NFL player becomes quadriplegic

[injuryupdate]

Surgeon: Everett has life-threatening spinal-cord injury
Associated Press

Updated: September 11, 2007, 1:39 PM ET

ORCHARD PARK, N.Y. -- Kevin Everett sustained a "catastrophic" and life-threatening spinal-cord injury while trying to make a tackle during the Buffalo Bills' season opener and is unlikely to walk again, the surgeon who operated on him said Monday.

"A best-case scenario is full recovery, but not likely," orthopedic surgeon Andrew Cappuccino said. "I believe there will be some permanent neurologic deficit."

Everett was hurt Sunday after he ducked his head while tackling the Denver Broncos' Domenik Hixon during the second-half kickoff. Everett dropped face-first to the ground after his helmet hit Hixon high on the left shoulder and side of the helmet.

Cappuccino noted the 25-year-old reserve tight end did have touch sensation throughout his body and also showed signs of movement. But he cautioned that Everett's injury was life-threatening because he was still susceptible to blood clots, infection and breathing failure.


AP Photo/Don Heupel

A trainer attends to Kevin Everett after he showed no signs of consciousness following a helmet-to-helmet hit on Denver's Domenik Hixon at the start of the second half.

Everett is in the intensive care unit of Buffalo's Millard Fillmore Gates Hospital, where he is under sedation and breathing through a respirator as doctors wait for the swelling to lessen. Cappuccino said it will take up to three days to determine the severity of the injury and the recovery process.

Cappuccino repaired a break between the third and fourth vertebrae and also alleviated the pressure on the spinal cord. In reconstructing his spine, doctors made a bone graft and inserted a plate, held in by four screws, and also inserted two small rods, held in place by another four screws.

Doctors, however, weren't able to repair all the damage.

Bills punter Brian Moorman immediately feared the worst when Everett showed no signs of movement as he was placed on a backboard and, with his head and body immobilized, carefully loaded into an ambulance.

"It brought tears to my eyes," Moorman said after practice. He said the sight of Everett's motionless body brought back memories of Mike Utley, the former Detroit Lions guard, who was paralyzed below the chest after injuring his neck in a collision during a 1991 game.



Physics of big hits


Buffalo Bills reserve tight end Kevin Everett likely experienced about two-thirds of a ton of compressive force on his spine in a hit Sunday that left him with a serious spinal injury, according to a professor who has studied the physics of football.

Dr. Timothy Gay, professor of physics at the University of Nebraska-Lincoln, said kickoffs produce more violent collisions than almost any other play in football because players have more of a chance to get up to full speed.

Gay, who was not at the game but saw video slow-motion replays, said it appears Everett's head was down when he made the tackle. That means the force of the collision was applied to his spine.

"That's why you don't go flying at a guy without your head up," said Gay, who played football at Caltech."The problem is ultimately it's a dangerous sport. You have 250-pound guys running 10 feet per second into each other. You're putting yourself in a dangerous position."

There were physics and physiology at play in Everett's case, said Gay, author of "Football Physics: The Science of the Game." The physics at play mostly involved Newton's 2nd Law of Motion: F = ma (force equals mass times acceleration). When a player undergoes extreme deceleration -- as Everett did when he hit Denver's Domenik Hixon during the second-half opening kickoff -- there will be a big force required to cause that deceleration. If Everett's head was up so his neck was not compressed, then the same force would not have done the same physiological damage.

Gay said, in his opinion, more protective head restraints or different equipment likely wouldn't have made a difference in Everett's case because the issue was the angle of his head at the moment of impact.

-- Jena Janovy, ESPN.com

Utley, Moorman recalled, at least was able to give what's become a famous "thumbs up" sign as he was taken off the field. Everett didn't.

"That's what I was waiting for, and that's what everybody else was waiting for," Moorman said. "And to have to walk back to the sideline and not see that made for a tough time."

Utley, who lives in Washington state, was saddened to see replays of Everett's collision.

"I'm sorry this young man got hurt," Utley told The AP. "It wasn't a cheap shot. It was a great form tackle and that's it."

