Joseph Maroon

Last updated
Joseph Maroon

MD, FACS
Born (1940-05-26) May 26, 1940 (age 83)
NationalityAmerican
Alma mater Indiana University Bloomington (B.S.),
Indiana University School of Medicine (M.D.)
OccupationNeurosurgeon
Known forTeam neurosurgeon for the Pittsburgh Steelers
Medical Director of WWE
Website www.josephmaroon.com

Joseph Maroon (born May 26, 1940) is an American neurosurgeon, author, and triathlon athlete. He is the professor and vice chairman of the Department of Neurological Surgery at the University of Pittsburgh Medical Center and is the current medical director of WWE. [1] [2] He is particularly known for his work studying concussions and concussion prevention as well as his hypothesis (after the discovery of the CTE by Dr. Bennet Omalu) on the development of chronic traumatic encephalopathy (CTE).

Contents

Education

Maroon earned his B.S. degree in anatomy and physiology from Indiana University Bloomington in 1961 and his M.D. from the Indiana University School of Medicine (IUSM) in 1965. He received post-graduate education at IUSM (1966), Georgetown University Hospital (1967), John Radcliffe Hospital (1969), IUSM (1971), and the University of Vermont College of Medicine (1972). [3]

Career

Neurosurgical research and innovations

Maroon has conducted extensive research into neurotrauma, brain tumors, and diseases of the spine, which led to many innovative techniques for diagnosing and treating these disorders. Maroon was the first to publish on the use of ultrasound to detect venous air emboli (1968). Maroon et al. were the first to publish on the use of ultrasound to detect air in patients during neurosurgical procedures (1969) and to assess ophthalmic artery reversal of flow, indicating a thrombosis of the carotid artery (1969). [4] Maroon et al. published the simplified instrumentation for performing microvascular surgery in 1973, and in 1975, they pioneered the microsurgical approach to intra-orbital tumors. [5] In 1977, they pioneered the use of CT scanning as a guidance system for performing intracranial biopsy. In the same year, Maroon published the first paper on “burning hands” syndrome related to sports-related spinal cord injuries in JAMA. [6]

In 1982, Maroon et al. pioneered the radical orbital decompression procedure for severe dysthyroid exophthalmos. [7] In 1985, they were the first to compare microsurgical disc removal with chemonucleolysis [8] and in 1986, they were the first to use a carbon dioxide laser in the management of lymphangiomas of the orbit. [9] That year, Maroon et al. were among the first to describe their surgery outcomes with microlumbar discectomy. [10] In 1987, Maroon and Onik introduced percutaneous automated discectomy as a new minimally invasive way to remove lumbar discs and subsequently published extensively on this technique. [11] [12] [13] In 1990, Maroon et al. published the first microsurgical approach to far lateral disc herniations in the lumbar spine [14] [15] and in 2007, they published the case of Golfer's Stroke from Vertebral Artery Dissection. [16]

Further groundbreaking publications include the use of fish oil as an anti-inflammatory and alternative to nonsteroidal drugs for discogenic pain (2006); [17] a unifying, immunoexcitotoxicity hypothesis for chronic traumatic encephalopathy (2011); [18] and the possible use of a restricted calorie ketogenic diet for the treatment of glioblastoma multiforme (2013). [19]

Sports medicine, concussion, and chronic traumatic encephalopathy (CTE)

Maroon is the team neurosurgeon for the Pittsburgh Steelers [20] and the medical director of WWE. [21] He is past president of the Congress of Neurological Surgeons. [22]

Together with neuropsychologist Mark Lovell, Maroon developed ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing), [23] a test to assess the presence and severity of concussion symptoms. This has become the standard tool to assess sports-related concussions. [24]

Maroon is interested in the prevention and treatment of concussions, specifically in football. [25] In 2006, he joined the National Football League’s Mild Traumatic Brain Injury Committee, which, in 2007, was renamed the Head, Neck, and Spine Committee. He has been consulted as an expert by American media on this subject. [26] [27] [28]

Based on his research into the predictors and scope of chronic traumatic encephalopathy (CTE), [29] he claims there is reason to be skeptical of the reported widespread incidence of CTE. His position has mostly been met with negative comments across the media and sports press due to the NFL having as many as 4500 former players reporting symptoms of CTE. [30] [31] [32] [33] [34] [35] [36] [37]

