In an extremely rare and complex operation, surgeons at Hadassah Medical Center reattached the head of a 12-year-old boy to his neck after a serious accident in which he was hit by a car while riding a bicycle, the Jerusalem hospital said on Wednesday.
Suleiman Hassan, from the Jordan Valley, was flown to Hadassah Hospital’s trauma ward in Ein Kerem, where it was found that the ligaments holding the posterior base of his skull had been severed from the upper vertebrae of his spine. The condition, a bilateral dislocation of the Atlantic occipital joint, is commonly referred to as internal or orthopedic decapitation.
The injury is very rare in adults and even more common in children.
“We fought for the boy’s life,” said Dr. Ohad Einav, the orthopedist who treated the patients with Dr. Ziv Asa and a large operating room and intensive care team operated. The operation was performed in early June.
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“The procedure itself is very complicated and took several hours. In the operating room, we used new plates and fixations in the damaged area… Our ability to save the child was due to our knowledge and the most innovative technology in the operating room,” said Einav.
Hassan was recently discharged home with a cervical splint and continues to be closely monitored by Hadassah staff.
“The fact that such a child has no neurological deficits [and] “It’s no small feat to be able to walk and function after such a long process,” Einav said.
A 2003 report by the Children’s Hospital of Philadelphia said that of the 2006 patients it treated for spinal cord injuries between 1983 and 2003, only 16 suffered from a dislocation of the occipital joint.
The survival rate of those who suffer internal decapitation is low. In most cases, the injury results in death. There is evidence that children are better off than adults, but there is not enough data to compare children and adolescents.
A 2021 review of childhood injury studies found that 55% of respondents did not survive the initial injury, transport to hospital, surgery and recovery.
The hospital reported that the boy’s father did not leave his son’s bed during his recovery from surgery.
“I will thank you all my life for saving my dear only son. Bless you all. Thanks to you, he regained his life even when the odds were slim and the danger was obvious. What saved him was professionalism, technology, and quick decisions from the trauma and orthopedic teams. All I can say is a big thank you,” he told the medical staff.
In a statement to the media, Einav said the operation carried out at Hadassah was carried out elsewhere. He was aware of several cases involving adult patients at a Toronto trauma center.
“This is not a common operation at all, especially not in children and adolescents. To do that, a surgeon needs knowledge and experience,” he said.