Cappuccino said Everett was alert and aware of the extent of his injuries.

"I told Kevin that the chances for a full neurologic recovery were bleak, dismal," said Cappuccino, who works for the Bills as a consultant, specializing in spinal surgery. "I was honest with him, and he told me, 'Do everything you can to help me.' "

Cappuccino received permission to operate from Everett's mother, Patricia Dugas, who spoke by phone from her home in Houston. She and other family members arrived in Buffalo on Monday. Everett was born in Port Arthur, Texas, and played high school football there.

Buffalo's 2005 third-round draft pick out of Miami, Everett missed his rookie season because of a knee injury. He spent most of last year playing special teams. He was hoping to make an impact as a receiver.

The Bills now attempt to refocus while preparing to play at Pittsburgh on Sunday.

"It's difficult because you know the situation," said running back Anthony Thomas, one of Everett's best friends on the team. "We have to move on. But he'll always be in our thoughts and in our prayers."

Quarterback J.P. Losman said it was difficult to concentrate during practice.

"It seems like every couple of seconds that go by it's always popping into your head," Losman said. "Going through a walk-through, we're looking for him, wanting to hear his voice."

Coach Dick Jauron said NFL commissioner Roger Goodell called him Sunday evening, offering the league's support.

"We honor ourselves by our work, and we honor Kevin by moving forward and working while never forgetting Kevin and never getting him out of our thoughts and prayers," Jauron said. "We're going to wait and see what the outcome is here and we're really hoping and praying for the best."

Everett, who was on placed injured reserve Monday, was not the only injury sustained by the Bills.

Cornerback Jason Webster (broken forearm) and free safety Ko Simpson (broken ankle) had surgery, and Jauron said both could miss the rest of the season. Also, linebacker Coy Wire has a sprained knee and is out indefinitely.

Copyright 2007 by The Associated Press

[scott turner]

Sad story, like they said it was a poor tackling technique for that situation. On another point, I wonder sometimes if the helmets they wear actually make them more prone to neck injury?

[jellybean]

Some more optimistic news in the latest reports below. Demonstrates the importance of having access to immediate medical care from practitioners with up-to-date knowledge in acute spinal cord injury management. (The knowledge about reducing permanent spinal cord damage by reducing swelling, alleviating pressure has been around for a while, but how many people with spinal cord injuries are actually lucky enough to have immediate access to this sort of treatment?). While it's not clear whether he will regain full function, it appears that his prognosis is far more optimistic than first thought. Lucky guy!


http://sport.guardian.co.uk/breakingnews/feedstory/0,,-6945770,00.html
Bills' Everett continues to improve, doctors say
By Jeff Franks

HOUSTON, Sept 24 (Reuters) - Buffalo Bills tight end Kevin Everett has a good chance of walking again, but it is too early to know if he will recover fully from a spinal injury suffered in a game two weeks ago, doctors said on Monday.

Everett, 25, can lift his legs and sit up for several hours, but has more limited movement in his upper body, they said at the Houston hospital where he is undergoing rehabilitation.

"We have to base it on what he shows us, and so far everything looks bright and I'm optimistic walking will definitely be a possibility," said physician Teodoro Castillo at Memorial Hermann hospital.

As for a full recovery where he can live a normal life, "That's a very difficult question. It all depends on what he shows us in the coming weeks," Castillo said.

Everett was injured on Sept. 9 while making a tackle on a kickoff against the Denver Broncos in the first game of the 2007 season for the two National Football League teams.

Initially, he was unable to move and doctors feared he would be paralyzed for life, but they became more optimistic as some muscle movement returned.

Everett, who is in his third year in the NFL, is from south eastern Texas and was moved to Houston on Friday to be near his family.

He sat up for several hours on Saturday and on Sunday showed improved muscle movement in his right arm, Castillo said.

Everett's injury is called "central cord syndrome," which affects the upper body more than the legs, said Castillo.

He cautioned that Everett's recovery is a "staged process" of indeterminate length.

