Several months ago, a soldier who had been injured in a training accident arrived by emergency helicopter to Rambam. Having sustained a spinal injury, the soldier was completely paralyzed from the waist down. Worse yet, his doctors were not even sure he’d live through the night.
To save the soldier’s life, his spinal column had to be stabilized. To this end, Orthopedic Surgeon Dr Lior Merom performed spinal fixation surgery. In addition, he released pressure on the young man’s back by removing bone fragments lodged in his spine. While operating, the surgeon aimed for improved neurological function, but didn’t dare to think in terms of restoring his patient’s ability to walk. “When you work, you go into automatic mode,” says Dr Merom. “You are busy with technical aspects, you do the job as fast and as well as you can, and just hope it will help.”
For this reason, the news that reached Dr Merom shortly after the operation came as a most unexpected, yet extraordinary, surprise. “He’s moving his legs”, the attending nurse exclaimed into the telephone to the surgeon. This can’t be, Dr Merom thought to himself and rushed to the intensive care department to find the young man, who had also undergone abdominal surgery, shifting his legs back and forth. “Patients who suffer definite spinal damage remain paralyzed. In my career I have seen a few of these patients regain movement, but it is very rare,” says Dr Merom. “In medicine, as in life, you can’t always explain everything.”
The next day Dr Merom met the soldier’s family at his bedside. Not surprisingly, the surgeon describes this meeting as “very happy, exciting and emotional”.
After nearly two months of hospitalization, the soldier was released from Rambam. He was able move his legs proximally, from the point of attachment to the body, as well as his knees and thighs. In other words, he could walk.
Currently, the soldier is undergoing physical rehabilitation in Tel Aviv and is being monitored by Dr Merom through regular checkups.
Promoting Movement Through Stability
If the spine is unstable following traumatic spinal cord injury (SCI), surgical fusion and bracing may be necessary for stability and to prevent re-injury of the spinal cord from repeated movement. Spinal fixation surgery may promote early rehabilitation and movement.
Spinal fixation is a neurosurgical procedure in which two or more vertebrae are anchored to each other through a synthetic fixation device. The procedure is designed to limit movement of the vertebrae to prevent possible damage to the spinal cord and/or spinal roots.
Doctors may employ spinal fixation in cases of vertebral fracture, vertebral deformity, or degenerative vertebral disorders. Spinal fixation devices usually involve a permanent rigid or semi-rigid prosthesis made of titanium that includes rods, plates, screws, and various combinations thereof.