Dennis Byrd tackles spinal injury - former New York Jets lineman's rehabilitation from paralyzing injury - Cover Story

Science World, Nov 19, 1993 by Karen McNulty

The story of his tragic accident and remarkable recovery.

Am I going to be paralyzed?"

That was the question New York Jets defensive lineman Dennis Byrd kept asking the people around him as he lay in an ambulance, unable to move or even feel his limbs, last November 29.

Minutes earlier, the 270-pound lineman had been barreling down the field, intent on sacking the opposing team's quarterback. But just as Byrd lunged, the QB stepped clear. And Byrd slammed instead into 275-pound teammate Scott Mersereau, who was steam-rolling in for the sack from the opposite side. In that tragic second, Byrd hit head-first, shattering a vertebra, one of the 33 bones that make up the spine.

"The hit was deafaning," recalls Byrd. "I remember the feeling of slowly falling to the ground.... I tried to take my helmet off, to unsnap the snaps with my hand, and it ... it just wouldn't work right.... At that point, I began to realize that there wasn't any feeling."

AGAINST THE ODDS

There was no feeling because when the bone burst, pieces of it flew like shrapnel into the delicate nerve tissue it normally surrounds and protects: the superhighway of communication between body and brain known as the spinal cord.

The spinal cord and the brain make up the body's central nervous system (CNS)--the place where all body functions, like tackling a quarterback, are coordinated. The brain makes most of the decisions, for example, on how to move. But the spinal cord plays a vital role in collecting the information those decisions are based on, and sending the instructions on how to act to other body parts, like muscles.

The nervous system does well this communicating via electrical signals that travel along nerves made of neurons, or nerve cells. Nerves outside the CNS--in the peripheral nervous system--collect information from sense organs (e.g., eyes, skin, and so on) via sensory nervous. These neurons send their signals to spinal cord neurons, which send the info up to the brain. Spinal cord neurons then carry signals down from the brain to motor neurons, which instruct muscles and organs on what to do.

Damaging the spinal neurons, as Byrd did, cuts off this two-way communication. The neurons below the injury are left disconnected, unable to send or receive signals. For Byrd, whose broken vertebra was in his neck (just below the nerves that control breathing), that meant everything from his shoulders down was paralyzed. Though his brain tried to tell his hands to take off his helmet, his hands couldn't get the message.

To make matters worse, damaged nerves of the central nervous system do not regenerate, or grow back. So it was unclear if Byrd would ever walk or use his arms again. "In my heart, I felt that he never would," says Jets team doctor Elliott Hershman.

But just ten weeks later, Byrd did walk--on crutches, into a press conference at Mount Sinai Hospital in New York, to announce that he was going home. How did he make such a remarkably recovery?

The answer lies in the nature of Byrd's injury and how he was treated immediately following the accident.

LIMITING THE DAMAGE

Football trainers and team doctors know that players literally risk their necks on the field. So they already had a plan of action in place When Byrd went down.

Part of the plan involved injections of a new drug into Byrd's bloodstream. The drug a steroid, is the first ever to be effective at limiting the damage of spinal injury. It's only been in use since 1990.

The drug works because the crippling damage of spinal injury doesn't happen all at once, explains researcher Dr. Wise Young. "It's like being punched in the eye," he says. "Initially you don't have a black eye. But over a period of a few hours, the eye puffs up and starts to hurt more."

In the spinal cord, this "secondary damage" occurs when toxic chemicals leak out of dying nerve cells, killing those that were initially unharmed. In addition, inflammation around the injury chokes off the surviving cells' blood supply.

The drug can block these secondary effects if injected within eight hours of injury, says Young.

Such preventive treatment was particularly important for Byrd because early tests showed that he did retain some sensation. That meant his injury was incomplete--some spinal nerves were still functioning. Saving those from further damage could mean the difference between life in a wheel-chair and walking.

The next step was surgery. For seven hours, doctors worked to remove bone debris from Byrd's spinal cord and shore up his backbone with metal plates. They also gave him an experimental drug that some researchers say may stimulate repair in spinal neurons.

REHAB THERAPY

Two weeks later, Byrd began rehabilitation therapy. At first, he was unable to move on his own. Therapists flexed and stretched his motionless limbs to keep the muscles there from deteriorating further from lack of use. (He'd already lost some 40 pounds.) Meanwhile he worked to strengthen his usable neck and shoulder muscles.

Little by little, he made progress. "Within a couple of weeks he was ... doing wheelchair races with me," says physical therapist Joanne Giammetta.