Courtney’s Story: Traumatic Spine Injury

Courtney is positive that she was wearing her seatbelt. Perhaps that is why her head and neck – thankfully — were fine. Perhaps that is also why her midsection was so violently impacted, as the force of the rollover twisted her limber cheerleader’s body around and out of the car and into a ditch along the side of the road.

She had been on her way to help out at her father’s store, driving a Jeep, when one of the tires went off the road. “I over-corrected and flipped the Jeep,” she recalled. “My indoor soccer coach found me. They were driving down Hopper Hill Road and they saw the red Jeep lying on its side. They got out, looked in it and didn’t see anybody. Then they looked in the ditch and saw me. And I actually remember hearing someone talking to me. I remember my coach’s wife saying, ‘It’s Shelley, it’s Shelley, Courtney.’ I remember fading in and out, hearing that. After the ambulance came, they said I started telling them the medications I was allergic to. It’s funny how I was able to remember that.”

Courtney’s injuries to her lower spine were severe. She suffered a lumbosacral fracture-dislocation with a shattered L5 vertebra. But during a staged (two-part) spinal reconstruction, Charles Kuntz IV, MD, a neurosurgeon with the Mayfield Clinic, rebuilt Courtney’s lower spine and gave her back her chance for a promising future.

Courtney remembers her first meeting with Dr. Kuntz, a specialist in complex spinal injuries and disorders, at Cincinnati’s University Hospital. “I remember hearing him talking and telling me, ‘Courtney, you’ve broken your back but you’re going to be OK. We’re getting ready to do surgery.’ He was very calm about everything, and he had a very good bedside manner. He’s a great doctor. I was glad he was on call when I got hurt.”

Dr. Kuntz first performed a posterior lumbosacral decompression, with fusion and fixation. During the decompression, which relieved pressure on Courtney’s spinal nerves, Dr. Kuntz carefully removed bone and disk fragments from the nerve roots and reconstructed the dura, the tough, fibrous membrane that envelops the spinal cord and nerve roots. He then placed instrumentation with pedicle screws and rods in Courtney’s spine to provide fixation and to reduce the fracture-dislocation. A fusion was performed to provide for long-term stability.

Several days later, Courtney was taken back to the operating room for an anterior lumbosacral decompression with cage fusion. During this procedure, Dr. Kuntz removed the shattered L5 vertebral body and then inserted a titanium cage packed with porous bone. The bone would gradually grow through the holes in the cage, fusing Courtney’s vertebrae together.

The pain, which was severe, eventually subsided while Courtney was in the hospital. But her recovery was not without difficulty. She lost her appetite and, during her weeks of being bedridden, developed a blood clot in her left leg. After a full month at University Hospital, she was transferred to Cincinnati Children’s Hospital Medical Center, where she underwent intensive physical therapy for another month.

“I was in a wheelchair during most of my time at Children’s,” Courtney recalled. “Then I graduated to two four-point canes. I left the hospital with two canes, and then I finally got down to one cane. I also wore a back brace for six months. It was like wearing a corset: I had to suck in when I put it on.”

Courtney laughed. “It was good for portion control!”

During her time at Children’s, Courtney had her first exposure to child-life specialists, associates who help patients live as normally as possible in a hospital setting. “I didn’t know that the career existed until I went to Children’s,” Courtney said. “My child life specialist was the best. She really worked hard to make your stay a lot better. Because I had to finish my senior year of high school online, she would bring me a laptop. She would come into my room, would bring in board games and would invite me up to the teen room. She brought in activities so that I wasn’t just lying in bed, bored. She made it a lot more exciting and helped me forget the fact that I was in the hospital.”

Three years after the accident, few people would guess that this outgoing and effervescent young woman had been through such an ordeal. She is majoring in psychology at UC, working on the adolescent psychiatric unit at Cincinnati Children’s, and hoping to pursue a graduate degree in child and adolescent clinical psychology.

“Despite a severe injury to the lumbosacral nerve roots,” Dr. Kuntz said, “Courtney has made a miraculous recovery, returning to an independent lifestyle with neurological function that is virtually normal.”

She enjoys working out and walking around campus. She is conscious of her back, however, and takes care not to injure it. She avoids soft mattresses, high heels, and standing in one position for too long. She takes precautions to avoid a fall. “If it’s snowing and the streets aren’t cleared off, I don’t go to class,” she said.

She has been left with a lasting gratitude. “I came to realize how much it takes to walk,” Courtney said, “and I am grateful to Dr. Kuntz, and to my nurses and therapists, that I can do so.”

 

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Hope Story Disclaimer – This story describes an individual patient’s experience. Because every person is unique, individual patients may respond to treatment in different ways. Outcomes are influenced by many factors and may vary from patient to patient.

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