Maroon was asked to testify to the New York City Council on a proposed rule on sideline medical coverage for organized youth football in the city. [38] Together with Russell Blaylock, he developed an inflammation hypothesis for the biochemical mechanisms involved in the development of CTE following head trauma. [39] In the 2015 movie Concussion, which "examines how American football players suffer from major head injuries and life-long debilitating problems as a result of repeated concussions, and efforts by the National Football League to deny it," [40] Maroon was played by actor Arliss Howard. [41] In the movie, Maroon is portrayed as an NFL-biased doctor who tries to deny any relationship between football concussions and the brain pathology that Dr. Bennet Omalu found and attributed to CTE. Since the release of the movie, several people have come forward in defense of Maroon, stating that his portrayal in the movie is sensationalized and incorrect. [42] [43] [44]

Burnout prevention and balancing life

After his personal experience with burnout at the peak of his medical career, Maroon developed a strong interest in burnout prevention and living a more balanced life. He conducted extensive research into burnout, burnout prevention, and what constitutes a healthy, balanced, and successful life outside of a professional career. Maroon has given keynote presentations on this subject matter at national and international conferences. [45] In 2017, he published the book Square One: A Simple Guide to a Balanced Life. [4]

Publications

Maroon has published over 300 peer-reviewed scientific articles, some of which may be found in the United States National Library of Medicine's publication database; his H-index, a measure of scientific research impact, is 58. [3] Currently, Maroon is working with Dr. Pravat K. Mandal and has proposed oxidative stress as the underlying pathogenesis of Alzheimer's disease and Parkinson's disease. [6] [7] [8] [9] [10] [11] [12]

Books

Square One: A Simple Guide to a Balanced Life [46] Maroon J, Kennedy C. (2017) ISBN   978-0-9983509-0-5

The Longevity Factor: How Resveratrol and Red Wine Activate Genes for a longer and Healthier Life [47] [48] Maroon JC. (2008) ISBN   9781416565161 (made into a PBS Special)

Fish Oil: The Natural Anti-Inflammatory [49] Maroon JC, Bost J. (2006) ISBN   9781591201823

Practice Diagnosis and Management of Orbital Disease [50] Kennerdell JS, Cockerham KP, Maroon JC, Rothfus WE. (2001) ISBN   9780750672603

What You Can Do About Cancer. Maroon JC. (1969) Doubleday& Co., New York, 185 pp. (English, Italian, German and French translations).

Athletic career

Maroon has competed in 8 Ironman Triathlons (Hawaii – 1993, 2003, 2008, 2010, 2013; [51] [52] Canada – 1995; New Zealand – 1997; Germany – 2000) [53] and is to this day an active triathlon athlete. Dr. Maroon was inducted into the Lou Holtz Upper Ohio Valley Hall of Fame [54] in 1999, the Western Chapter of the Pennsylvania Sports Hall of Fame in 2009 and in 2010 also to the National Fitness Hall of Fame in Chicago. [55] For 2016, in the global ranking of Ironman athletes, Maroon ranks in 4th place in his age group. In 2022, Maroon placed second in the National Senior Games for his age group [13] and placed first in the Chicago Triathlon for his age group. [14]

Honors and awards

Maroon received the Distinguished Alumni Service Award from Indiana University in 2011. He was also named the Humanitarian of the Year by the Jerome Bettis Bus Stops Here Foundation in 2018. Furthermore, the Indiana University Medical School presented him with the Distinguished Alumni Award in 2022.

Related Research Articles

<span class="mw-page-title-main">Neurosurgery</span> Medical specialty of disorders which affect any portion of the nervous system.

Neurosurgery or neurological surgery, known in common parlance as brain surgery, is the medical specialty concerned with the surgical treatment of disorders which affect any portion of the nervous system including the brain, spinal cord and peripheral nervous system.

<span class="mw-page-title-main">Concussion</span> Medical condition

A concussion, also known as a mild traumatic brain injury (mTBI), is a head injury that temporarily affects brain functioning. Symptoms may include loss of consciousness; memory loss; headaches; difficulty with thinking, concentration, or balance; nausea; blurred vision; dizziness; sleep disturbances, and mood changes. Any of these symptoms may begin immediately, or appear days after the injury. Concussion should be suspected if a person indirectly or directly hits their head and experiences any of the symptoms of concussion. Symptoms of a concussion may be delayed by 1–2 days after the accident. It is not unusual for symptoms to last 2 weeks in adults and 4 weeks in children. Fewer than 10% of sports-related concussions among children are associated with loss of consciousness.