STANDING ACTIVITIES
"He sits up, tolerates the sitting, then we can do a little bit of standing activities, but it's very hard to really predict," he said.

Castillo and Walter Donovan, medical director of The Institute for Rehabilitation and Research at Memorial Hermann, praised the care Everett got in Buffalo, which included lowering his body temperature by injecting a chilled saline solution.

Donovan expressed reservations about whether the cold treatment helped, saying it has shown positive results in experiments on rats, but "it's really not been proven that it does any good for humans."

"I think the folks in Buffalo, they wanted to just do everything they could and therefore administered the treatment," he said.

On Sunday, Cedric Killings of the NFL Houston Texans suffered an injury similar to Everett in a game in Houston, also on a kickoff play, and had to be immobilized and taken to a hospital.

On Monday, he was able to stand up, but still had some upper body weakness, according to news reports.

"The game's a violent game. The collisions are getting bigger and badder and it's very disconcerting to have two of these in a very short period of time," said Texans' team physician Walter Lowe.

********************************************

http://www.iht.com/articles/2007/09/12/sports/nfl.php
Football: Optimism on Kevin Everett, NFL player, spinal cord injury
By Matt Higgins
Published: September 12, 2007

BUFFALO, New York: Two days after he was paralyzed during a game, and one day after doctors described his condition as potentially life-threatening, Buffalo Bills tight end Kevin Everett was moving his arms and legs.

The doctor who performed surgery on Everett, Andrew Cappuccino, said Everett's condition had "improved."

Another doctor, who has consulted with Cappuccino, said Tuesday that Everett could eventually walk out of the hospital.

"Kevin Everett is moving his arms and legs, his legs stronger than his arms," said the consulting neurosurgeon, Dr. Barth Green. "He's moving them both to a point, to a degree that he will end up walking. He will walk out of the hospital."

On Monday afternoon, Cappuccino, an orthopedic spinal surgeon, described Everett's chances of a complete recovery as "unlikely" and in the range of 5 to 10 percent.
The next day, however, Green said he had spoken to Cappuccino and described him as "elated."

"I think he's walking on clouds right now," Green said. "Any physician would be.
"What he told you yesterday is the case 99 percent of the time. That is that people who are paralyzed stay paralyzed."

On Monday, team doctors said Everett, a 25-year-old backup tight end, was paralyzed from the shoulders down and in life-threatening condition after a collision Sunday during a 15-14 loss to the Denver Broncos.

Everett was injured on the second-half kickoff while attempting what appeared to be a routine tackle of Domenik Hixon. But after striking his helmet on Hixon's shoulder pads, Everett immediately collapsed. He lay motionless for about 15 minutes.

The Bills' team physician, Dr. John Marzo, described Everett as conscious and alert on the field but unable to move his extremities. Everett was immobilized using a back board and taken by ambulance to the hospital.

During the ride, Cappuccino began lowering Everett's body temperature to protect his brain, spinal cord and other organs.

At the hospital, Cappuccino operated for four hours Sunday night to repair damage to Everett's third and fourth cervical vertebrae and spinal cord. Cappuccino said that Everett had suffered direct compression of his spinal cord between the C-3 and C-4 vertebrae, but that the spinal cord was not snapped.

Reached by phone Tuesday night, Cappuccino said he was not permitted by the Bills to comment further.

Green is chairman of neurosurgery at the University of Miami. He is also president of The Miami Project to Cure Paralysis, a foundation he started with the NFL Hall of Fame linebacker Nick Buoniconti, after Buoniconti's son Marc had a spinal cord injury in 1985 while playing football for The Citadel, a college in South Carolina.

Green is also friends with the Bills' owner, Ralph Wilson, who has helped support The Miami Project.

Green said the fact that Cappuccino lowered Everett's temperature to 92 degrees Fahrenheit (33.3 Celsius) immediately after the injury made a difference in his recovery.
The procedure is called moderate hypothermia.

"It's like a bruising of an arm, an ice pack will help," Green said. "The vascular system was the ice pack for Everett's spinal cord."

