Buffalo Bills’ Everett May Walk Again

Sept. 12, 2007 — Hospitalized Buffalo Bills tight end Kevin Everett has moved his arms and legs, raising hopes that he may one day walk again.

Everett sustained a severe spinal cord injury in Sunday night’s game against the Denver Broncos. Minutes later, Everett got what’s called modest or moderate Hypothermia treatment from Andrew Cappuccino, MD, an orthopaedic surgeon for the Buffalo Bills.

Everett, 25, is being treated in Buffalo at the Millard Fillmore Gates Circle Hospital, where he had surgery for his injuries. Everett is awake and asking questions, and he is no longer on a ventilation (breathing) machine. Everett is being fed through a feeding tube and is taking medication to try to prevent clots from forming in this legs, doctors said at a news conference today.

When Everett arrived at the hospital on Sunday, he couldn’t move his arms or legs. Since then, he has been able to move his legs and ankles, bend his hip, wiggle his toes, and move some arm muscles.

WebMD spoke with professor Barth Green, MD, FACS, about Everett’s hypothermia treatment. Green chairs the neurosurgery department at the University of Miami’s Jackson Memorial Hospital. He’s also the president and co-founder of the Miami Project to Cure Paralysis, which is part of the University of Miami’s Miller School of Medicine.

Everett’s prognosis is “very good,” Green tells WebMD. Having talked with Everett’s doctors, Green predicts that Everett will walk again.

“He’s got good movement in his arms and legs, and his legs are moving better than his arms,” says Green. “That’s wonderful.”
Kevin Everett’s Treatment

Green explained the hypothermia treatment Everett received on Sunday.

“He received ice-cold saline, which is a salt solution, into the veins of his arm. That lowered his whole body temperature,” Green says.

“This is just a minimal drop in temperature from 98.6 to to 92 degrees Fahrenheit, for example,” Green says. “What this does is just like putting an ice pack on a bruised arm. It prevents the hemorrhage and swelling that would occur if you didn’t put an ice pack on. It’s as simple as that. So it prevents the spinal cord from self-destructing” after the initial injury, says Green.
Timing, Temperature Count

The speedy timing of Everett’s treatment was “totally, totally important,” says Green. He notes that as far has he knows, Everett was the first person to get hypothermia treatment so quickly for a spinal cord injury.

He points out that Cappuccino had earlier attended a Miami Project lecture about hypothermia treatment.

It’s crucial that the hypothermia technique not drop the patient’s temperature too low.

“If it drops below 92 [degrees Fahrenheit], patients can develop cardiac arrhythmias or bleeding problems, so you don’t want it to get too cold,” Green says. “That’s why it’s called modest or moderate hypothermia, rather than profound hypothermia.”

Doctors also gave Everett hypothermia treatment at the hospital.
Hypothermia Treatment: Too Rare?

Hypothermia treatment is used in some U.S. hospitals to help treat heart attacks and strokes.

“We just had a patient here at Jackson [Memorial Hospital] a couple days ago who had a major stroke following a cardiac procedure, and they pulled the clot out and they gave him hypothermia, and he’s walking and talking normally today,” Green says.

But hypothermia treatment isn’t routinely used for spinal cord injury, Green says.

Everett’s case may change all that.

“It just makes us think that all the paramedics in America should be keeping this iced saline in an ambulance,” Green says.

“In Australia, all the paramedics carry these iced saline bottles in their ambulances because they treat all the heart attack victims. …,” Green says. “We use it in the ICU in Jackson for newborns who have brain damage, we use it for heart attack victims at Jackson, we’re using it for spinal injury, brain injury.

“It’s a wonderful tool to have. And the beauty of it, for us, is that it was developed by our basic scientists 20 years ago and … now it’s now used all over the world.”
Spinal Hypothermia Treatment

Hypothermia treatment for injuries such as Everett’s is still considered experimental. Green and colleagues are gathering data on its use.

“But in the meantime, this happened [Everett’s treatment], and we’re not going to deny it happened,” Green says.

The hypothermia technique probably is better suited to some patients than to others.

“For example, a gunshot wound that blows through the cord or someone that has a total severance of their cord is less likely to respond than someone who’s in a football injury,” says Green.

There are “definitely a lot of factors, but the truth is, a lot of people don’t need to be sitting in wheelchairs,” says Green. “We hope we can gain enough attention through what happened to Kevin Everett to get other people the same type [of] opportunities.”

Green has also used the same hypothermia technique on spinal tumors.

“Yesterday I took out a huge spinal cord tumor, a 10-hour operation, and I never could have done it without hypothermia because it protected the cord while I was pushing on it and pulling on the tumor. This guy would have ended up very weak, if not in a wheelchair, and he’s walking around,” Green says.
Karma Plus

Buffalo Bills owner Ralph Wilson has been a major contributor to the Miami Project to Cure Paralysis for the past decade, and Everett played for the University of Miami’s football team, Green notes.

“We’re very grateful that Ralph Wilson believes in medical research,” Green says.

By Miranda Hitti
WebMD Medical News
Reviewed by Louise Chang, MD

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