Laura’s Story: Traumatic Spine Injury

What began as a shortcut became, for Laura Brunner, a monumental detour.

Laura, a prominent Cincinnati business executive, was enjoying a mountain hike in Montana with fellow trustees from the Dan Beard Council of the Boy Scouts when the group decided to take a shortcut.

They could shave 30 minutes off their return trip by traversing a 90-foot stretch of spring snow that straddled a valley. The men were heavy enough to compress the snowpack and gain sufficient traction as they hiked across. But Laura, smaller and lighter, lost her footing.

“All of the men managed to make it across,” Laura recalls. “But for me, I got about halfway across and fell. I slid about 90 feet down the mountain, on the ice, on my back, with my head pointing down the mountain.”

With nothing to grab onto, Laura was helpless. Nor could any of her fellow hikers stop or slow her slide. As she neared the bottom of the slope, her body turned sideways, a blessing as it kept her from crashing into a boulder head-first. The terrible impact was absorbed by her back, causing serious injury but probably sparing her life.

“I hit the boulders so hard I went back up into the air and came down again 10 feet further down the mountain,” Laura says, recounting the story during a break from work at her Cincinnati office. “I ended up lying on my stomach on top of a big boulder with all these poor men running around me screaming. The good news was there were boulders, not a cliff. The bad news was boulders aren’t very soft.”

The shortcut at its frightful end, Laura’s long, painful road to recovery began. Yet for every horror there was an element of good fortune, culminating with the bracing and meticulous rebuilding of her spine by Charles Kuntz, IV, M.D., an expert in spinal trauma at the Mayfield Clinic and the University of Cincinnati Neuroscience Institute.

“In the hospital I was thinking, it’s all good. I’m not paralyzed and I’m not dead,” Laura says. “It was a combination of going home to the right hospital and getting the right surgeon.”

After recovering from contusions, a punctured lung, multiple broken ribs, fractured vertebra in her neck, and multiple fractured vertebrae in her upper back (thoracic spine), Laura went back to being a never-idle executive who also contributes to her community through service in the non-profit sector. She also emerged as a “spine athlete,” a person who devotes a portion of her life to maintaining fitness, flexibility, and the overall health of her spine.

What happened immediately after Laura’s fall was an ad hoc test of Scouting resourcefulness. Four of Laura’s six colleagues were Eagle Scouts, and all went to work to save her. One hiked back up to the mountain, hoping to acquire a cellular signal. Two ran down the mountain to the car to call for help. The other three stayed with Laura, who was in shock for a while but never lost consciousness. After debating whether to move her, they decided they had no choice. “I was on my stomach, circling over this boulder, and there was no way I could stay in that position until help came,” Laura says.

The men moved Laura, who was crying out in agony, into the most comfortable position possible, positioning her on her buttocks and leaning her gently into the back of one of the hikers, who sat with his arms behind him and his legs outstretched in front of him. They also removed their vests and placed them under her so that she wasn’t sitting directly on the ice.

“Laura was fortunate to have received outstanding care by the Boy Scouts, who administered first aid, immobilizing her spine and transporting her to receive definitive medical care,” Dr. Kuntz said. “The Boy Scouts likely prevented Laura from sustaining a more significant injury to the spinal cord.”

A hiker came by and gave her a hat and scarf, which warmed her. A while later, a small helicopter touched down, but it was too small to carry Laura inside. The pilots helped by putting her on a stretcher and immobilizing her neck in a cervical collar. Eventually, a large helicopter that passed over the area was coaxed down onto a suitable landing space by a hiker who had a radio. By this time nearly three hours had elapsed since Laura’s fall. “The guys I was with carried me down this gravel cliff,” Laura says. “I felt so sorry for them. They were slipping and sliding, trying to get me to the helicopter.”

Laura’s injuries were diagnosed at a nearby hospital, which was accustomed to seeing injured skiers. Two nights later, immobilized in a temporary brace, Laura was able to fly home on a medical jet, thanks to an emergency travel policy. She was met at Lunken Airport by an ambulance and taken directly to University Hospital, where she would be treated by Dr. Kuntz and Jay Johannigman, M.D., Chief of the Division of Trauma and Critical Care. “It was Saturday night; I remember my husband being there,” Laura says. “Jay Johannigman came in wearing a tuxedo, around midnight. I saw Charles Kuntz Sunday morning. It was Father’s Day.”

Dr. Kuntz’s comprehensive evaluation of the spinal injuries revealed that the neck fractures would likely heal in a brace while the upper back (thoracic) fractures and ligament disruption would require surgery. “As a general rule, well approximated, relatively stable spinal fractures can often heal in a brace,” Dr. Kuntz explains, “but fractures associated with significant ligamentous disruption frequently require surgery.”  In addition, Laura had sustained a mild thoracic spinal cord injury, and the thoracic spine would need to be stabilized to prevent further injury to the spinal cord. On Monday, in an operation that lasted multiple hours, Dr. Kuntz performed a posterior thoracic segmental fixation and fusion, inserting screws into four of Laura’s 12 thoracic vertebrae, T7 through T10.

The surgery realigned Laura’s spine, and on Thursday Laura received her brace, which extended from her tailbone to the top of the back of her head. On Friday she went home. “The worst part was that my head could move only an inch,” Laura recalls. “I couldn’t stretch my mouth.” She wore the brace 24 hours a day for two months. The third month she was able to take it off to sleep.

As Laura healed, her feisty spirit returned. She was still the woman who hiked over a risky mountain pass with Eagle Scouts, after all, and being strapped into a brace was akin to being sandwiched in a crevasse. She returned to work five weeks after her surgery.

While still in her brace, Laura worked with a yoga instructor, who helped her with movement and stretching that was as simple as leaning her head on a counter or putting her hands on a wall and leaning forward. The yoga instructor also helped Laura learn to meditate.

“Attitude is so important,” Laura says. “The body needs to rest in order to heal. My instructor played music and talked me into a place where I wasn’t sleeping but where I was resting. If you’re active and go into confinement, you need to find ways to cope.

“I kept trying to negotiate with Dr. Kuntz,” she says, with a laugh. “I’d ask, ‘Can I exercise, can I do this, can I do that?’ And the answer kept being, ‘No, you don’t want to injure your neck and require surgery, do you?’ And after I got my brace off a week after Labor Day, I asked again, ‘Can I exercise?’ He said, ‘No, you can swim.’ I’m not a good swimmer, and that’s the only thing he would let me do. But I listened to him. You look at him and think, I trust you. I do take a lot of risks, but I really am going to listen to you. It was the Type A personality trying to be restrained, which is not easy. But in the end it all paid off.”

More to her liking than swimming were Pilates and a no-impact fitness regimen called Gyrotonic, which uses a system of weights and pulleys to develop strength, flexibility, and balance. The Gyrotonic system, she says, “had an incredible impact on my ability to heal.”

On the one-year anniversary of her injury, Laura held a luncheon for the colleagues who helped her survive on that icy mountain in Montana. In addition to lunch, she presented them with Boy Scout merit badges. She also sent a badge to Dr. Kuntz – for meritorious service in First Aid.

* * *

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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