Miracle Patients
Two men beat the odds, thanks to intricate spinal surgery
In the intersection where Willie Williams lay motionless after being hit by a car, paramedics covered him with a sheet because they thought he was dead. Almost a year later, Stephen Webb fell off his backyard wall while trimming a tree but didn’t think he was seriously injured.
Though the circumstances of their accidents were vastly different, both men had suffered a traumatic internal injury called "internal decapitation" that severed their neck ligaments and separated their skull from their spine, leaving only their neck muscles and skin to support their fragile spinal cords.
Amazingly, both men also experienced the same incredible outcome: After being rushed to John C. Lincoln North Mountain Hospital and undergoing intricate, hours-long surgeries led by Gianni Vishteh, MD, they have defied the odds and returned to their normal lives.
Dr. Vishteh, the John C. Lincoln neurosurgeon and spine surgeon who put both men back together, shakes his head and calls them his miracle patients.
"You have to understand," he explains, "that more than 90 percent of individuals who have this kind of injury never make it to the hospital. They die in the field. Half of those who do make it to the hospital die in spite of our best efforts, and the remainder are left with significant disabilities."
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| Gianni Vishteh, MD, shows Stephen Webb where a pin was inserted to bolt Stephen's skull to his spine, following Stephen's fall from a ladder. |
Dr. Vishteh is a board-certified neurosurgeon who has also completed a fellowship in spinal surgery. He has written widely in the fields of neurosurgery and spinal surgery, having authored or co-authored more than 170 published manuscripts, book chapters and abstracts, as well as having served as an editor for the medical journal Operative Techniques in Neurosurgery.
He praises the outstanding effort of the trauma and neurosurgery teams in John C.’s Level 1 Trauma Center and operating rooms, as well as nursing and support staff in ICU, physical therapy and rehab services, for contributing to the incredible recovery of both Steve and Willie.
Overcoming a Terrible Motorcycle Injury
Willie’s saga started first. A motorcyclist most of his life, Willie was riding his Harley home from work when a car turned directly in front of him. In the split-second before impact, there was nowhere for him to go.
"I hit the back door and my body busted the window out," says Willie, who was 40 years old at the time of the accident. "My body started to go into the back seat but my head hit the top of the door, and that’s what did my neck in."
Unconscious, unresponsive, not breathing and paralyzed on the pavement, paramedics pronounced him dead, but per protocol put him in an ambulance for the nearest Trauma Center — John C. Lincoln North Mountain Hospital. During the ambulance ride, EMTs were stunned when Willie faintly gasped for breath.
When he got to John C. Lincoln’s Trauma Center, Dr. Vishteh and the neurosurgery team were called into action.
The first thing the neurosurgical team did was immobilize Willie’s head and neck by installing a "halo," a device that frames the body and is literally bolted to the skull. Next, the trauma anesthesia team and ear-nose-throat specialists performed an "awake" intubation to make sure no additional neurologic injuries occurred.
Slowly, precisely and delicately, Dr. Vishteh opened Willie’s neck, and started piecing him back together. Using titanium screws, rods and crosslinks, Dr. Vishteh reattached Willie’s skull to his spine. Then he harvested a piece of Willie’s hipbone to create a living bridge to strengthen the connection between Willie’s skull and spine.
When surgery was complete, eight weeks of rehabilitation followed. Willie slowly regained control over his arm and leg. "I had to relearn everything," he says, "how to talk, how to walk, how to climb stairs."
He cites his lifelong stubborn determination for part of his success, but gives most of the credit for his recovery to God. "He has the answer, not me," Willie says. "Every morning, every night, I thank Him."
Surviving a Backyard Fall
Willie was re-learning how to ride a new Harley last April when Stephen Webb came home early from work to remove a broken eucalyptus tree branch that had fallen across the backyard wall.
"It’s the kind of thing I’ve done hundreds of times before," Stephen, 38, observes. "It was no big deal. But while I was standing on the wall, I got a twinge in my shoulder and I lost my balance."
Stephen tucked and rolled but landed upside down on the back of his neck. "It knocked the breath out of me," he says, "so I lay there for a moment trying to figure out if I was ok."
He slowly sat up and didn’t feel any excruciating pain, so he figured he wasn’t seriously injured. But when he turned his head to look around, "then it hurt," he says. "I figured I’d better get checked."
When Stephen started to walk, his head "felt sort of like it was floating," so he grabbed his cheeks and held his head steady with his hands. He hung on to his head all the way to the Emergency department at John C. Lincoln North Mountain Hospital.
"As long as I didn’t move, it didn’t really hurt all that much," he recalls, "except when my father drove over some bumps in the road. That really hurt. My whole body would tingle."
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| Kathleen Webb marvels at how her son, Stephen, recovered from a complex surgery that reattached his skull to his spinal cord. |
When he got to the hospital, Stephen was alert and was joking with the nurses and other clinical staff members in the ED. So it came as a shock to everyone when the CT scan showed Steve’s skull had been totally separated from his spine. That’s when Dr. Vishteh and the neurosurgical team were called.
Like Willie, the first thing they did was get Steve immobilized in a halo to prevent spinal cord injury. Then the neurosurgical team went into action.
Although the mechanical hardware in Stephen’s case was slightly different from Willie’s, the surgery was similar. A contoured Steinman pin and wires were used to bolt Stephen’s head back to his spine. Dr. Vishteh also harvested a piece of Stephen’s hip to fuse a permanent living link to reinforce the connection between Stephen’s skull and spine.
Like Willie, Stephen today is doing virtually everything he could do before he was injured. "If you didn’t know what happened, you probably wouldn’t notice anything is different," observes his mom, Kathleen Webb.
She has her own explanation for Stephen’s amazing recovery. "God hears a mother’s prayers for her child," she says, "no matter how old he is."