Case History of Jim
Jim is a motorcycle deputy in the Los Angles County Sheriff Department stationed in Malibu. While on patrol, he was struck by an automobile driven by a robbery suspect who was fleeing the scene of a crime. He was brought into the Ronald Reagan UCLA Medical Center Emergency Room with numerous severe injuries. He was immediately taken to the operating room by the general surgery service for treatment of a life threatening liver laceration. On examination he was noted to be unable to move his left leg, and had severe weakness of the right leg. CT and MRI scans disclosed that he had a serious spinal injury. He suffered a T5-6 fracture (mid-back) (
Fig. 1), and a C6 fracture (neck). There was significant pressure on his spinal cord, and his spine was mechanically unstable. Without surgery, he virtually had no chance of regaining functional use of his legs, and the instability of his spine precluded him from sitting up.
I made the decision that he would need to undergo extensive surgery, simultaneously treating the fractures in his neck and mid-back. I had a long talk with his wife regarding the procedure. We used computer image guidance, a cutting edge technology in which placement of the bone screws were guided by a computer workstation. He required two surgeries, and a total of sixteen titanium screws and two rods were placed (
Fig. 2). His spine was fused from the C5-T8 levels.
Jim made remarkable progress following surgery. He slowly began to regain function in both legs, and was able to lift them off of the bed upon discharge. He then was transferred to an acute rehabilitation center, and continued to make a wonderful recovery. Approximately six weeks after surgery he was able to walk with a walker, and now he is able to walk normally without any assistance.
I feel blessed that I was able to participate in his care. He is a fantastic human being, and was injured while attempting to make our lives safer. May God continue to bless Mr. Mulay and his entire family.
By Langston T. Holly, M.D.