By Sheila Dwyer, MedTech1 Staff
On April 8, 2000, Tom Keppeler set out to train on a mountain bike trail. That day on the eight-mile course, he was a confident, competitive bicyclist who was trying to keep his muscles warm from a more intense workout the previous day. Just a couple of hours after he started the trail, however, Tom found himself inside a hospital emergency room, unsure he would ever walk, much less bike, again.
A tree’s root was hidden under leaves at a crucial turn in the road. Tom did not see it, and his bike flipped him over the handles. “It was the nastiest spill I had ever taken. I landed directly on my head.” Fortunately, Tom, like all serious bikers, was wearing a helmet.
After a self-evaluation, Tom decided to ride himself home, which happened to be in downtown Boston. As he biked past some hospitals, his neck began to tense up from his shoulders to his head. The adrenaline from the accident was beginning to wear off, and his true injury was starting to make itself known. Still wearing his helmet, Tom walked into the emergency room at Brigham and Women’s Hospital.
His range of motion by the time he walked up to the desk was minimal. He was developing a locked jaw. Worst case scenario, Tom feared he had broken his clavicle or collarbone. Until he passed out and woke up strapped to a stretcher. He could hear doctors and nurses talking about getting him to an X-ray as quickly as possible. Tom upgraded his worst case scenario to a hairline fracture in his skull, which was painful, yet survivable. He also noticed that his helmet was still on his head.
The doctors X-rayed him from above while he was flat on his back, as well as from either side of his neck. After the test, Tom found himself alone and able to move only his eyes. In this state, his doctor gave him his diagnosis, which was far worse than anything Tom had expected to hear.
As a curious bystander, Tom had read about the injury sustained by actor Christopher Reeve in his fall from a horse a couple of years before. Tom knew that Reeve had broken his C1 and C2 vertebrae, and that the actor has been a quadriplegic ever since. When the doctor told Tom that he had sustained the same injury in his bike accident, all he could do was cry as quietly as possible so as not to move his neck.
The nerves that run through C1 control your breathing. The nerves that run through C2 control your motor skills from the neck down. What is amazing is not that Tom managed to break the two vertebrae, but that he recovered fully from his accident.
Today, Tom is a fully-functional 21 year old, thanks to the medical technology available to him and his doctors. Following his X-ray, Tom underwent a CT scan to investigate his spinal column. The doctors evaluated his situation and decided that their only option was to put Tom in a halo device.
Tom wore a halo to restrict his neck movement as much as possible. He wore a molded plastic body jacket with a “cervical extension” that points upward and attaches to a round, metal ring around his head. This ring is the halo. The halo itself had four steel pins that screwed directly into Tom’s skull to hold his head and neck in a completely immobile position.
Tom was hospitalized for only five days, during which time his doctors determined he would make a full recovery. When he left the hospital, however, the halo went with him. The device is designed to stay in place and arrest virtually all movement of the cervical spine until the bones mend completely.
Although he still has visible scars on his forehead from the halo device, perhaps the most lasting scars come from the taunts he received in public over the three months he wore the halo. “When I was walking down the street, people would give me funny looks. That was not a big deal until it became the norm,” he says. “I had this fence around me and people could not bear to look at me.”
A year after the accident, he can look back on the halo days with a grateful detachment. “This is a device that saved my life, that allowed me to take this interest of mine to the threshold of death and return,” Tom says. “Although it made me look like an alien, the halo did allow my bones to heal. Now I have a spine that is tougher than anyone else’s.”
