Of the spinal surgery products you have been involved in developing, which product are you most proud of and why?
Each of the products I have been involved in developing have a special place and memory for me because of the achievement and the work that went into them, and I am really proud of all of them.
The one that has been most successful and the one that I am most proud of is the PediGuard (SpineGuard) device, which detects perforation in bone when implanting pedicle screws. I developed this with Mr Maurice Bourlion and Mr Alain Vanquaethem, two engineers who were really responsible for most of the technological achievements. I am proud of it because it took an enormous amount of effort and development in terms of prototypes and overcoming technical problems and trials of different versions. After all of the setbacks and work involved, it was tremendous to finally develop a useful and commercially viable device that is growing exponentially in popularity. I am also proud of it because it is a product that is directly aimed at improving the lives of surgeons and patients, and it is a device that is directly related to the safety of patients.
What are the three spinal surgery questions that need answering?
- While we know that most degenerative diseases and low back pain can be explained by genetic factors, I would like to see a better understanding of what exactly the environmental triggers are in association with these genetic factors.
- I would like to see a treatment, which I do not think at the end of the day would probably be surgical, for intramedullary spinal cord tumours, particularly astrocytomas. These are very difficult tumours to treat and they are usually not completely excised with surgery. I would like to see some development, perhaps of immunotherapy or chemotherapy, which would help us deal with these particular tumours that are devastating for the patients and their families.
- What is the best treatment for low back pain? This is a question that still perplexes us and one that we still do not have the full answer to.
What are your current areas of research?
I am involved in many areas of research; however, nowadays, I have far less involvement in more basic research. Most of my investigation is related to the development of minimally invasive techniques of accessing the spine from top to bottom. I am also currently running a trial looking at a bone substitute, which hopefully turn out to be osteoinductive.
At a broader level, I continue to have an interest in the brain stem, which for most spinal surgeons is the bit of the body on top of the actual spine. It is an intriguing area and I am still doing quite a bit of work in relation to monitoring of brain stem function.
What recent spinal paper have you found the most interesting and why?
The recent papers I have found most interesting really are a series of papers from the SPORT (Spinal Patients Outcome Research Trial) group. While that particular study has come in for a lot of criticism, it has produced a lot of very interesting data in relation to the management of patients, particularly with spinal stenosis. The most interesting feature to emerge recently is the fact that decompression of the canal contents can, in fact, produce an improvement in back pain itself, which is something that we preached for a long time was not the case.
You are the recipient of several awards for your work in spinal surgery. Which award was the biggest honour and why?
I think the biggest award was the Presidential Design Award from the president of Singapore for the PediGuard. This was a great honour as it is a large international award, covering not only medicine but all areas of technological development. I think to receive this award was a tremendous recognition of the work done by everyone involved in the development of this device.
Do you think social networking, such as Twitter, has a role in the spinal community and if so, what role?
I think social networking could have a role for the spinal community, but I am not sure that the format of something like Twitter would be very useful. Twitter tends to be a more immediate short comment kind of communication, whereas I suspect that the networking that we could associate with the spinal community would be far more along the lines of a longer interaction with transfer of images and files and development of an online community where one could get advice and show difficult cases etc. I think such communities will emerge in time on perhaps on Facebook, rather than Twitter.
What are your hobbies outside of medicine?
Outside of medicine my major interest is in flying. I fly a twin-engine Beech Baron Pressurised Airplane. It is a beautiful aeroplane, which allows me to fly at 25,000 feet around Europe above the weather and gets me from place to place particularly for all the different European meetings that I attend. It was very useful during my year as president at Eurospine.
I have an interest in space travel and technology, and I was in fact the official Irish astronaut to the European Space Agency in the early 90s. Although I never got to actually fly in space, I did get to do the full selection process that involved G-Force testing in a centrifuge with lots of interesting experiences related to that.
Unfortunately, as I say, I never got to go into space and I think I am past the stage where I would be a reasonable candidate now—although the experience of John Glenn [who went into space aged 77] in the USA gives me hope that maybe by the time I am 70, it will be something I can return to!
How did you become the first official Irish astronaut?
I became the official Irish astronaut following a selection process in Ireland related to a recruitment drive from the European Space Agency in the early 90s. However, Ireland contributes very little to the European Space Agency and I do not think it was any surprise that an Irish astronaut has yet to be selected to actually go into space. My family, however, are firmly convinced that I have always been a “space cadet” and while I never made it to the moon I have made it to Beaumont Hospital in Dublin, which sometimes resembles a lunar landscape!
2002–present Professor of Clinical Neuroscience, Beaumont Hospital, Dublin, Ireland
2002–present Head of Department, Royal College of Surgeons in Ireland, Beaumont Hospital, Dublin, Ireland
2001–present Director of Research Development, National Neurosurgery Unit, Beaumont Hospital, Dublin, Ireland
2000–present Consultant neurosurgeon, Beaumont Hospital, Dublin, Ireland
1996–2000 Consultant neurosurgeon, Frenchay Hospital, Bristol, UK
1995 Consultant Neurosurgeon, Royal Adelaide Hospital, Adelaide. South Australia
1995 SAC Accreditation Neurosurgery, Royal College of Surgeons
1995 FRCSI (SN) Intercollegiate, Royal College of Surgeons
1994 PhD, Trinity College Dublin
1991 FRCSI, Royal College of Surgeons in Ireland
1987 MB BCh BAO, Trinity College Dublin
1984 BA (mod) Neurophysiology,Trinity College Dublin
2000 Royal Academy Medicine Ireland
1999 Intensive Care Society, London ISSLS, Hawaii
1987 Gold Medal Final MB Adelaide Hospital
1985 Gold Medal, Biological Society
1984 Gold Medal Final BSc, Trinity College Dublin
- President (2011), Eurospine (Spine Society of Europe)
- Representative of SBNS to EANS and WFNS
- Instructional Training Course, Eurospine (Spine Society of Europe)
- Fellowship Training Programme, Eurospine (Spine Society of Europe)
- Research and development officer, British Cervical Spine Society
- Scientific Programme Committee Eurospine (Spine Society of Europe)
- Scientific Programme Committee, World Federation Neurological Societies
- Advisor, Computer Assisted Orthopaedic Surgery Scientific
- Regional Oncology Task Force Spinal Malignancy, report, Department of Health, UK
- National Infection Advisory Committee Neurosurgery, report, Department of Health, UK
- Research Fellowship Advisory Board, Royal College of Surgeons (UK)
- Royal College of Surgeons (UK) Working Party on Image Guided Surgery
- Council member, Society British Neurological Surgeons