Six-time Olympic gold medalist swimmer Amy Van Dyken Rouen severed her spine in an all-terrain vehicle (ATV) accident over the weekend in Arizona. According to Associated Press, she told emergency medical technicians she could not move her toes or feel anything touching her legs.
A report by the local police department said the ATV she was driving hit a curb in a restaurant parking lot and sent her over a drop-off between 5 to 7 feet. A witness at the scene reported she was not wearing a helmet at the time of the crash. Van Dyken Rouen severed her spinal cord at the T11 vertebrae and the broken vertebrae came within millimeters of rupturing her aorta.
In the 1996 Atlanta Olympics, Rouen became the first U.S. female athlete to win four gold medals in a single Olympic games. She captured the 50-meter freestyle and 100-meter butterfly and also competed on the winning relay teams in the 400 freestyle and 400-meter medley.
Four years later at Sydney, she added two more gold medals in the 400 free and 400 medley relays before retiring from competition.
Treating this type of traumatic spinal injury requires precise surgical skills and state-of-the-art technology and techniques all of which are held by Texas Back Institute surgeon Craig Callewart. We spoke to him about the prognosis for a patient with a severed spine.
“Breaking a vertebra does not necessarily lead to paralysis”
After beginning his practice as a trauma surgeon in the Baylor Hospital emergency room and continuing to his present day practice, Dr. Callewart estimates he’s treated about 2500 broken spines in his career. About 25 percent of these fractures required he perform surgery. He knows that the term “severed spine” can mean different things to different people.
“The press reports say Ms. Rouen has experienced a ‘severed spine’ but it’s difficult to tell how serious this injury is and if it will result in paralysis without knowing how extensively the spinal cord has been cut,” Dr. Callewart said. “Breaking the vertebra does not necessarily mean that the patient will experience paralysis. However, completely severing the cord will most likely cause this.”
“In most cases, this type of roll-over accident will result in the breaking the bone and the edge of this jagged bone tearing the spinal cord,” he noted. “This will cause extensive bruising of the cord but with surgery, bracing and time, the cord can (sometimes) return to normal and there will be no paralysis as long as it’s not completely torn or cut.”
“The T11 is a common one to break”
The reports note the damage was to Ms. Rouen’s T11 vertebra. Does the location of the fracture affect her prospects for full recovery?
“Location of the break is significant,” notes Dr. Callewart. “The lower the fracture on the spine the less likely there will be permanent damage. The T11 vertebra is a common one to break – it’s mid-torso – and it produces more damage than one in the belt area or lower. If the injury was higher on the spine, it could result in a loss of the use of her arms which would dramatically impact her post-operative, day-to-day life.”
According to Dr. Callewart, being a life-long athlete should help Amy’s recovery.
“The type of shape someone is in will certainly affect their recovery,” he notes. “If a victim of this type of accident is overweight, a smoker or has osteoporosis, their recovery is much more challenging.”
“They’re fun to drive”
What is it about ATV’s that seem to lead to this type of injury?
“Well, they’re fun to drive and they’re big machines,” he notes. “When you have this much power and a 750-pound vehicle, any time there is a sudden stop, obstacle or acceleration surge, the momentum and the vehicle’s balance can cause a back-over-front roll-over. This appears to be the case with this accident.”
“In my experience, accidents with smaller ATV’s don’t have near the devastating effects as these larger vehicles for the simple reason that there is less weight falling on the driver,” he said.
“She’s going to have a very different life than she had before”
What can Amy expect?
“Her biggest challenges will be emotional and spiritual,” Dr. Callewart notes. “This is especially true if she is paralyzed.”
“It’s going to be a long road in rehabilitation – about a year – and if she is paralyzed she’s going to have a very different life than she had before the accident,” he notes. “Simple things like driving, taking a shower or going to the toilet will be much more difficult if she is paralyzed. In about 20 percent of the cases, another surgery is required to take care of problems from the original procedure. This is mentally challenging, especially to someone who has been an athlete most of her life.”
If you need information on treatment for traumatic spinal injuries, contact the specialists at Texas Back Institute.