<span class="mw-page-title-main">Discectomy</span> Surgical removal of an intervertebral disc

A discectomy is the surgical removal of abnormal disc material that presses on a nerve root or the spinal cord. The procedure involves removing a portion of an intervertebral disc, which causes pain, weakness or numbness by stressing the spinal cord or radiating nerves. The traditional open discectomy, or Love's technique, was published by Ross and Love in 1971. Advances have produced visualization improvements to traditional discectomy procedures, or endoscopic discectomy. In conjunction with the traditional discectomy or microdiscectomy, a laminotomy is often involved to permit access to the intervertebral disc. Laminotomy means a significant amount of typically normal bone is removed from the vertebra, allowing the surgeon to better see and access the area of disc herniation.

<span class="mw-page-title-main">Degenerative disc disease</span> Medical condition

Degenerative disc disease (DDD) is a medical condition typically brought on by the normal aging process in which there are anatomic changes and possibly a loss of function of one or more intervertebral discs of the spine. DDD can take place with or without symptoms, but is typically identified once symptoms arise. The root cause is thought to be loss of soluble proteins within the fluid contained in the disc with resultant reduction of the oncotic pressure, which in turn causes loss of fluid volume. Normal downward forces cause the affected disc to lose height, and the distance between vertebrae is reduced. The anulus fibrosus, the tough outer layers of a disc, also weakens. This loss of height causes laxity of the longitudinal ligaments, which may allow anterior, posterior, or lateral shifting of the vertebral bodies, causing facet joint malalignment and arthritis; scoliosis; cervical hyperlordosis; thoracic hyperkyphosis; lumbar hyperlordosis; narrowing of the space available for the spinal tract within the vertebra ; or narrowing of the space through which a spinal nerve exits with resultant inflammation and impingement of a spinal nerve, causing a radiculopathy.

Ralph Bingham Cloward was an American neurosurgeon, best known for his innovations in spinal neurosurgery. Cloward is known for the development of the Posterior Lumbar Interbody Fusion and Anterior Cervical Discectomy and Fusion. Cloward moved from Chicago to Hawaii in 1938, becoming the state's lone neurosurgeon. He is well known for his work treating victims of brain injuries after the Pearl Harbour attack in 1941.

<span class="mw-page-title-main">Chronic traumatic encephalopathy</span> Neurodegenerative disease caused by head injury

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease linked to repeated trauma to the head. The encephalopathy symptoms can include behavioral problems, mood problems, and problems with thinking. The disease often gets worse over time and can result in dementia.

<span class="mw-page-title-main">Andre Waters</span> American football player and coach (1962–2006)

Andre Maurice Waters was an American professional football player who was a safety for the Philadelphia Eagles and Arizona Cardinals of the National Football League (NFL) from 1984 to 1995. Waters was regarded as one of the NFL's most aggressive players, serving as an integral part of one of the league's top defenses. On November 20, 2006, Waters died by suicide and was subsequently diagnosed with chronic traumatic encephalopathy (CTE). He is one of at least 345 NFL players to be diagnosed after death with CTE, which is caused by repeated hits to the head.

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<span class="mw-page-title-main">Bennet Omalu</span> Nigerian-American pathologist

Dr. Bennet Ifeakandu Omalu is a Nigerian and American physician, forensic pathologist and neuropathologist who was the first to discover and publish findings on chronic traumatic encephalopathy (CTE) in American football players while working at the Allegheny County coroner's office in Pittsburgh. He later became the chief medical examiner for San Joaquin County, California, and is a professor at the University of California, Davis, department of medical pathology and laboratory medicine. He is currently the President and Medical Director of Bennet Omalu Pathology.

Concussions and play-related head blows in American football have been shown to be the cause of chronic traumatic encephalopathy (CTE), which has led to player deaths and other debilitating symptoms after retirement, including memory loss, depression, anxiety, headaches, stress, and sleep disturbances.

