Health and Hope
Patient's Courage and Surgeon's Skill Turn
Traumatic Injury into Hope for Recovery
Crystal Swenson, a 28-year-old outdoors enthusiast, was skiing with friends in the mountains of New Hampshire when on the first trail of the day, she fell and suffered a potentially fatal neck injury - dislocating her skull from the top of her spine -- that initially went undiagnosed.
At the time of her fall, she was brought off the mountain and seen at the local emergency department. "After I fell, I couldn't move my head even an inch, and I couldn't open my jaw because it was dislocated. They told me that I had whiplash and gave me a prescription. So I went to the pharmacy, filled the prescription and bought a neck brace." She stayed resting at the condo for the two remaining days of the ski trip. "When we got home, I still couldn't move my neck and the pain was so bad that I went to my local emergency department. That's when I had the first x-ray of my neck."
Now knowing the severity of her injury, her local emergency department prepared to transport her to a Boston teaching hospital for further evaluation. "I had a choice of two places. One was Beth Israel Deaconess. My friend had just had a great experience at Beth Israel Deaconess, so I chose to go there."
She remained at BIDMC for nearly two days, during which she was further evaluated and learned the full extent of her injuries. She had a broken neck and had torn the ligaments holding her skull to the top of the spine on the right side, specifically the ligaments between the occiput (the back part of the skull), C1 and C2 vertebrae, which are responsible for allowing the head to move up and down and side to side. It was a devastating injury.
"Once I was told what my injury was, I spoke with two surgeons about my options. The first suggested that, with this type of injury, the best approach was to wear a halo for three months, and said that I would likely not regain much range of movement - maybe about 20 percent. There was also the risk of neurological damage, he explained, with surgery. Then I spoke with Dr. Groff, who was fantastic. He had another idea and described exactly what he thought he could do and the kind of results he thought he could achieve. He explained to my parents and me that a halo would not help because I had not only broken my neck, I had also torn off the ligaments on the right side and a halo couldn't fix that. Something needed to be done to help hold my head up. He said he could help me obtain more range of motion with a different surgery."
"Historically, with this type of injury, fixation was not possible at just the C1 and C2 levels, where, in this case, the injury occurred. It would require surgeons to create much longer constructs down the spine for support, minimizing the patient's mobility," says Michael Groff, MD, neurological surgeon and co-director of the
Spine Center at Beth Israel Deaconess Medical Center. "But with recent advances in instrumentation, we were able to take a new approach and fuse only the injured levels of the spine and neck, minimizing the impact on her range of motion."
The results were what both had hoped for. "My recovery has been just as he said it would be. Ten days after my accident, I walked down the aisle at my sister's wedding without a neck brace, and six weeks after my surgery I went on a 10-day road trip around Ireland where I was able to do plenty of walking, hiking, and dancing."
Swenson admits that the whole experience was scary. Seven months after her accident, she continues her recovery. "I am great. It is still a little painful to turn my head to the right since that is where all my ligaments were torn, but I have about 50 percent range of motion and for me that is the new normal. I have been able to do everything that I have wanted to do. I spent the summer camping, hiking and going to music festivals."
She adds, "I am so grateful to Dr. Groff and his team at the Beth Israel Deaconess Spine Center because I know that if I had gone anywhere else, I wouldn't have had the miraculous recovery that has allowed me to continue living my life to the fullest."
To make an appointment at the Spine Center at Beth Israel Deaconess Medical Center, call 617-667-8900.
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Posted November 2010