Englewood
Alex Pass flipped into the family’s Southern California pool June 22, broke his neck on the bottom, and felt nothing below his chest for three weeks.
Now at Craig Hospital with cervical spine damage, 16-year-old Pass can lift his left leg, move his toes and wiggle fingers.
On Sunday, Pass was watching TV as the Buffalo Bills’ Kevin Everett injured his C3 vertebra during a tackle in a game against the Denver Broncos.
“You don’t listen when they say you’ll never walk again,” Pass said. “I’d tell Everett you don’t listen to them.”
While many patients with injuries similar to Everett’s have passed through Craig – which specializes in the rehabilitation of spinal and brain injuries – their outcomes are impossible to predict, doctors here said.
Some cervical patients must rely on sip-and-puff devices to move a wheelchair, doctors said.
Increasingly, those with serious spinal injuries are pushing their wheelchairs with muscular arms – and even walking.
The key to improving prognosis doesn’t seem to be the steroid injections now common for reducing spinal inflammation, and maybe not even the cutting-edge saline injections Everett received, doctors say, but simple early interventions.
“It’s the way the medics put them on a backboard, immediate stabilization, decompression,” said G. Alexander West, a neurosurgeon at Swedish Medical Center in Englewood. “It’s the early care … and rehabilitation.”
Hospitals now treat spinal- cord injuries like heart attacks, he said, rushing patients first to imaging and then into decompression surgery to reduce pressure on the spine.
That pressure can cause extensive secondary damage, West said, and in the past, it often pushed patients with less severe injuries into the more serious “complete” category, with a total loss of sensation.
“Now, we have instruments to do everything. We can replace a disc. … We can use a cage to replace the whole vertebral body. We can stabilize the spine immediately,” West said.
Stabilized patients can be up and moving within days, which means fewer bed-related complications, such as pneumonia or urinary tract infections.
“It’s the small things that are making differences,” West said.
Cooling a patient down with chilled saline solution to preserve cells may someday prove to help prevent cell damage, West said – but the clinical studies are too new to bear out the value of deliberate hypothermia.
Studies have not borne out any effect of the steroid injections now given to virtually every spinal injury patient, said Thomas Belazy, a doctor at Craig Hospital.
Steroids decrease inflammation, and the injected drug is meant to reduce that damaging secondary inflammation
“But it doesn’t improve the outcome in studies yet,” Belazy said. “It’s probably used as much for medical liability reasons as anything else. The risks are real and the benefits are controversial.”
Steroids, for example, can leave patients more vulnerable to infections, he said.
By the time patients get to Craig – usually weeks after the initial injury – the opportunity for early intervention has passed, Belazy said.
Then, it’s all about rehabilitation, jumping on muscles that suddenly start twitching, getting a patient to really work on fingers that one day may begin to feel something.
“If the damage leaves no innervation, you can’t make that muscle work. But if there’s some, and you can make the cells work, you may not lose them,” Belazy said.
Belazy said he was baffled by the early, dismal prognosis Everett’s doctors discussed.
Even two weeks after injury, it can be hard to tell the difference between bruised tissue and spinal cells crushed beyond recovery, Belazy said.
Three weeks after Pass’ injury, he felt nothing below the chest, the young man said.
After getting back some movement in his legs and toes, he’s now focused on his fingers.
“They’re coming back,” Pass said. “I hope this just keeps going.”
Pass, who says he’s a huge Broncos fan, is also hoping Everett ends up with him in the Englewood hospital.
After that infamous tackle, Pass said, he and several other patients watched on a hospital television as Everett fell flat without dropping his hands to catch himself.
“Everybody in there, we all said ‘Oh, that’s the next Craig patient.”‘
Earlier this year, U.S. News & World Report listed Craig as one of the country’s top 10 rehabilitation hospitals.
Thursday, Everett’s doctors said their patient could wiggle his toes, bend his hip, move his ankles, elevate and kick his leg, extend his elbows and slightly flex his biceps.
The Associated Press contributed to this report. Staff writer Katy Human can be reached at 303-954-1910 or khuman@denverpost.com.
