Novel Cooling Therapy May Have Aided Injured Football Player
Thursday, September 13, 2007; 12:00 AM
THURSDAY, Sept. 13 (HealthDay News) -- As Buffalo Bills football player Kevin Everett was being rushed by ambulance to a hospital Sunday night with a life-threatening spinal cord injury, he was already getting experimental treatment that may have saved him from paralysis.
Everett's spinal cord was damaged in his neck as he tried to tackle Denver Bronco Domenik Hixon during the Bills' season opener. Everett dropped face-first to the turf after his helmet hit Hixon on the left shoulder.
In the ambulance to Buffalo's Millard Fillmore Gates Hospital, a doctor injected Everett with steroids -- standard treatment to reduce swelling and potentially damaging inflammation. But, at the same time, paramedics started pumping an ice-cold saline solution into Everett's veins, to lower his body temperature, according to news reports. The approach, though experimental, has shown promise in stroke and cardiac arrest patients, and even in infants deprived of oxygen.
The theory behind the therapy: By lowering the core body temperature between six and eight degrees, doctors can tamp down swelling and inflammation, and limit the release of harmful chemicals -- such as free radicals -- that can cause even more damage than that left by the initial injury.
Still, Everett's prognosis on Sunday was dim. Once at the hospital, however, the body-cooling efforts -- called moderate hypothermia -- were continued using an external system as well as intravenous saline that reduced his core body temperature by 8 to 10 degrees, according to published reports.
"The advantage of cooling is that it is a neuro-protective agent that is able to attenuate [limit] the amount of injury that occurs after a spinal injury," said Dr. David Greer, an instructor in neurology at Massachusetts General Hospital. "It decreases the amount of injury and the swelling that occurs from the injury and thereby, hopefully, affects the outcome for the patient."
For hypothermia to be effective, it needs to be started as soon after the injury as possible, Greer said. Usually, a patient remains cooled for one to two days and then is re-warmed, which takes about half a day.
Using cooling for a spinal injury is a new application of the technique, Greer said. "It has been used in traumatic brain injury for years as a neuro-protective agent," he said. In fact, soldiers who suffer severe traumatic brain injury in Iraq are being treated this way, he added.
"I like to think of hypothermia as a bridge from when the injury occurs to getting a more definitive therapy like decompressing the spine," Greer said.
Once at the hospital, Everett was diagnosed with a potentially fatal fracture/dislocation between the third and fourth cervical vertebrae in the neck. On Sunday night, he underwent emergency decompressive surgery to prevent pinching of the spinal cord.
During the operation, surgeons repaired the break in the vertebrae and also reduced pressure on the spinal cord. They also made a bone graft and inserted a plate, held in place by four screws, and also implanted two small rods, also kept in place with additional screws.
On Monday, Everett's doctors said there was not much hope that he'd make a full recovery. But, on Tuesday, they announced that the tight end could move his arms and legs, and his spinal cord was intact.