Boy Suffers Internal Decapitation

Dec. 14, 2010 — -- Heather Andrews, 34, of Phoenix felt a vehicle slam into the front passenger side of the car she was riding in one night last August.

"I was trying to work through the sensations I was feeling in my legs and arm," said Andrews.

She called out to her children who were sitting in the back seat. Her 4-year-old daughter responded, but her 2-year-old son, Micah, who was sitting in the rear passenger seat, lay still.

"I put my hands on either side of his face, because if he was to wake up I didn't want him to jolt," she said. "And I leaned as close to him as I could and listened to his breath."

Before long, rescue teams pulled them out of the car and rushed them to St. Joseph's Hospital and Medical Center in Phoenix. John Andrews, 34, Andrews' husband, who wasn't involved in the accident, met his family at the hospital.

"I walked in and saw Heather," he said. "She said, 'I'm fine but Micah's not responding.' It was shocking. It knocked the wind right out of me."

Micah was strapped into a car seat at the time of the accident, which many believed had initially saved his life. Still, doctors told his parents that the impact had jolted his head sideways so forcefully that his skull separated from his spine -- a condition called atlanto-occipital dislocation.

"Essentially, this is a child whose head was not connected to the rest of the body," said Dr. Nicholas Theodore, a neurosurgeon at Barrow Neurological Institute, part of St Joseph's Hospital and Medical Center, who treated Micah.

Even the slightest head movement in Micah's condition could stretch his spinal cord and lead to paralysis or death. Theodore told the Andrews' he would need to operate to save Micah's life.

"I was really concerned with them being able to keep him stable," said Heather Andrews. "It's surgery next to your brain stem and nerves. It's not a large space to be doing such an intricate surgery."

But Micah's parents said they couldn't help but feel relieved by Theodore's reassurance.

Reattaching Base of Skull to Spine

Atlanto-occipital dislocation, or internal decapitation, although a rare condition, is treated by surgically implanting a titanium loop to reattach the base of the skull to the spine. A piece of the patient's rib holds the rod in place.

"His head was kept perfectly still with sandbags on either side of his head, and he was taped down very precisely, so that he wouldn't move," said Theodore, who said he has used this procedure more than 75 times.

While the procedure could inevitably result in lifelong paralysis, Micah surprised his family, and even his doctors. The 2-year-old was released from the hospital nearly two months after surgery. And with therapy, he can walk and talk again. Although he struggles to regain physical balance, and with some aspects of his speech, his parents said they've seen a great improvement and have already begun to home school him.

"We're going to keep pushing him and pushing him and pushing him with his therapy," said Micah's father.

And Theodore said he only expects Micah's condition to improve.

"You know, miracles happen every day," said Theodore. "And when I first saw Micah I certainly never would have imagined at this point that he'd be looking as good as he does, and I think he continues to surprise us."

To learn more about how safety seats can protect a child's life, please visit the Child Safety section on the National Highway Traffic Safety Administration website.