Watkins Medical Centre
Level 8, 225 Wickham Terrace,
Spring Hill QLD, 4000

All appointments
Phone: (07) 3831 7034

Personal Details

Dr McCombe is an orthopaedically trained spinal surgeon. He has a special interest in disc replacement surgery in the lumbar (low back) spine and cervical (neck) spine as well as in disorders of spinal posture (sagittal imbalance). He is also interested in cases of deformity causing nerve compression such as spondylolisthesis and degenerative adult scoliosis. He inserted the first cervical disc replacement in Australia in 2000. He has an interest in spinal implant design and, in conjunction with a neurosurgical colleague, has designed two implant systems used for posterior lumbar interbody fusion (R90 and Capstone Contol). He conducts clinical research into patient outcomes and theoretical mathematical analysis of spinal balance.

Dr McCombe has contributed to the Spine Society of Australia by serving as Secretary and President (2008-2010).

Curriculum Vitae

EDUCATION

Undergraduate MB.BS. University of Queensland 1977

Postgraduate
FRACS (Orthopaedics) 1987

Certified member of American Board of Independent Medical Examiners

MEMBERSHIPS

Member Australian Medical Association
Fellow Australian Orthopaedic Association
Member Spine Society of Australia

Corresponding member North American Spine Society

OTHER POSTS

Chairman Department Orthopaedics
St Andrews War Memorial Hospital
Brisbane 2003 -2006

Secretary Spine Society of Australia
2004 – 2007

Vice President Spine Society Australia
2007 – 2008

President Spine Society Australia
2008 - 2010

Immediate past President Spine Society
2010 - 2012

Honorary Senior Lecturer, Department of Medicine, University of Queensland

2002 - present day

Chairman of Orthopaedics Royal Brisbane & Women's Hospital

2012 - present day

Chairman Australian Orthopaedic Association - Queensland branch 2013

 

POST GRADUATE EXPERIENCE
Jan 1993 - present

Public Practice
Visiting Orthopaedic Surgeon
Royal Brisbane Hospital

Private Practice
Visiting Orthopaedic Surgeon
St Andrews War Memorial Hospital Brisbane

 

Jun 1991 - Dec 1992

Queen Elizabeth II Jubilee Hospital
Visiting Orthopaedic Surgeon

Private Practice
VisitingOrthopaedic Surgeon St Andrews War Memorial Hospital and Sunnybank Private Hospital

Jan 1989 - Jun 1991

Queen Elizabeth II Jubilee Hospital
Director of Orthopaedic Surgery

Jan 1987 - Dec 1988

Royal Orthopaedic Hospital
Birmingham UK.
Senior registrar
Locum consultant
Research fellow

Jan 1982 - Dec 1986

Australian Orthopaedic Association training program
Princess Alexandra Hospital
Mater Hospital Brisbane
Royal Brisbane Hospital

Jan 1978 - Dec 1981

Internship and Basic Surgical Training
Princess Alexandra Hospital Brisbane

Innisfail District Hospital

Princess Margaret Hospital Hospital Swindon UK

PUBLICATIONS

'Swanson silastic wrist replacement. A retrospective study of fifteen cases.' Journal of Hand Surgery; Vol 10-13. No 2. Jun 1985.

 

'Reproducibility of physical signs in low back pain.' Spine; 14:908-919; 1989

 

'Pull-out force of 3M staplizer staples in cadaveric femoral metaphyses.' Journal of Orthopaedic Trauma .4:2; 158-162 1990

 

'Outcomes following treatment of metastatic spine tumours.' Bull. Hosp. Jt. Dis.1998;57:11-5

 

Adam C, Pearcy M, and McCombe P. 'Stress analysis of interbody fusion--finite element modelling of intervertebral implant and vertebral body.' Clin. Biomech.(Bristol., Avon.) 2003;18:265-72.

'An analysis of the histories of patients with common syndromes of back pain from a computer database.' In 'Back Pain Classification of Syndromes.' Manchester University Press 1990. Edited Pynsent and Fairbank.

