Colin Shirley

Mr Colin Shirley Consultant Clinical Neurophysiologist

I am a consultant clinical neurophysiologist working at the University Hospital Birmingham NHS Foundation Trust. I graduated with medical honours and the medical school’s year medal from the University of Dundee and undertook core general medical training in Tayside including time spent in neurology, neurosurgery and stroke medicine, during which time I co-authored a book for the Royal Society of Medicine Press.

I subsequently moved to the West Midlands and undertook specialist training in Clinical Neurophysiology at UHB, UHNS and Birmingham Children’s Hospital and spent a period of time as a neurology registrar.

My sub-specialist interests include intra-operative monitoring for spinal deformity surgery, corticography and eloquent cortex mapping for epilepsy surgery, long term monitoring in epilepsy and micro electrode recording for deep brain stimulation electrode placement. I also work as part of the peripheral nerve and plexus injury team to perform pre-operative assessment of plexus injuries.

I currently contribute to the national neurophysiology audit group and am involved a number areas of research and service development including peripheral nerve re-construction and the novel use of peripheral nerve transfer techniques.
The spinal monitoring team consists of a very dedicated group of physiologists and my colleague Dr Rajdeep Jain and myself.

No form of surgery is without risk and one important but relatively uncommon complication of spinal deformity surgery is injury to the spinal cord. The risk of this happening is in part dependent on the type of surgery being performed and whether there are specific pre-existing problems with the individual patient’s spinal cord.

There are a number of techniques available for monitoring spinal surgery, the basic principle involves generating electrical impulses in the front or back (anterior or posterior) parts of the spinal cord. By establishing a base line before surgery begins we can then repeatedly monitor the spinal cord’s function throughout the procedure, the aim of this is to alert the surgeon to any potential changes that may indicate that the cord is being compromised at the earliest opportunity and allow the surgeon to take action to avoid permanent injury to the cord.

Whilst there are still rare cases where problems can still be experienced following spinal deformity surgery, where spinal cord monitoring was unable to detect the problem, there is a substantial amount of research that has demonstrated the technique to be very effective at preventing spinal cord injury.

Spinal cord monitoring when used appropriately is a safe and effective procedure. Our team assesses patients prior to surgery to ensure the technique is likely to be effective and that there are no good reasons why any particular part of monitoring should not be undertaken. It also gives the team the opportunity to explain how we perform monitoring and allows patients and their relative’s time to ask questions they may have about the monitoring process.