A cattle ranchers, Male, 45 years old was brought to my hospital due to terrible accident during his daily routine caring for his cows. A raging cow suddenly kicked him from behind and bounced him then landed with his head first hitting the ground, render him unable to move all of his extremity. He even cannot move his lower extremity at all, but still able to move his upper extremity weakly
The picture clearly showed a bilateral facet dislocation of C5-6, with ASIA A at the level C4
I decided to perform urgent decompression and stabilisation of the cervical spine. As now a days we actually know there is two contrary group between urgent decompression versus late decompression, and also disputable concept whether corticosteroid will be given or not initially. During my residencies it is also a big taboo to perform surgery during first 2 weeks after the trauma, our senior said that "patient who can survive more than 2 weeks is considered fit for surgery and they have bigger chance to pass those crucial emergency period"-- it was like a mantra for me during that day. But we know the term of life is movement and movement is life and there is nothing last forever, except the process of changing itself. No one concept is eternal, so i put my mind to proceed and perform the surgery
Can you see those black baseball helmet? Yes, it is a conventional baseball helmet that was bought at hiroshima city - japan, by my friend who joined attachment programme at hiroshima university. i customised it and use it as a head rest complement for operating table preparation.