'Decision Analysis' in 'Assessment Methodology in Orthopaedics.' Butterworth Hieneman 1997. Edited by Pynsent and Fairbank

 

'Kinematics of cervical and lumbar total disc replacement.' (with Sears W and Sasso R) Semin Spine Surg 18:117-129 2006

 

'Health-related quality of life: a comparison of outcomes after lumbar fusion for degenerative spondylothesis with large joint replacement surgery and population norms.' (with Mokhtar, Sears, Williamson, Morgan & White) The Spine Journal Vol 10 No 4: 306-312 April 2010

 

'Lumbo-pelvic lordosis and the pelvic radius technique in the asessment of spinal sagittal balance: strengths and caveats.' (with White,G., Mokhtar.S., Sears,W.R.) European Spine Journal 20 Suppl 5:591-601, 2011

MAJOR INVITED LECTURES AND AWARDS

1989 Volvo award for clinical research into low back pain. Awarded by the international society for the study of the lumbar spine

 

Sofamor Danek Prize for best paper at Australian Spine society meeting Adelaide April 2000

 

Spinal Research award Australian Spine Society meeting Freemantle 2001

 

Sofamor Danek Prize for best paper at Australian Spine Society meeting Melbourne, April 2002

 

 'Orthopaedic Spine surgery and Neurosurgical spine surgery: Ebony and Ivory or Harmony.' Invited lecture American Association of Neurological Surgeons and Congress of Neurological Surgeons. Joint section Spine Surgery. Phoenix Arizona USA March 2007.

 

 'Motion Preservation: Current Clinical & Basic Science Challenges -Lumbar Total disc Replacement; Basic Science.'  Invited lecture Spine Arthroplasty Society Meeting , London, April 2009.

 

 'Posterior lumbar interbody fusion vs Transforaminal lumbar interbody fusion.' Medtronic Interbody meeting, Melbourne, March 2009.

 

'How much lordosis is necessary in degenerative scoliosis?' Advances in Spine Meeting - The Aging Spine, Hunter Valley NSW August 2009.

 

'Clinical decision making: a statistical perspective' Elevating Best Practice in Spine 2011 Meeting, Sydney, March 2011.

 

'Evidence, regulation and reimbursement' Elevating Best Practice in Spine 2011 Meeting, Sydney, March 2011.

 

International Society for the Advancement of Spine Surgery meeting 'Kostuik Innovation Award', Las Vegas April 2011

 

Invited Biomechanics chairman International Society for the Advancement of Spine Surgery meeting , Las Vegas April 2011

 

Kostuik innovation award 2011 - International Society for the advancement of spine surgery, Las Vegas April 2011 for paper 'Cost effectiveness of Cervical disc replacement'

 

Alistair Robson Award 2012, The Spine Society of Australia 23rd Annual Scientific Meeting 2012 for paper, 'Compensatory mechanisms and the effect of age on sagittal balance in spondylolisthesis: an analysis utilizing the pelvic radius technique.'

 

Invited guest speaker  President's Session,  Spine Society of Australia Annual Scientific Meeting, Adelaide April 2018.

SCIENTIFIC PRESENTATIONS

'Reproducibility of physical signs in low back pain.' ISSLS meeting Kyoto 1989

 

'Reproducibility of physical signs in low back pain.' Spine Society of Australia scientific meeting, Canberra 1990

 

'Analysis of 3 dimensional motion of patients with back pain.' Spine Society of Australia scientific meeting, Gold Coast 1997

 

'Laparoscopic anterior lumbar fusion with carbon fibre cages.' Spine Society of Australia scientific meeting, Queenstown 1998.

 

'Osteogenic protein as an adjunct to laparoscopic anterior interbody fusion.' Spine Society of Australia scientific meeting, Queenstown 1998.

