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Neurological Disorders Channel
Reported July 1, 2011

Internal Decapitation

PHOENIX, AZ (Ivanhoe Newswire) -- What if every step you take, every move you make, every breath you breathe, you were at risk of becoming paralyzed, a quadriplegic, or even dying? That’s what some people face all because of an injury you can’t see and many doctors misdiagnose or don’t know how to treat.

Running is s a fun game now, but just two days before, Micah Andrews ran for the first time in seven months.

“We went downstairs and found him running, giggling, elated he could run,” Heather Andrews, Micha’s mom, told Ivanhoe.

Nine months before that, a day of shopping ended with a crash. The car Micah, his mom and big sister were in, was t-boned by an SUV.

“He was looking like he was asleep,” Heather said. “I put my hands on either side of his face, and breath was coming.”

“The ambulance went right by me. I had no idea it was hauling my family,” John Andrews said.

Micah’s mom and dad were dealing with the news their little boy suffered severe brain damage. But while Micah was in his coma, doctors found another injury.

“All the ligaments connecting his skull to his spine were severed,” Nicholas Theodore, M.D, a neurosurgeon at Barrow Neurological Institute and St. Joseph’s Hospital and Medical Center, said.

It’s called internal decapitation. Micah’s head was still connected by the skin and the spinal cord, but no muscles were there to support it.

“All the rubber bands that connect the bones together and actually hold, fasten the skull to the spine, were all torn,” Dr. Theodore said. “Any movement could be fatal for him.”

Doctor Theodore worked to relieve the pressure on Micah’s brain. Once that was done, he focused on what could leave the little boy a quadriplegic or even dead.

“He turned to me and said, ‘I’ll treat him like I was operating on my own son,'” John said.

But doctors cannot just re-attach the ligaments, they cannot be repaired.

“With each breath, you can see the skull and spine moving like two separate parts,” Dr. Theodore explained.

Doctor Theodore used a titanium rod to reattach the head.  He then took a piece of Micah’s rib for extra support.

“It will grow together so that not only do we have the metal there, but there will be a boney bridge between his skull and his upper spine,” Dr. Theodore explained.

Micah will never be able to play contact sports, but Doctor Theodore says a child Micah’s age will get most of his motion back, while adults lose about 75 percent of their ability to move their neck.  That’s what happened to Judy Kerns.

“When I took my neck brace off, that’s when my head fell," Judy Kerns told Ivanhoe.

Doctor after doctor told Judy the pain she felt in her neck was whiplash caused in a car accident, but there was something else going on, too.

“I was just in so much horrible pain,” Judy said. “It was like somebody stuck a knife in me. My whole body just froze up with pain.”

The bone in Judy’s neck had literally crumbled. She lived like this for months.

“I was scared. I guess I was just in so much pain. I just wanted it all over,” Judy said.

She walked into the Vanderbilt ER, and that’s when doctors finally figured out how to fix her painful problem.

“This was the first time I had ever had to rebuild somebody’s cervical spine,” Matthew Mcgirt, M.D., a spine surgeon at Vanderbilt University Medical Center said.

But before surgeon Matthew Mcgirt could fix her spine, he had to deal with major sores caused by Judy’s head laying on her chest and the malnutrition she suffered while she was injured. Judy had lost 30 pounds.

“She couldn’t open her mouth, she couldn’t eat.” Dr. Mcgirt said.

It took two weeks to get her healthy enough for surgery. Doctors had to create a special titanium cage to replace the front of her spine and re-attach her skull. It would take one week to get the job done.

“Each day was a victory, so every night when we finished one of the three surgeries, we all waited to see her wake up, wiggle her toes and move her hands,” Dr. Mcgirt said.

Just three days after the final surgery, Judy was walking.

“It was a great moment for Judy,” Dr. Mcgirt said. “The courage she had to go for four weeks of very painful treatment.”

Although Judy can walk, she has lost her ability to move her neck and head.

“I can’t move my head up or down or side to side,” Judy said.

But nothing will take away the joy she feels to be alive and with her family.

“I’m so proud of my family,” Judy said.

Two families who can now celebrate the small accomplishments, taking life one step at a time.

“He’s already been a miracle, and I think he’s going to continue to amaze us,” Dr. Theodore said.

 “It was all this perfect moment when we got Micah back,” Heather Andrews said.

Doctor Mcgirt believes there are many more like Micah and Judy who never make it to the ER or, like Judy, are told their problem can't be fixed and die before they can be properly treated.

More Information

Click here for additional research on Internal Decapitation

Click here for Ivanhoe's full-length interview with Dr. Nicholas Theodore

If this story or any other Ivanhoe story has impacted your life or prompted you or someone you know to seek or change treatments, please let us know by contacting Marsha Hitchcock at mhitchcock@ivanhoe.com

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