For injured athlete, key is rapid treatment

Aggressive approach gives NFL player hope

September 12, 2007|By Chris Emery and Mike Klingaman | Chris Emery and Mike Klingaman,Maryland Guard in Iraq

When Buffalo Bills tight end Kevin Everett damaged his spinal cord during a football game Sunday afternoon, his only hope was the state-of-the-art medical treatment he received within a remarkably short time.

Despite grim initial assessments of his chances for recovery, there were signs yesterday that aggressive treatment might have worked. The surgeon who operated on Everett said that his patient had voluntarily moved his arms and legs and that he was optimistic that Everett will walk again.

Still, experts said, the severe neck injury Everett sustained making a "heads-down" tackle puts the 25-year-old at risk for life-threatening infections and blood clots.

The kind of injury that occurred during the televised game is the nightmare of teammates and of families who watch their loved ones play football with the knowledge that the worst can happen and occasionally does. It is also the nightmare of coaches who drill their players in "heads-up" tackling from the first day, specifically to prevent such rare injuries.

"It's as bad an injury as you can have," Dr. Paul McAfee, chief of spine surgery at St. Joseph Medical Center, said of Everett's case. "It's the same kind of thing Christopher Reeve had."

McAfee was referring to the actor, famous for his portrayal of Superman, who died in 2004, almost a decade after an equestrian accident left him paralyzed.

McAfee learned the details of Everett's condition from Dr. Andrew Cappuccino, the orthopedic surgeon who operated on the tight end. Now in private practice in Buffalo, Cappuccino spent a year training under McAfee at St. Joseph a decade ago. The two have consulted on Everett's case.

McAfee said Everett's chances for recovery were improved by the cutting-edge care he received immediately after the injury.

"It was about as fast as you could humanly treat a person," McAfee said.

Everett was injured trying to tackle the Denver Broncos' Domenik Hixon during the second-half kickoff at Ralph Wilson Stadium in Buffalo. After driving his helmet into Hixon's shoulder pad as the two collided head-on, Everett collapsed face-down and remained motionless, conscious but unable to move his arms or legs.

A rescue squad rushed him to a nearby hospital, and within 15 minutes of his arrival, Mc- Afee said, doctors were cooling his spinal cord using intravenous fluids.

They also administered anti-inflammatory medications and oxygen to help protect the nerve cells in Everett's damaged spinal cord, which carry messages from the brain to the rest of the body.

"The injury limits blood flow to the area, so the cells are starved of oxygen," McAfee said. "Cooling, steroids and giving oxygen prevent cell death."

MRI and CT images of Everett's cervical spine showed that the impact of his collision with Hixon had compressed the C-3 and C-4 vertebrae in Everett's neck, fracturing both vertebrae, damaging the soft cervical disc between them and crushing the front of his spinal cord, McAfee said.

Such injuries typically occur when a defensive player rams the top of his helmet into another player during a tackle, a technique known as "spearing." Such tackles often happen during a kickoff, when opposing players are running toward one another at top speed.

The impact travels through the helmet and skull into the neck, where it compresses the vertebrae.

"The vertebra actually explodes," McAfee said. "You can't make a helmet that will prevent such a neck injury if you want to allow a high degree of motion."

The neck rolls worn by some players are designed to prevent hyperextension of the neck, not the compression injuries that result from spearing, he said.

To prevent spinal injuries, high school leagues have banned spearing, and coaches and officials remove players from a game for tackling with their heads down. The practice brings a 15-yard penalty for unsportsmanlike conduct in high school, college and professional football.

High school coaches said they regularly train their players in correct tackling.

"No matter how busy we get with the X's and O's, we'll be cognizant of the safety aspect," said Roger Wrenn, head football coach at Polytechnic Institute. "Because I never want to be the guy who calls a player's mom and says, `There's been an accident.'"

Brian Abbott, head football coach at Loyola Blakefield, said it can be difficult to rid players of the spearing habit.

"A kid's natural instinct is to duck his head when tackling," he said.

Abbott was a second-year head coach at Loyola in 2004 when Van Brooks Jr., a 16-year-old junior defensive back, was paralyzed when his head struck the knee of another player while he was making a tackle.

"I've never used Van's name during any tackling drill," Abbott said. "That's inappropriate. But [the injury] is definitely on these kids' minds.

"We do tackling drills every day. Your goal as a tackler is to be able to see what you hit. If a player puts himself in jeopardy, I take him out of the game and tell him, `Lead with your head and you're not going to play.'"

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