 

'Experience with OP-1 in human interbody spine fusion.' 3rd international OP1 conference. Woodstock Vermont USA

 

'Decision analysis in spinal fusion for back pain.' Spine Society of Australia scientific meeting, Adelaide April 2000

'Should posterolateral fusion be added to posterior lumbar interbody fusion.' EuroSpine meeting, Antwerp Belgium Oct 2000

 

'Experience with OP-1 in human interbody spine fusion.' Spine Society of Australia scientific meeting, Freemantle April 2001

 

'Should posterolateral fusion be added to posterior lumbar interbody fusion?' Spine Society of Australia scientific meeting Freemantle April 2001

 

'Decision analysis in spinal fusion for back pain.' International Society for the Study of the Lumbar Spine meeting. Edinburgh, Scotland, June 2001

 

'Can Posterior Lumbar Interbody Fusion with carbon spacers restore lordosis and disc height?' Spine Society of Australia scientific meeting Melbourne April 2002

 

'Stress analysis of interbody fusion – a finite element methodology for modelling the intervertebral implant and vertebral body.' IMAST conference Montreaux Switzerland, May 2002

 

'Can Posterior Lumbar Interbody Fusion With Carbon Spacers Restore Lordosis And Disc Height?' IMAST conference Montreaux, Switzerland, May 2002

 

'Should posterolateral fusion be added to posterior lumbar interbody fusion?' Australian Orthopaedic Association (QLD) scientific meeting, Townsville, June 2002

 

'The design rationale for a new insert & rotate posterior lumbar interbody fusion spacer. Australian Orthopaedic Association (QLD) scientific meeting, Townsville, June 2002

 

'A multicenter, prospective, randomized study of an artificial cevical disc versus fusion for primary cervical disc surgery.' Cervical Spine Research Society, Miami USA, Dec 2002

 

'Posterior lumbar interbody fusion using insert and rotate interbody implants.' Spine Society of Australia scientific meeting, Canberra, April 2003.

 

'A multicenter, prospective, randomized study of an artificial cevical disc versus fusion for primary cervical disc surgery.' Spine Society of Australia scientific meeting, Canberra, April 2003

'Comparison of anterior and posterior fusion with disc arthroplasty for discogenic back pain.' Spine Society of Australia scientific meeting, Coolum Queensland, April 2004

 

'Comparison of SB Charité disc arthroplasty to Maverick disc arthroplasty in the lumbar spine.' Spine Society of Australia scientific meeting, Auckland New Zealand, April 2005.

 

'A minimum energy stiffness model of spinal sagittal balance: feasibility study and initial results.' Spine Society of Australia scientific meeting, Sydney, April 2006.

 

'Limiting disc arthroplasty subsidence by moving the centroid of the end plate closer to the axis of rotation.' Spine Society of Australia scientific meeting, Adelaide, April 2008

 

'A theoretical kinematic analysis of sliding core disc arthroplasty devices.' Spine Society of Australia scientific meeting, Adelaide April 2008

 

'A self stabilizing sliding core disc arthroplasty prosthesis.' Spine Society of Australia scientific meeting, Brisbane April 2009.

 

'Comparison of the movement of the instant axis of rotation between two types of mobile core total disc arthroplasty by numerical simulation.' Spine Society of Australia scientific meeting, Christchurch April 2010.

 

'Comparison of the movement of the instant axis of rotation between two types of mobile core total disc arthroplasty by numerical simulation.' International Society for Advancement of Spine Surgery  SAS) meeting, New Orleans April 2010.

'New technologies have a role in the treatment of lower back pain' Debate Australian Orthopaedic Association  scientific meeting, Melbourne, April 2011.

'Evaluation of evidence for surgical interventions' Joint AOA -Spine Society of Australia scientific meeting, Melbourne April 2011.

'Observations on evidence based medicine and application to surgical practice' Spine Society of Australia scientific meeting, Melbourne April 2011.

'A software simulation of spinal sagittal balance' Spine Society of Australia scientific meeting, Melbourne April 2011.

'Cost effectiveness of single level cervical disc arthroplasty'  International Society for the Advancement of Spine Surgery meeting  , Las Vegas April 2011

'The fusion approach - a cervical case study' International Society for the Advancement of Spine Surgery meeting , Las Vegas April 2011

'Posterior column osteotomies, PSOs & VCR' Sydney Spinal Deformity Meeting, Sydney June 2011

'Cost effectiveness of single level cervical disc arthroplasty'  ' North American Spine Society 26th Annual General Meeting, Chicago November 2011.

