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HomeNewsDoctors on the Scene Acted Quickly to Treat Everett With Cold Therapy

Doctors on the Scene Acted Quickly to Treat Everett With Cold Therapy

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BUFFALO, Sept. 15 — In the moments after a serious spinal cord injury paralyzed Kevin Everett of the Buffalo Bills below the shoulders, doctors began an innovative treatment based on a familiar premise: apply ice to reduce swelling.

In this case, though, instead of using ice, doctors chilled Everett from the inside, infusing cold fluids into his veins. The treatment is experimental, though, and medical experts caution that it is impossible to say in an individual case whether it helped or hurt.

Even if it does work, it is not clear whether the chilling has to start immediately, as happened with Everett, or whether it can start later, at a hospital. But the surgeon who operated on Everett is convinced. He said the treatment, known as moderate Hypothermia or cold therapy, is responsible for Everett’s ability to move his arms and legs days later.

“I will hang a good portion of my belief in this recovery on cold therapy,” the surgeon, Dr. Andrew Cappuccino, said by phone Friday, “because we don’t normally see this recovery in people with spinal cord injury where cold therapy is absent.”

Cappuccino treated Everett with cold therapy after he sustained direct compression, or a bad dislocation, of his spinal cord between the C-3 and C-4 Vertebrae in his neck. In such cases, only about 5 percent to 10 percent of patients regain normal function, Cappuccino said.

Everett was injured last Sunday on the first play of the second half of the Bills’ 15-14 loss to Denver while making what appeared to be a routine tackle of the Broncos’ Domenik Hixon. Everett lowered his head at the last moment, striking his helmet on Hixon’s shoulder pad and collapsing face first to the turf. He lay motionless for about 15 minutes while he was tended to by the medical staff.

On the ride to the hospital, Cappuccino began cold therapy treatment. He had the ambulance air-conditioning set at the lowest temperature, as Everett received two liters (about two quarts) of ice-cold saline solution intravenously, and called the hospital to prepare a cooling blanket.

“There is no specific written protocol” for cold therapy, Cappuccino said. But he said the goal was to lower a patient’s body temperature to reduce inflammation and the destruction of cells in the spinal cord, which can lead to further damage.

Everett was taken to Millard Fillmore Gates Circle Hospital in Buffalo, where he underwent four hours of surgery by Cappuccino and a team of doctors. They realigned his neck and stabilized it in front with a titanium plate. The rear was secured with titanium screws and short rods.

After surgery, a Catheter was inserted into Everett’s left femoral artery, near his groin, to circulate ice-cold saline in his veins, lowering his body temperature to 92 degrees for about 24 hours.

“It does seem to have some benefit,” said Dr. Robert Cantu, co-director of the Neurologic Sports Injury Center at Brigham and Women’s Hospital in Boston. “Whether it’s responsible exclusively for the return or the recovery in this particular case, it’s a little hard to say. It may have happened anyway. But nobody could say it didn’t contribute to this quite remarkable turnaround.”

But studies have not always borne out the initial promise. For example, although neurosurgeons had high hopes for hypothermia to quell damage from brain injuries, a rigorous study showed it did not help. In fact, patients who were chilled actually spent more days in the hospital with medical complications than those whose bodies were kept at a normal temperature.

Cantu said that hypothermia treatments, which date to the 1960s, fell out of favor because of side effects, including blood clots and harm to vital organs.

“There is a burgeoning volume of literature and research on the utilization of limited hypothermia in the care and treatment of acute stroke,” Cappuccino said.

But Everett’s case may be the earliest application of treatment for a spinal cord injury because doctors were on the scene.

There are 11,000 spinal cord injury cases a year in the United States, according to the Spinal Cord Injury Information Network. Most victims do not have doctors standing by, thus making cases of early intervention with cold therapy difficult to study.

“How could you get treatment to a patient quickly in another scenario?” said Dr. James Weinstein, editor of the journal Spine and director of Dartmouth Institute for Health Policy and Clinical Practice.

Cappuccino said he learned about hypothermia treatment in spinal cord cases during a seminar last year conducted in part by Dr. Barth Green, chairman of neurosurgery at the University of Miami medical school. Green is also president of The Miami Project to Cure Paralysis, a foundation created in 1985 with Marc Buoniconti, the paralyzed son of the Pro Football Hall of Fame linebacker Nick Buoniconti.

Marc Buoniconti sustained an injury similar to Everett’s in 1985 while playing football for The Citadel. “When I first heard of Kevin’s injury, I was very disappointed,” Buoniconti said. “I want the public to know that I hear about this stuff every day. It’s unfortunate the only time the public hears about it is when it happens to prominent people.”

Still, cold therapy will remain unavailable for most spinal cord injury patients. Cantu said, “The only negative thing about this to me is that if someone didn’t get this treatment, that’s not like saying they didn’t get appropriate medical treatment.”


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