopic Manoeuvres
Mohamed Saufi Awang ; Mohd Zaid Abdullah
Malaysian Journal of Medical Sciences 2011;18(2):53-57
Background: Surgical robots have been appearing in operating rooms over the past decade,
and neurosurgery has been one of the pioneers in this area. In neurosurgery, the clinical use of
robots has been limited to stereotactic procedures and endoscopic manoeuvres, although the brain
is a unique organ and well-suited for robotic application. The aim of this study was to assess the
ability of our vision-guided robotic system to perform basic neurosurgical procedures.
Methods: The study was divided into two parts: bone drilling and endoscopic manoeuvres.
The robotic system was instructed to recognise targets on artificial skull models placed in different
positions (supine, lateral, sitting, and prone) and to make burr holes. A total of 10 selected burr
holes were used to assess the capability of the robot to insert an endoscope.
Results: The accuracy ranged 0.1–1.0 mm with repeatability ranged 0.03–0.92 mm.
Conclusion: Generally, the present robotic system is able to perform the surgical tasks.
However, further study is needed to refine the robotic system, including the safety mechanisms.
2.Retrospective Review of Outcomes of a Multimodal Chronic Pain Service in a Major Teaching Hospital: A Preliminary Experience in Universiti Sains Malaysia
Nizar Abdul Jalil ; Zaharah Sulaiman ; Mohamed Saufi Awang ; Mohamarowi Omar
Malaysian Journal of Medical Sciences 2009;16(4):55-65
Background: Chronic pain is a common medical issue. Beside chronic devastating pain, patients
also suffer dysfunction more generally, including in the physical, emotional, social, recreational,
vocational, financial, and legal spheres. Integrated multidisciplinary and multimodal chronic pain
management programmes offer clear evidence for relief of suffering and return to functional lifestyles.
Materials and Methods: This retrospective review was performed in order to evaluate one-year
outcomes among all newly referred patients of the multimodal chronic pain service at Hospital Universiti
Sains Malaysia (HUSM). All patients received multimodal pain therapy, including pharmacological,
physical, and psychological therapy, exercise, and pain intervention. The variables evaluated were
based on a patient’s global pain assessments, which were made using the Visual Analogue Scale (VAS)
and Oswestry Disability Index (ODI), modified by patient self-report, and were taken within days to
months of commencing our multimodal pain regime.
Results: A total of 169 patients were enrolled in this study. Out of this number, 102 (60.4%)
were seen at the pain clinic, and 67 (39.6%) were referred while they were inpatients. About one-third
of the patients had chronic pain due to cancer. Our data showed that 128 (75.7%) of our chronic pain
patients were successfully managed when ≥50% of pain relief (as measured by their VAS score) was
achieved at any point during the course of the study period. In addition, 104 patients (61.5%) showed
improvement in their modified ODI by 50% or more.
Conclusion: A multimodal chronic pain service plays a significant role in managing chronic pain
patients in a major hospital, as it is capable of delivering comprehensive and attainable care to manage
refractory and intractable chronic pain.
3.A Rare Case of Monostotic Spinal Fibrous Dysplasia Mimicking Solitary Metastatic Lesion of Thyroid Carcinoma
Mohd Ariff Sharifudin ; Zamzuri Zakaria ; Mohamed Saufi Awang ; Mohamed Azril Mohamed Amin ; Azian Abd Aziz
Malaysian Journal of Medical Sciences 2016;23(1):82-86
Monostotic fibrous dysplasia of the vertebra is a rare entity. A case of a 53-year-old lady who presented with an 8 months history of pain in the thoracic spine region with paraparesis is discussed. She had a history of papillary thyroid carcinoma and had undergone total thyroidectomy one year prior to her current problem. Magnetic resonance imaging revealed isolated osteolytic lesion over the posterior element of the T12 vertebra with narrowing of the spinal canal causing compression of the cord. The diagnosis of fibrous dysplasia was made histologically. Fibrous dysplasia rarely occurs in axial bones compared with peripheral bones. This case illustrates that osteolytic lesion of the vertebrae should be evaluated with detailed radiological and histopathological examination before an empirical diagnosis of spinal metastasis is made in an adult with a background history of primary malignancy well-known to spread to the bone.
Fibrous Dysplasia, Monostotic