Why did you decide to become a Consultant Orthopaedic and Spinal Surgeon ?

I trained as a general orthopaedic surgeon, and during my training I was exposed to all areas of bones and joints. I was particularly taken with spinal surgery because it's exceptionally rewarding to be able to take a problem such as a spinal deformity and, with surgical skills, correct it such that the problem goes away for the patient. It's very rewarding in terms of how good the outcomes are and how satisfied the patients are. The spine is also a core part of you. It's not on the periphery like a hand or a wrist. It involves all systems: heart, lungs, all the organs in the abdomen. It's the core from which everything else is built. It holds you up, so it's very important, and it's challenging, technically very difficult. I was attracted to all of those things, but mainly it's the satisfaction of being able to make people so much better. There's a particular contrast with adult spine surgery, where it's much harder to make patients better. In children, there's a great feeling from being able to help them out, make them better, and give them a different life to what they would have had. That's what attracted me to it.

What are the common symptoms that your patients tend to present with?

Scoliosis and spinal deformity often don't come with any symptoms. Usually patients are fit and healthy, and most often they come in with some asymmetry around the spine, which is noticed in the summer, either by a dance teacher, a physiotherapist or a sports coach, or when they're on holiday on the beach and a parent notices. It doesn't normally come with any symptoms, and quite often the children don't know they've got a problem until it's pointed out. It can occasionally come with a bit of back pain and aching. Conditions such as back pain come primarily with back pain. Rarer conditions can come with multi-system problems, so if it's associated with other conditions like cerebral palsy or problems with the spinal cord, they can come with neurological symptoms or problems with the legs. In the main, presentations are relatively asymptomatic apart from a bit of backache, which is why it's important that patients are seen and assessed. Often, in the absence of any symptoms, families don't seek any help until there's a really significant deformity, and then it's perhaps too late to do something other than operate.

What are the treatments that you're able to offer your patients?

On the diagnostic side, it's very important when assessing spinal deformity to get a clear picture of what's going on, and that requires a combination of X-rays, MRI scans and occasionally CT scans, used judiciously with the right equipment to get good pictures with the lowest dose of radiation. We're very fortunate to have an EOS scanner, a very low-dose X-ray machine, and up to date MRI scanners for looking at the spine in great detail. On the treatment side, we try to avoid surgery as much as possible, and that often involves core physiotherapy and the use of bracing whilst children are growing. Sometimes those treatments are not enough, and then we do need to be able to intervene with surgery, which is very effective at straightening the spine and preventing it from getting worse. So we offer the full range, from conservative and non-operative treatments through to operative treatments to deal with spinal problems.

What are your areas of sub-specialist interest?

I work in the NHS at Great Ormond Street, which deals with some of the most complex problems you can imagine, not just of the bones of the spine, but also of the child as a whole in terms of other medical problems they have. So my specialist area is complex paediatric spinal surgery: the kinds of surgeries that can't be done elsewhere in other hospitals, but that need to come to national centres, not just because of the spinal problem, but because of all the other issues these children have in terms of their heart, their lungs and their brain.