A 2-year-old boy involved in a car accident underwent a groundbreaking surgery to reconnect his head to his spinal cord. Dr. Mohamad Bydon of UChicago Medicine explains the complex procedure and its potential impact on pediatric neurosurgery.

Chicago

A two-year-old German boy named Oliver Staub suffered life-threatening injuries in a car accident while vacationing in Mexico, resulting in a rare internal decapitation and complete spinal cord transection. Initially believed to be dead, Oliver was stabilized by paramedics and later transported to the University of Chicago after his family sought help from specialists across Europe and North America.

At the University of Chicago, a large multidisciplinary team performed several complex surgeries over multiple days to reconnect Oliver's head and spine. The procedures involved neurosurgeons, plastic surgeons, ENT specialists, anesthesiologists, and pediatric doctors. Despite the severity of his injuries and the initial prognosis, Oliver survived the ordeal, with the surgeries considered a significant medical achievement.

Doctor reconnects 2-year-old’s head to spinal cord after crash

Tell me about this boy who you operated on. So Oliver Staub is a young two-year-old boy from Germany. His father's from Germany. They were vacationing, he and his family in Mexico when a very devastating car accident hurt the entire family minimally with the exception of Oliver who was really maximally injured. It was thought that Oliver was in fact dead on the scene. He probably didn't breathe for up to 20 minutes, people think, and so there's a lot of questions around the paramedic record at that time, but the family thought that he was dead in that moment. And the paramedics came right away. They did, as soon as they got there, the paramedics did very quickly put a breathing tube in for Oliver and take care of him and stabilize him, but he was thought to be dead. And when he went to the hospital, the physicians in Mexico told the family, he's dead, you should register him to be an organ donor. And indeed, the family signed him up to be an organ donor, but he didn't die. He started to open his eyes. So then they said, okay, we want everything done for Oliver. But the injuries that he had at that moment were really devastating. They were beyond what we consider to be injuries compatible with life. For example, he had what we call an atlanto-occipital dissociation, meaning dissociation between his head and his spine internally. He had a complete transection of his spinal cord, meaning it was cut in half. He had a complete break of his vertebral body and of his posterior elements. And so he had injuries- Well, let me stop you there. Let me stop you there. Does that mean his head wasn't connected to his body? Is that what that means? Internally, yes, that's what that means. So what was holding it on? Just the exterior part of his neck was holding it on? The skin, the muscles, those are the elements that were holding everything together for Oliver. And then that's considered a highly unstable condition, as you can imagine. And so the physicians locally put him in a brace and his parents are the most loving, devoted parents. He's got twin siblings. They did every precaution to ensure that there was no movement, no deviation, but any little trigger, any little issue, and he was on a ventilator. He was sent home like that. And so any little issue could have resulted in his death. How did you hear about him? The parents went to centers and physicians all over North America and all over Europe with them being from Germany. And so they sought centers from everywhere to seek help. I'm a leading neurosurgeon in this country and I've done a lot of work around spine and spinal cord injury. And so they sought me out. And they said, everybody, what can you do? Everybody has said no to us. The doctors here think he's just going to die. And I said to them, I said, this is a highly unstable condition. I don't know that what we're going to do surgically is going to help him, but we can try because your alternative is to remain in this current condition, which is just so terrible. And so as I saw it, I couldn't believe that he was alive three months after his injury, that he was still alive and that they were keeping him going in that state. And they medical transported him then from Mexico to, they sold their home in Germany. They medical transported him to the University of Chicago. And when we first saw him and first began to prepare for surgery, the brace hadn't been removed in three months. He had abrasions and lesions just coming from him. And so he was in very, very dire straits when he came to us. How long was the surgery? Multiple surgeries over multiple days, each of which extended all day over many hours. And so this was a really significant feat requiring large teams of surgeons. We have Comer Children's Hospital at the University of Chicago. And so surgeons from there, neurosurgeons, other types of plastic surgeons, ENT surgeons, many anesthesiologists, critical care medicine, pediatric doctors. And so really a whole team came together to deliver multiple surgeries for Oliver.

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