Dr. Edward Benzel, a spinal surgeon and chairman of Neurosurgery at the Cleveland Clinic, said that doctors have many things to sort out before making a definitive prognosis for patients like LeGrand. Doctors will likely assess the injury through neurologic examination to see if there is even the slightest amount of motor, movement, or sensory function.
"Aggressive examinations will take place to see if he can move or feel below the level of injury, and if there is any voluntary motion," Benzel said. "The rectum is usually one of the last areas of sensation to go. If, and only if, those are all gone can a doctor say that the prognosis is exceedingly poor. If he has any sort of sensation, he has a chance of substantial recovery."
Benzel continued, "I use this analogy in a person with a neurologic injury: There are two types of injured neurons, neurons that are dead and neurons that are stunned. Dead neurons are unable to recover, but with the stunned neurons, by creating the right environment for the spinal cord, the stunned neurons could recover and function again."
Still, it's tricky to figure out which neurons are dead and which ones are stunned, Benzel said. In general, patients can see neurologic recovery up to two years after the injury, but it is mostly seen about six months after. If a patient is going to recover, the process begins within the first month. But Benzel made sure to reiterate that those are extreme generalizations, and he's seen people improve who he didn't expect to improve, and vice versa.
"It is a long road of frustration and not knowing, and we have to make sure to care for the patient's mental health during the process," said Dr. Jeffrey Kutcher, assistant professor of neurology at University of Michigan and director of Michigan Neurosport. "In rehab, doctors will start with the smallest movements, and try and support those movements with exercises that will improve the strength for bigger movements."
While spinal surgery has been researched and examined extensively over the years, some doctors say there has been an unfortunate lack of advances in the field.
Benzel said that spinal surgeons have learned to use air ventilators in patients to support their breathing and catheters to prevent kidney infections. There have been improved techniques in taking pressure off the spinal cord, but otherwise, breakthroughs and treatments have been slow.
"In my opinion, no treatments in the past few decades have been real breakthroughs," said Benzel. "We see small improvements here and there, but nothing major. I'm still hopeful that at some point there will be more opportunities for better treatment. "
But doctors and researchers are trying. Just last week, U.S. doctors began treating a new spinal cord injury patient with human embryonic stem cells. The hope is that the cells will travel to the site of the injury and help the damaged nerves regenerate.
After Ted Roosevelt broke his nose playing football at Harvard in 1906, his father, President Theodore Roosevelt, established the the NCAA, to set rules for amateur sports in the U.S. Today, the organization works to set safe regulations in a positive environment for young athletes.