Professor of Spine Surgery
Jeremy graduated from Cambridge University and St Thomas's Hospital Medical School in London. He was trained in a Spine Fellowship at Oswestry, where he wrote his MD thesis on the facet joint. He moved to an orthopaedic rotation based at St Bartholomew's Hospital, London, that included time in Norwich, the Royal National Orthopaedic Hospital and Great Ormond Street Hospital in London, as well as a 6 month Fellowship in Dallas, Texas.
Jeremy is Professor of Spinal Surgery at the Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences, He is just retired as a spinal surgeon from the Spinal Unit, Oxford University Hospitals.
Activities and specialities
He published the Oswestry Disability Index (ODI) in 1980, which has grown into a near on universally used outcome measure in spinal disorders. He moved to Oxford in 1989. He developed and led the MRC Spine Stabilisation Trial, which has had international impact in comparing the outcome of intensive rehabilitation in the management of chronic low back pain versus spinal fusion.
Throughout his time in Oxford he has worked with scientists on aspects of spine research, particularly Dr Jill Urban. His research includes a series of in-vivo studies of the physiology of the intervertebral disc (pressure profiles, pO2 and pNO2, gadolinium diffusion), clinical trials in back pain, including the MRC trial described above. He has been joint Chief Investigator on 2 EU-funded project grants, EuroDisc and GenoDisc. He has recently published a collaborative analysis of adjacent Segment disc degeneration and clinical outcomes in the participants of 4 large randomised trials of spinal fusion versus non-operative care. Currently he is working with engineers in the University of Oxford developing image analysis of lumbar MRI scans, work which has recently been awarded the 2017 ISSLS Prize for spinal research. A separate project is to publish long-term results of a new method of staged, low invasive surgery in children and young adults at high risk from spinal deformity surgery. He has collaborated with Dr Emma Clark in Bristol to see the consequence of spinal curvatures on the growth and development and schooling within the birth cohort, ALSPAC. He has nearly 200 refereed publications.
The Oswestry Disability index has played a large part in his research career, and has taught him much about health outcome measures and how they need 'care and attention'. Other investigators can always see ways to improve a measure, but these 'improvements' frequently have unintended consequences. He became involved in the MAPI Trust to help protect the instrument from these destructive changes. This Trust based in Lyon, France cares for over a thousand 'instruments' or questionnaires. It is particularly concerned about accurate translation of these instruments. The process of accurate translation has proved to be an important process for evaluating an instrument, and we have learnt much about the function of an instrument in doing this. ODI provides a gold standard for new outcome measures. ODI has over 60 translations. He was a member of the ICHOM team set by Harvard Business School developing preferred outcome measures for spinal disorders.
In the UK he has been involved in research administration, and was joint clinical Director of the Thames Valley Clinical Research Network for 5 years. This was part of a nationwide network that sought to develop clinical research in all parts of medical practice, and particularly the use of Research Nurses to facilitate clinical trial recruitment. During his office, Thames Valley raised its national ranking in terms of recruitment to clinical trials from 12th position to first. The NHS in Britain has developed into an important research tool for large scale studies and rapid recruitment to specific trials. Recently he has become more involved in patient and public involvement in developing research questions and the design of clinical trials, especially in surgery. He was a member of a James Lind Alliance Priority Setting Partnership on spinal cord injury, and now he is clinical lead of another PSP on Scoliosis. Grant givers in the UK are paying increasing attention into public involvement in studies that they fund, and this has now gone far beyond just paying lip service to the thoughts of a few patients to a principle of real impact for clinical and health related laboratory research.
Jeremy has been Secretary of the Society for Back Pain Research, President of British Scoliosis Society, President of International Society for the Study of the Lumbar Spine and Chair of United Kingdom Spine Societies Board. He has been a member of the NIHR HTA Interventions Panel since 2014. He has sat on and sits on various Boards or research committees of charities involved in spinal research and patient support. These include BackCare, British Scoliosis Research Foundation, Orthopaedic Research UK, Neuro Foundation, Action Medical Research, Back-to-Back...
Leisure and life
Jeremy has loved the outdoors. At various times this has involved sailing, hiking, biking and skiing, and just having fun. His daughter has enjoyed competitive eventing since her very young years, and her father has done and still doing much support work for this. Jeremy has written papers on historic aspect of the spine. Most recently this has been about scoliosis in the man (Gideon Mantell) who discovered several of the first dinosaurs in the Sussex weald, whose post-mortem triggered an understanding and description of the first screening test for scoliosis. In 2016 was reported the first (and only) fossilised dinosaur brain ever discovered. It was from Iguanadon mantelli (http://dx.doi.org/10.1144/SP448.3).