Writing books and learning neurosurgery by questions and answers

I recently published a book mainly aimed at doctors doing neurosurgery for their post-graduate end-of-training examinations, both the US residency boards and the UK FRCS(Neuro.Surg) exams among others.  It was quite an undertaking largely tackled by its hard working first author.

Neurosurgery Self-Assessment: Questions and Answers

It’s only my second foray into academic book publishing.  My first book published earlier in 2016 was more of an academic monograph related to my doctoral research with Mr. Alex Green and Mr. Jonathan Hyam in

Surgery of the Autonomic Nervous System

I have written over 20 book chapters, notably chapters on epilepsy surgery and imaging in the well known neurosurgical textbook Schmidek and Sweet, and recently the Basal Ganglia chapter with Prof. Tipu Aziz of the famous medical tome Gray’s Anatomy.  However, to write a whole academic book is a much more daunting commitment over a couple of years and it’s very gratifying to learn that the final product has been well received both in print and in its interactive online versions on ExpertConsult and Inkling.  The book is unique in containing the type of extended matching questions increasingly used in the British and other examinations.

I am delighted to learn from Elsevier that the question book is a best-seller among the neurosurgical community and that they are now doing a reprint within a few months of its release.  This gives us a great opportunity to incorporate feedback from the trainees and established neurosurgeons who have read it and spotted any first edition typos or other minor points for correction!

Advertisements

Can deep brain stimulation or spinal cord stimulation improve spinal cord injury?

This is an exciting field of research.  I am lucky to be working as an academic consultant neurosurgeon in a University Hospital with an academic neurosurgeon colleague, Professor Marios Papadopoulos, an experienced general, complex spinal and vascular neurosurgeon whose current research is yielding fascinating insights into acute spinal cord injury (SCI) that may change its initial treatment and improve outcomes.

One of my research interests lies at the interface of spinal cord injury and neuromodulation with the question of whether brain computer interfaces can improve the disabling signs and symptoms of SCI.  We just published a review of the field:

Surgical Neurostimulation for Spinal Cord Injury.

SCI is a devastating neurological condition characterized by a constellation of symptoms including paralysis, paraesthesia, pain, cardiovascular, bladder, bowel and sexual dysfunction. Current treatment for SCI involves acute resuscitation, aggressive rehabilitation and symptomatic treatment for complications. Despite the progress in scientific understanding, regenerative therapies are lacking. In this review, we outline the current state and future potential of invasive and non-invasive neuromodulation strategies including deep brain stimulation, spinal cord stimulation, motor cortex stimulation, transcutaneous direct current stimulation and repetitive transcranial magnetic stimulation in the context of SCI. We consider the ability of these therapies to address pain, altered sensation, weakness, blood pressure and bladder problems (autonomic dysregulation) associated with SCI. In addition to the potential to make important contributions to SCI treatment, neuromodulation has the added ability to contribute to our understanding of spinal cord neurobiology and the pathophysiology of SCI.

The prospect of using spinal cord stimulation to improve spinal cord injury is appealing as it is a procedure I already perform regularly to treat chronic pain when medicines don’t work.  Similarly, I do deep brain stimulation surgery frequently to treat Parkinson’s disease.  I also perform deep brain stimulation and motor cortex stimulation for chronic pain, but unfortunately these treatments are generally not NHS funded so I can only do the surgeries privately or internationally.

My own doctoral research during my neurosurgical training investigated the role of deep brain stimulation of a structure called the midbrain periaqueductal grey to relieve chronic pain, and its effect upon autonomic function, supervised by two established academic functional neurosurgeons at Oxford University, Mr. Alex Green and Prof. Tipu Aziz.  Modern biomedical science progresses through incremental discoveries building on a body of knowledge and expertise, rather than Eureka moments, so to investigate deep brain stimulation for SCI would be a natural continuation of that award winning research.