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Walking tall

Lee Hambrook, with wife Diana, is looking forward to getting back on the water soon.

Man Undergoes Record 14-hour, Double-Sided Spinal Surgery

On October 10, 2006, a driver ran a red light in Venice, Fla., and rammed 71-year-old Lee Hambrook's car. Shaken up, Hambrook walked away from the destroyed car. But later, even though everything seemed fine, he pondered whether he should get himself checked out.

That bit of caution likely saved him from becoming a wheelchair-bound quadriplegic, his doctors now say. It also prompted some history making at Mayo Clinic in Jacksonville, because Hambrook eventually underwent spinal surgery of a magnitude rarely performed in the clinic's operating rooms.

Two days after the accident, Hambrook went to a Sarasota clinic to make sure everything was okay. He was stunned by what his diagnostic scans revealed. "I was told I would probably need major surgery because of what they saw around my spinal cord," he says.

He was even more surprised when it later turned out that no physician in South Florida would take on the operation. Hambrook was referred instead to Mayo Clinic in Jacksonville and told that only the surgeons there could provide the care he needed.

Hambrook and his wife of 45 years, Diana, saw Mayo neurosurgeon Dr. Ronald Reimer in late November. When Reimer examined his X-rays, CT and MRI scans and described what needed to be done, the seriousness of his situation finally set in.

Hambrook's post-surgery neck X-ray.

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"If the initial injury had compressed the spinal cord just a millimeter or two more, it could have rendered Mr. Hambrook a quadriplegic," says Reimer. "He was very fortunate."

"When it's your back and neck they're talking about ... ," says Hambrook. "This was all quite scary."

Up to that point, he didn't know that the moderate weakness he was starting to feel was anything to be concerned about.

"I couldn't get out of my chair without Diana helping me, and I was walking a little unsteady," he says. "It was more than just a lack of energy — more like a total encompassing weakness — but I didn't associate it with anything except just old age and maybe the shock of the car accident."

His physical exam revealed moderate weakness in his arms and gait unsteadiness. Hambrook had a significant disc herniation at the last vertebra in his neck, which was compressing and flattening his spinal cord and putting the function of his arms and legs at risk, Reimer says. In early December, Hambrook had an operation, led by Reimer with the help of several other surgeons and support staff.

"Our integrated group practice allows us to orchestrate the expertise of many specialists to perform this kind of complex surgery," Reimer says.

The operation was extremely complicated because to remove the problem disc, which had herniated and was pushing against the front of the spinal cord at the junction of the neck and chest, the surgeons had to take a highly unusual route. They had to go in through the chest via the sternum, exposing his heart and all its great vessels, as well as through the front of the neck. The team of surgeons removed the vertebral body and disc compressing the spinal cord and two injured discs above it. Reimer also removed a splinter from the fractured vertebral bone in his neck that, due to the traumatic impact in the accident, was indenting the spinal cord. They then used an expandable titanium cage to bridge the segment where the bone was removed, and placed bone grafts where the two upper discs were taken out. Lastly, they affixed a stabilizing titanium plate spanning the entire operated segment between Hambrook's mid neck and upper chest.

The surgery took eight hours, but Reimer wasn't done. Two days later, in a six-hour procedure, surgeons tackled the spine from the back. They inserted screws and implanted rods between the screws to adequately stabilize the spine. More bone was removed to relieve all pressure on the spinal cord.

"It is very rare that we have to perform both anterior and posterior surgery on the spine," says Reimer. "In my experience, this is one of the most extensive surgeries we have had to perform on anyone." Hambrook is recovering and is in physical therapy. He wears a brace that runs from his neck to his lower torso, but he hopes to shed it soon and get back to some of the activities, such as sailing and fishing, that brought the couple from Minnesota to Florida six years ago. He agrees with his wife when she says that the experience has brought the two of them closer than ever before. It's also resulted in some wonderful family time with their four sons and their families.

"We are all working together to get my back straight," Hambrook says. "I am a fortunate man."

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