Dr. Joseph Torg, professor of orthopedics at Temple University in Philadelphia, said Tuesday that it was difficult to make generalizations with spinal cord injuries.

"You want to see improvement in the first 24 to 72 hours if the individual will have a normal recovery," Torg said. "Every case is unique. You can't close any doors any way this early.

"The fact he has some spinal cord function is extremely optimistic."

Players for the Bills were unavailable for comment.

"It's a dangerous game, and yesterday we saw that and it came right to us," Coach Dick Jauron of the Bills said Monday. "It was right in front of us. It was one of our teammates down on the field."

[jellybean]

One more report

A Daring Course of Treatment
They cooled Kevin Everett down and then they operated. How quick-thinking doctors used some unproven interventions to help save a young football player with a spinal-cord injury.
WEB EXCLUSIVE
By Jeneen Interlandi
Newsweek
Updated: 7:14 p.m. ET Sept. 12, 2007

Sept. 12, 2007 - A series of difficult and controversial medical decisions made in the immediate aftermath of Kevin Everett’s spinal-cord injury may have saved the 25-year-old professional football player’s life and mobility. On Monday, less than a day after the Buffalo Bills tight end fractured his cervical spine during a game against the Denver Broncos, surgeons said he was unlikely ever to walk again. Today Everett is moving his arms and legs, and though he has a long and difficult recovery ahead of him, doctors say he may walk out of the hospital yet. Although no one can say for sure, the decision to chill Everett's body during the ambulance ride to the hospital and to operate immediately may have made all the difference.

An estimated 10,000-12,000 people suffer spinal-cord injuries in the United States every year, most of them men between the ages of 16 and 30. But while scientists have made enormous progress in the 12 years since Christopher Reeve’s riding accident brought national attention to spinal-cord injuries, most of that new knowledge has yet to move from the lab to the hospital. “We aren’t as in the dark as we were 10 years ago,” says Moses Chao, chair of the science advisory council at the Christopher and Dana Reeve Foundation. “But there’s still a lot that we don’t know.”

We do know this much, however: not all the damage from a spinal-cord injury is immediate. Neurons continue to die for hours, even days, afterward, and the choices doctors make in that time can determine whether a patient dies, lives, or walks again. Everett fractured the third and fourth vertebrae in his cervical spine during a routine tackle. When his helmet struck an opponent’s shoulder pad, those adjacent vertebrae jackknifed, compressing the spinal cord like two halves of dull but powerful scissors. The cord was severely damaged, but not severed.

Within 15 minutes of the injury, doctors injected steroids directly into Everett's spine and began administering an IV of cooled saline solution to lower his body temperature to 92 degrees—an experimental procedure known as moderate hypothermia. Although large-scale clinical trials have yet to be conducted, case studies show that lowering the temperature this way can minimize neurological and cardiovascular damage during heart and brain injury, presumably by slowing the process of cell suicide known as apoptosis.
While moderate hypothermia is not a new idea, it is by no means standard in spinal-cord-injury cases, says Naomi Kleitman, program director for the National Institute of Neurological Disorders and Stroke. “We know that it can slow injury progression,” she says. “But how fast to cool, and to what temperature, and then when and how quickly to reheat—these things have not been determined by rigorous study.”

Less than six hours after Everett was injured, surgeons performed emergency decompression surgery—an operation intended to fuse the damaged vertebra and relieve pressure on the spinal cord. While a growing body of evidence suggests that performing such surgery in the early stages of a spinal injury can reduce the amount of permanent damage, the timing of such operations remains controversial. According to the National Institutes of Health, evidence supporting early surgery has been largely confined to animal studies, and similar results have yet to be shown in human trials. “The thinking has typically been that because these are very sick patients with very little chance of recovery, the risks [of surgery] may outweigh the potential benefits,” says Kleitman. A large-scale clinical investigation is currently underway to evaluate the benefits of decompression surgery. In the meantime, Everett may well be on the road to recovery.
© 2007 Newsweek, Inc.