 'Motion preservation in the spine - A healthcare economics perspective, eg is it less of a burden on the healthcare systems to not have reimbursement for artificial cervical discs?' The International Society for the Advancement of Spine Surgery, Barcelona March 2012.

'Adjacent segment degeneration -will it ever be proven that motion preservation devices in the lumbar spine will delay the onset of adjacent segment degeneration?' The International Society for the Advancement of Spine Surgery, Barcelona March 2012.

 'Sagittal plane deformities and the importance of sagittal balance' Medtronic Deformity Symposium, Sydney, August 10-11 2012.

'Role of interbody fusion in adult deformity' Medtronic Deformity Symposium, Sydney, August 10-11 2012.

'Degenerative scoliosis: how high? How long? - strategy to include the sacrum and pelvis' Medtronic Deformity Symposium, Sydney, August 10-11 2012.

'Clinical relevance: literature review - flat back deformity, failed back, revision surgery: a sagittal imbalance problem?'Medronic Sagittal Balance Master Course, Bangkok, August 24-25 2012

'The aging process and sagittal balance consequences - the biomechanical consequences of aging - disc collapsing, canal narrowing, rotatory dislocation' Medronic Sagittal Balance Master Course, Bangkok, August 24-25 2012

'Kyphoscoliosis - where to start, where to finish, coronal and sagittal plane correction, how to avoid complications' Medronic Sagittal Balance Master Course, Bangkok, August 24-25 2012

'How did we manage to get an MBS code and what does it now mean? - a case discussion',Motion Preservation Symposium: The fusion illusion, Sydney November 16-17 2012.

'Extreme lateral interbody fusion forum' , Sydney November 30 - December 1 2012.

'Sagittal Balance - How to measure it' Medtronic Adult Deformity Symposium, Sydney August 23-24 2013.

'Anterior column support for L-S fusion - biomechanical rationale' Medtronic Adult Deformity Symposium, Sydney August 23-24 2013.

'Managing osteoporosis - peroperative assessment' Medtronic Adult Deformity Symposium, Sydney August 23-24 2013.

'Biomechanics & cervical arthroplasty implants: Are they all the same?' Deformity Down Under Symposium, Sydney August 29-30 2014

'Osteoporosis: Assessment and Surgical Planning' Ageing Spine Symposium, Melbourne November 21-22 2014

'Clinical Evaluation and Overview of Radiological Investigations' Ageing Spine Symposium, Melbourne November 21-22 2014.

'How new understnding of saggittal alignment of the spine is changing practice' AOA (Qld branch) Annual Scientific Meeting 2015 Gold Coast, May 30-31 2015.

'Forces - Vectors, moments, pure moments. Motion -translation, rotation, degrees of freedom, etc'. Spine Society of Australia: Biomechanics in the Barossa, May 26-28 2016.

'Sacral and iliac fixation'. Spine Society of Australia: Biomechanics in the Barossa, May 26-28 2016.

'Kinematics of segmental motion and disc replacement mechanisms'. Spine Society of Australia: Biomechanics in the Barossa, May 26-28 2016.

'The assessment & quantification of adult spinal deformity - what is clinically & surgically relevant for spinal surgeons'. Neurosurgical Society of Australia Annual Scientific Mtg 2016, Sydney,  August 31 - September 2 2016.

'A model for analysing proximal end constraint for biomechanical testing of the lumbar spine:Possible clinical significance'. Spine Society of Australia Scientific Mtg 2017, Hobart, 7-9 April 2017.

'What is the maximum T1 slope to achieve cervical correction'? The Ageing Symposium,  Sydney, 18-19 August 2017.

'What is Cone of Balance'? The Ageing Symposium,  Brisbane, 17 - 18 August 2018.

'A theory for the causation of proximal junctional kyphosis'. Spine Society of Australia Scientific Mtg 2019, Gold Coast, 5-7 April 2019.