'Internal Decapitation': Boy's amazing recovery

December 23, 2008 What the Hillsboro, Texas, woman does recall is how her car slammed into the side of a dump truck at an intersection at which she had the green light. She remembers losing consciousness and then awakening to find the flesh of her arm flayed by the broken glass of her shattered windshield.

But Perez says her most nightmarish memory of the accident was looking into the back seat to see the horrific injury her 9-year-old son had sustained.

"I remember getting out of the car and looking over at him and seeing his how his head had just fallen down," she said.

Jordan Taylor had been buckled in his seat. But the precaution did not protect him from what doctors term an atlanto-occipital dislocation. In other words, the force of the impact had shoved his skull an inch forward, separating it from his spine. It's an injury some call an "orthopedic decapitation."

"At that point I saw my arm, but I didn't care, because I was screaming for Jordan, and I didn't get a response," Perez said. "Two other people who had shown up were helping me because I couldn't really stand. They helped me to the ground, and I am just screaming his name."

Doctors say that 98 out of 100 times, this injury leads to death. Taylor, fortunately, survived long enough to reach a hospital.

"This was the first [patient] with this condition that I've seen survive," said Dr. Richard Roberts, the pediatric neurosurgeon who treated Taylor at Cook Children's Medical Center in Fort Worth. "It's not very frequent that this kind of patient makes it to us."

For most of those fortunate enough to survive, a lifetime of paralysis awaits. But after a recovery that even Roberts says he cannot completely explain, the boy was deemed well enough to be released Friday, three months after the accident.

And after he was discharged, Jordan walked out the hospital doors.

Surviving an 'Internal Decapitation'

Doctors quickly pointed out that an atlanto-occipital dislocation cannot be called a "decapitation" in the traditional sense. For one thing, even though the skull is disjoined form the spinal column, the head does not technically leave the body. And in Jordan's case, as with others, the spinal cord -- that crucial superhighway of nerve fibers that connects the brain to the rest of the body -- was not severed.

Still, Dr. Phillip Tibbs, chair of neurosurgery at the University of Kentucky, says that in many cases, the end result is much the same.

"We've seen several cases of it ourselves," he said. "It is not an uncommon injury for people who arrive DOA [dead on arrival]. ... It is rare to survive this."

Indeed, Jordan's case was severe; Roberts says the boy's condition was touch and go for weeks. But Jordan was particularly fortunate that his spinal cord had sustained minimal damage from his ordeal.

Initially, Roberts says, the damage to the nerves was apparent; Jordan suffered from weakness in his left side, which suggested that his spinal cord had been bruised, stretched or otherwise injured in the car accident.

The vulnerable nature of his spinal cord also made surgery an extremely delicate undertaking. To reattach Jordan's skull to his spine, Roberts and his team used an assemblage of metal plates, screws and titanium rods. Only after this surgery and intensive physical therapy would the true toll of the accident become apparent.

But in the weeks after the surgery, Jordan displayed an ability to recover that shocked his mother and his doctors.

"Everything started progressing positively really fast," Perez said. "It was like somebody during surgery had given him this medicine that would make him heal quickly, like a superhero or something."

And Roberts says that Jordan seems to be making progress toward a relatively normal life.

"I think he's very close to baseline," Roberts said. "We had to work on his left side initially, but he just recovered. That was just him healing."

A Changed Life

These days, Jordan spends his free time playing air hockey and video games with his uncles and learning how to play the guitar. His mother says that there will be things that he will never be able to do because of his ordeal.

The simple act of turning his head is one of these. Another is playing football -- a sport in which Perez says he had looked forward to participating. Jordan also still uses a breathing tube to keep his airway open.

But while most of those who have lived through a experience like Jordan's have sustained significant brain damage, Perez says her son still reads a grade above his level. At a time when many who are fortunate enough to survive this injury face severe physical impairment, Perez says the biggest challenge for her family is keeping up with Jordan as he continues to walk and run.

"He's like a little boy again," Perez said. "I'm just grateful that he is alive and breathing, and he is walking -- I have to tell him to slow down."

"This is the best Christmas miracle that I could ever imagine."

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