The March issue of Orthopedics has an interview with Andrew Cappuccino, who is the assistant team orthopedic surgeon for the NFL Buffalo Bills. Bills player Kevin Everett was injured while making a tackle and suffered complete paralysis below the neck. The injury was a fracture dislocation of the neck-area spinal vertebrae known as C3 and C4 (Cervical 3 and 4, with number 1 being the first vertebra below the skull).
Dr. Cappuccino is the surgeon who has operated on Everett and is supervising his recovery. His treatment is working very well, as he is now in rehabilitation, after three weeks of hospital treatment, and is lifting weights and working with a harness mechanism.
What is hypothermia?
Part of his treatment was moderate hypothermia during surgery. Hypothermia is a lower body temperature than normal – 98.4 degrees F. Taken too far, as someone might experience it after a skiing accident, hypothermia is fatal, as it slows down all body processes until the brain stops and the heart stops beating.
But used by skilled surgeons within strict parameters, it can help with recovery from trauma. Everett’s hypothermia started right on the football field after his injury, while he was being stabilized, given IV fluids and oxygen. He was given an iced saline infusion and ice packs in the armpits and groin.
In the emergency room he was given a complete workup with radiographs, MRIs and CT scans, and surgery to relieve pressure on the spinal cord at the neck where the bones were damaged. Throughout these procedures his body temperature was kept below 98.4 degrees F. Eight hours later a tiny movement was noticed in the legs. Cooling continued via an epidural catheter (cooling his spinal cord) until, 36 hours later, both his arms and legs moved a little. Then his body temperature was gradually raised to normal. He is now in recovery.
Why does hypothermia help?
Part of Everett’s recovery is due to the decompression on his spinal cord. But some is also due to the fact that a lower body temperature, by slowing body processes down, puts lower demands on the body’s nerves. This keeps them less active while surgery and healing occur, which helps speed recovery.
Little research has been done on use of moderate hypothermia and Dr. Cappuccino is in hopes that Everett’s recovery will inspire other spinal injury centers to give it more attention. New medical techniques are developed all the time, as are new medical devices and drugs. While there is undoubtedly some risk for patients receiving new drugs or treatments, there may also be great benefits as our medical skills expand. We rely on each surgeon’s best judgment to use only likely and appropriate techniques on each patient.
Most medical professionals are responsible and attentive, but there are times when unacceptable mistakes are made. If you have been injured by careless medical care and wonder if you might have a valid legal claim, please contact us for a free consultation.