Buffalo Bills Football Player Receives New Spinal Treatment
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RAY SUAREZ: Buffalo Bills tight-end Kevin Everett was making what appeared to be a routine tackle on Sunday against the Denver Broncos, but his helmet hit another player’s shoulder pad. In an instant…
ANNOUNCER: Everett is down.
RAY SUAREZ: … he lay motionless on the field. His teammates knelt down to pray, as Everett was loaded into an ambulance, having fractured and dislocated his spine between his third and fourth vertebrae.
The initial prognosis was grim. Doctors said Everett was paralyzed from the shoulders down. Dr. Andrew Cappuccino operated on the athlete.
DR. ANDREW CAPPUCCINO, Buffalo Bills Orthopedic Surgeon: I told Kevin that the chances for a full neurologic recovery were bleak, dismal. With my clinical examination, prior to surgical intervention, I felt that it was less than a 5 percent or 10 percent chance that he would ever regain full utilization.
RAY SUAREZ: Even Everett’s fellow players, accustomed to football injuries, struggled to make sense of the situation.
RYAN NEUFELD, Buffalo Bills Tight End: It’s pretty somber — you know, having a teammate get hurt like that’s pretty tough, but the surgery went well, as far as what we could tell, and he’s just recovering right now.
RAY SUAREZ: Then yesterday, news of a surprising improvement. Doctors reported Everett had some movement in his arms and legs. Dr. Kevin Gibbons.
DR. KEVIN GIBBONS, Millard Fillmore Gates Hospital: He demonstrated clear improvement in the motor function in his legs, brisk ability to push his knees together and apart, the ability to wiggle his toes, slight movement at the ankles, and most importantly, from our standpoint, the ability, with his knee elevated, to kick out his lower leg against gravity.
RAY SUAREZ: Doctors were also encouraged that Everett’s spinal cord was intact rather than severed, but they cautioned much is still unknown.
DR. ANDREW CAPPUCCINO: We still are looking at many weeks to month scenario, and walking out of this hospital really is not a realistic goal, but walking may very well be.
Analysis from a neurosurgeon
RAY SUAREZ: In the aftermath of his injury on Sunday, one treatment Everett received was a therapy called moderate hypothermia. Doctors cool the body a few degrees by injecting icy saline into the patient. The goal is to limit swelling, inflammation, and other spinal cord damage.
Some specialists say the therapy may hold hope for other patients like Kevin Everett. Eleven thousand Americans suffer a catastrophic spinal cord injury each year.
For more on the hypothermia treatment and its possibilities, we turn to Dr. Rob Parrish. He's a neurosurgeon at the Methodist Neurological Institute in Houston.
And, Dr. Parrish, here you've got Kevin Everett being rushed off the field with a disk in his neck pressing heavily against his spinal cord. Why cool down his body?
DR. ROB PARRISH, Methodist Neurological Institute: Well, there's some evidence that spinal cord injuries can be attenuated or lessened by treatment after the injury. You know, we have secondary or additional injuries that occur to the spinal cord in the hours, days, weeks, and months after the injury, and the hypothermia tries to decrease that injury and the cell death that comes after the initial injury.
RAY SUAREZ: Expand on that a little bit. What's happening to your spinal cord as a result of those bones pressing against it that you either slow down or stop by using a cooler body?
DR. ROB PARRISH: Well, it may not be just the cooler body. You know, the emergency surgery is also an important part of the treatment of the spinal cord injury, so it reduces the additional mechanical injury to the spinal cord. And we're not sure that it was the hypothermia that turned things around.
The hypothermia -- the use of hypothermia in stroke, and heart attacks, and head injuries is experimental at this time. It's been used in the past. It's doing better now that we have ways of controlling the temperature more precisely than we did even five years ago.
So I think it's an important way to go, but we only have this as an anecdotal case, you know, one case that showed success with hypothermia and emergency surgery and, I might add, very good care by the emergency medical people on the field.
Using hypothermia treatment
RAY SUAREZ: Now, hypothermia is something we normally try to avoid. When I was taking first aid merit badge in scouting, I was told that somebody just injured, if they show any signs of chills, bundle them up, because they're -- one of the side effects of shock could be loss of body temperature. How did we figure out that a little hypothermia, a little lowering of the body temperature might provide a window?
DR. ROB PARRISH: Well, I'm not sure how we figured it out, but there's a lot of investigation going on to spinal cord and neurological injury, both around the world and at the Neurological Institute here in Houston, so it's these advances that we have to look into and expand with more research.
RAY SUAREZ: Looking at the particular case of Kevin Everett, is a third and fourth vertebrae injury considered extremely serious compared to other spinal injuries?
DR. ROB PARRISH: Yes, sir. It's often fatal unless there are emergency medical teams right at hand. As many people may know, the diaphragm and ability to breathe is lost with an injury that high in the spinal cord.
RAY SUAREZ: And in addition to surgery and the other things they've attempted, I guess they found that there was still a lot of good living tissue and not accompanying cell death. What can you do in the immediate days, in the first few days after an injury, to try to get control of the situation so things don't continue to deteriorate?
DR. ROB PARRISH: Well, there are a number of studies that are underway around the country, around the world. These are studies that involve the molecular biology of spinal cord injury and the mechanics of spinal cord injury following the initial insult to the spinal cord.
Improving spinal injury treatment
RAY SUAREZ: And how long are we talking about keeping a patient slightly chilled? Is this something that is advised or, as we're finding out through more research, something that you just do for a finite period of time? Or is this something that can go on for several days?
DR. ROB PARRISH: Well, that's not known. That's a reason that research is underway into spinal cord injury and hypothermia for all those other diagnoses that I mentioned.
Hypothermia, as you pointed out, can be very deleterious to your health. It causes changes in the ability of the blood to coagulate. It can cause heart arrhythmias. And very profound hypothermia, of course, leads to death.
RAY SUAREZ: So do we even have a set of widely used techniques that are completely understood and sort of systematized in medicine for doing this, or is it just something that we're just sort of figuring out, still figuring out how to do?
DR. ROB PARRISH: Well, we're still figuring it out in some ways, but we do have methods of inducing hypothermia that are outlined in many of these protocols for stroke, spinal cord injury, cardiac arrest, and head injury.
RAY SUAREZ: Now, when we're talking about the way medicine works, in a big country like this, when there's a high-profile injury, when a technique is given a lot of attention in the news, does it become more widely examined? Does it get a little faster adoption? Can Kevin Everett's injury bring hypothermia as a treatment technique to wider use?
DR. ROB PARRISH: Well, I hope that it can bring it to more attention in the research around the country. It certainly has elevated the awareness of spinal cord injury. And, as you mentioned earlier, there are 11,000 people with spinal cord injuries just in our country each year. That's a huge social problem and one that we need to continue to investigate every way to prevent and to improve that outcome.
RAY SUAREZ: Well, Dr. Parrish, thanks for joining us.
DR. ROB PARRISH: Yes, sir. Thank you for having me.