Minimally invasive spine surgery, also known as MISS, has no specific meaning or definition. It implies a lack of severe surgical invasion. The older style of open-spine surgery for a relatively small disc problem used to require a 5-6 inch incision and a month in the hospital. MISS techniques utilize more modern technology, advanced imaging techniques and special medical equipment to reduce tissue trauma, bleeding, radiation exposure, infection risk, and decreased hospital stays by minimizing the size of the incision. Modern endoscopic procedures can be done through a 2 to 5 mm skin opening. By contrast, procedures done with a microscope require skin openings of approximately one inch, or more.

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<span class="mw-page-title-main">High-definition fiber tracking</span>

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<i>Concussion</i> (2015 film) 2015 film by Peter Landesman

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<span class="mw-page-title-main">Boston University CTE Center and Brain Bank</span>

The Boston University CTE Center is an independently run medical research lab located at the Boston University School of Medicine. The Center focuses on research related to the long-term effects of brain trauma and degenerative brain diseases, specializing in the diagnosis and analysis of chronic traumatic encephalopathy (CTE). According to researchers at Boston University, CTE is a brain disease involving progressive neurological deterioration common in athletes, military personnel, and others who have a history of brain trauma. The disease is primarily caused by repeated blows to the head, some of which result in concussions or sub-concussive symptoms.

Most documented cases of chronic traumatic encephalopathy have occurred in many athletes involved in contact sports such as boxing, American football, wrestling, ice hockey, mixed martial arts, rugby and soccer. Other risk factors include being in the military, prior domestic violence, and repeated banging of the head. The exact amount of trauma required for the condition to occur is unknown. Below is a list of notable cases of CTE in sports.

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References

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  6. 1 2 Maroon JC (1977-11-07). "'burning hands' in football spinal cord injuries". JAMA. 238 (19): 2049–2051. doi:10.1001/jama.1977.03280200061022. ISSN   0098-7484. PMID   578906.
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  13. 1 2 Maroon, J. C.; Onik, G.; Sternau, L. (1989-01-01). "Percutaneous automated discectomy. A new approach to lumbar surgery". Clinical Orthopaedics and Related Research. 238 (238): 64–70. doi:10.1097/00003086-198901000-00009. ISSN   0009-921X. PMID   2910619.
  14. 1 2 Maroon, J. C.; Kopitnik, T. A.; Schulhof, L. A.; Abla, A.; Wilberger, J. E. (1990-03-01). "Diagnosis and microsurgical approach to far-lateral disc herniation in the lumbar spine". Journal of Neurosurgery. 72 (3): 378–382. doi:10.3171/jns.1990.72.3.0378. ISSN   0022-3085. PMID   2303871.
  15. Onik, G.; Maroon, J.; Shang, Y. L. (1990-10-01). "Far-lateral disk herniation: treatment by automated percutaneous diskectomy". AJNR. American Journal of Neuroradiology. 11 (5): 865–868. ISSN   0195-6108. PMC   8334087 . PMID   2120989.
  16. Maroon, Joseph C.; Gardner, Paul; Abla, Adnan A.; El-Kadi, Hikmat; Bost, Jeffrey (2007-02-01). ""Golfer's stroke": golf-induced stroke from vertebral artery dissection". Surgical Neurology. 67 (2): 163–168, discussion 168. doi:10.1016/j.surneu.2006.03.045. ISSN   0090-3019. PMID   17254877.
  17. Maroon, Joseph Charles; Bost, Jeffrey W. (2006-04-01). "Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain". Surgical Neurology. 65 (4): 326–331. doi:10.1016/j.surneu.2005.10.023. ISSN   0090-3019. PMID   16531187.
  18. Blaylock, Russell L.; Maroon, Joseph (2011-01-01). "Immunoexcitotoxicity as a central mechanism in chronic traumatic encephalopathy-A unifying hypothesis". Surgical Neurology International. 2: 107. doi: 10.4103/2152-7806.83391 . ISSN   2152-7806. PMC   3157093 . PMID   21886880.
  19. Maroon, Joseph; Bost, Jeffrey; Amos, Austin; Zuccoli, Giulio (2013-08-01). "Restricted calorie ketogenic diet for the treatment of glioblastoma multiforme". Journal of Child Neurology. 28 (8): 1002–1008. doi:10.1177/0883073813488670. ISSN   1708-8283. PMID   23670248. S2CID   1994087.
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