U-clamp, screws keep manâ€™s head on his body
By Scott Davis
Newhouse News Service
SAGINAW, MICH. —
Harry Hagadorn shouldn’t have survived.
In a tumble down his basement stairs , the 48-year-old completely separated his skull from his spine, although his spinal nerves remained intact.
Doctors weren’t hopeful.
"In almost all of these injuries, people die at the scene," said Dr. Gerald Schell, a neurosurgeon at St. Mary’s of Michigan hospital in Saginaw. "They stop breathing."
Sometimes, however, all it takes is simple hardware to put a man back together.
Using a U-clamp and a few screws, Schell, assisted by Dr. Waheed Akbar, an orthopedic surgeon, reattached Hagadorn’s skull to his spine in a July 24 operation at the hospital.
Within days of the procedure, Hagadorn could take a few steps again, and now — after weeks of therapy — he’s hoping to resume his life with some degree of normalcy.
"It was pretty complicated carpentry," Schell said. "It’s amazing. He’s alive and doing well."
Doctors say such a spinal injury is rare — less than 1 percent of all spinal-related injuries — and recoveries are even more rare.
Schell, who is affiliated with Field Neurosciences Institute in Saginaw Township, said he had never treated an occipital cervical dislocation like Hagadorn’s in his 25 years of practice. He said he may write about the case in a national medical journal.
Hagadorn, however, is not too concerned about national attention. He said he’ s just glad to walk again.
"It was pretty hard news to take," Hagadorn said of learning af ter his accident that he might not walk again. "I’m real happy now."
Hagadorn, whose memory of the accident is hazy, was walking down into his basement when he tumbled down about 10 steps.
Schell said Hagadorn apparently landed flat on the top of his head, creating the traumatic force that dislodged his skull from his spine. The injury, however, did not sever spinal cord nerves connecting his brain and his spine, offering hope of full movement again.
His mother, Beulah Hagadorn, found her son unconscious at the bottom of the stairs and phoned 911.
"His spinal cord was very resilient," Schell said. "Usually, a spinal cord would not be able to tolerate that kind of injury."
Hagadorn’ s luck continued. Schell said the responding paramedics were very careful not to move his neck; any movement might have killed him.
The outlook at the hospital was grim. Hagadorn’s spine had separated — having moved an inch toward his chin — and even if he survived the surgery, chances were he might have lost his ability to walk.
Schell assembled the tools for the job — made mostly by Medtronic, a Minneapolis-based corporation that produces medical products worldwide.
The neurosurgeon gathered up titanium screws — ranging in length from 10 to 15 millimeters — and, before surgery, a Medtronic representative arrived at the hospital with titanium U-clamps in various sizes from which Schell could choose.
The task ahead resembled a Bob Vila home improvement project. Schell decided to use a 4-inch U-clamp to reattach Hagadorn’s skull to his spine, and then screw it into place.
But first Schell and his team had to position Hagadorn’s spine. Schell and his assistants threaded a wire into a vertebra and then pulled up the spine 3 centimeters into place.
Once the U-clamp was aligned, Schell used a screwdriver to drive eight titanium screws into the spinal column and skull base and set the clamp in place.
During the three-hour procedure, technicians used high-tech monitors to check electrical impulses along Hagadorn’s spinal cord to make sure the procedure never damaged the nerves.
After surgery, Hagadorn said, he awoke to find small spasms
in his neck, making his neck feel "bent" for a few days — a routine reaction in such surgeries.
Within days, doctors say, he was out of bed, taking his first steps again.
"With the capabilities here and the capabilities of the surgical team, this is what you would hope for," said Dr. Mark Lester, St. Mary’s president of clinical excellence. "I’ m not surprised that it was a success, but no one takes it for granted."
Now at home, Hagadorn is able to walk with only slight dificulty.
"He’s doing fine," Schell said. "He’s out of the woods."
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