On December 30, 16-year-old Jack Jablonski was paralyzed during a high school hockey game when a player accidentally checked him from behind.
Jablonski, who attends Benilde-St. Margaret’s High School in St. Louis, MN, suffered a severed spinal cord and broken vertebrae after he was illegally checked from behind into the boards. Last Wednesday, he underwent a successful spinal fusion at Hennepin County Medical Center. Unfortunately, he will never be able to walk again.
Dr. Silverman Comments:
Cervical spine trauma can occur when the top of the head strikes a solid object. When we get hit on the top of the head, our cervical spine is converted into a solid straight line. Imagine the weight of our body and the force pushing it through the fist-sized cervical spine into a wall. If it can’t give, something has to break, and you always break in the weakest place.
The cervical spine has the smallest bones of the entire spinal column. It crumbles and the spinal cord is damaged. In low energy injuries there is only a bruise and temporary loss of function. In increased energy levels the results are much more serious: injury paralysis, loss of motor function, and loss of feeling below the level of the injury.
Sadly, Jablonski sustained the latter.
According to reports he sustained an injury to the C5 and C6 vertebrae and to the spinal cord at C5. What does this mean?
- The initial injury level gives doctors an idea what to expect in the future. No more than one level of recovery is common, thus there is some fluidity to the prognosis in the beginning. In 6 months, the level is permanent.
- The levels defined will give an idea how much motor function is expected to return.
With a complete C5 injury you can bring your arm away from your side and work your diaphram to breathe, but you lose all flexion and extension of the elbow, all wrist, hand, and finger movement, and all motion of the trunk and lower extremities.
With a complete C6 injury, you retain some elbow flexion and possibly some hand motion, but all else is lost.
How do we stop these injuries? Play heads up. The coaches constantly drill the kids in football and hockey to keep their heads up at all times. If you are looking down at the puck and you get checked into the boards you can be injured.
By some reports Jablonski was checked and was hit again as he fell. The second hit wasn’t hard or malicious, but it doesn’t need to be. The top of the head just needs to hit the boards.
Axial loading of the cervical spine with the head down (neck is flexed):
The bones can be fixed and they will heal but the damage to the spinal cord is permanent. Once the nerves are cut in this area, scar tissue forms in between the nerves and they can’t grow together.
Our thoughts go out to Jack Jablonski and his family. His injury reminds us of the fragile nature of life and the risks that we take every day. We can’t protect our children from everything.
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