Spinal Dislocation and Spinal Cord Injury

By: Crystal Huff

Being crushed by a car should have left Stone Wittman paralyzed for the rest of his life, but because of Matthew Goodwin, MD, PhD, a surgical spine specialist with Washington University Orthopedics at Barnes-Jewish Hospital, 23 year-old Stone will make a complete recovery.  

Stone Wittman and his girlfriend at a demolition derby before his accidentOn September 7th of this year, Stone was finishing up some minor repairs on his race car. He was preparing for a demolition car race the next day.  

“I was squatting under the car welding to add structural strength and without warning the car came off the chains supporting it and crushed me,” says Stone. The car came down with such force that it bounced and rolled back and luckily did not trap Stone. Stone had been knocked forward and once the car was off of him he was able to flip over to his back. “I knew instantly that I had broken my back. I had a little movement in my feet but had no feelings in my legs.” Stone’s younger brother, Luke, immediately starting clearing equipment from around him.  

His girlfriend, Kelsey, heard the commotion and came out to see what had happened. Stone told her to call 9-1-1. “Kelsey is six months pregnant and all I kept thinking while lying there waiting for the ambulance is  with a baby on the way, I cannot be paralyzed.”

Once the ambulance arrived, they decided to have Stone Airlifted to Barnes. Stone arrived around noon and Dr. Goodwin was in the middle of another surgery which wrapped up around 11 pm. Stone recalls, “While I was in the ED the residents and fellows kept coming in because as my family and I understood that from the results of my CT and the extent of my injuries it was a miracle that I wasn’t paralyzed.”  

Dr. Goodwin explains, “Stone had a traumatic three-column injury through L1, dislocation of bilateral facet joints, and translation of T12 on L1 with severe stenosis and kyphosis. In other words, he essentially dislocated his entire spine and his spinal cord was getting crushed. The residents and fellows were phenomenal in expediting his case. One look at his radiograph and even someone who has never seen an x-ray before would spot the injury!”

As Stone was being prepped for surgery, Dr. Goodwin came out and introduced himself to Stone and his immediate family.  “He exchanged cell phone numbers with my parents and sent updates regularly.”  

Due to Stone’s delicate situation, even though he was taken to the operating room at 11 pm the first incision was not made until 1 am. “They had to be very careful on my positioning and getting me flipped over onto my stomach because one false move and I would have been paralyzed.”  

Dr. Goodwin gives most of the credit to an amazing team at Barnes-Jewish Hospital. “The residents, fellows, and OR staff at Barnes-Jewish Hospital went above and beyond as they do with every case.  In fact, Michael Reiter, MD is a spine fellow who worked on Stone with me for the full length of that case. I really could not have done it without him. In the OR, I was very direct with the team in how I wanted the situation handled because Stone’s ability to walk depended on it.” 

Stone’s dislocation had his upper body pitched forward; he was at risk of pinching his cord and causing permanent damage if made to “lie flat.” Dr. Goodwin had a resident actually stay with Stone during his MRI to ensure that Stone was not forced flat on his back but they could still obtained the images that were needed. “With spine injuries, lying flat is the typical spine precaution. There are reports of people getting paralyzed or dying in situations similar to this. Using a resident, a highly trained MD, to do this is costly in many ways, but something we do in these cases because of our commitment to patients like Stone. We take this very seriously.”

Because Stone’s injuries were so critical, every extra precaution had to be made.  

“Once we were in the OR, I had his scans up on the monitor and made everyone look at them with me so they understood that his ability to walk depended on everyone’s best effort. We then performed multiple “time outs.” One upon entering the room, to be sure everyone knew not to lie him flat, a second time before moving him, and a third time just before cutting his skin. The real credit should go to the Barnes-Jewish Hospital OR staff in POD5, who not only were flawless in their handling of moving Stone, but also were incredible in really coming together as a team to care for him. I am also very lucky in that I have six incredible spine surgeons as partners here. Anyone of them is happy to take a call if I want to discuss a tough case or talk through what the options are. That makes us really strong as a team and allows us to deliver a consistently high level of care, day or night.”

Post-surgery, Stone was in the ICU for a few days and then was scheduled for a second surgery to repair his shattered ankle. Stone recalls after his spine surgery, “My older brother, Mitch, told me he had been researching Dr. Goodwin to make sure I was in good hands. He said, “Your surgeon is really good, he is number six on the list of Top 20 spine surgeons under 40 for 2019.” 

Stone working as an Ameren linemanAfter his ankle surgery, Stone was moved out of the spine unit and onto the 6th floor. “Dr. Goodwin continued to monitor my progress very closely and if I had any questions or concerns he would quickly respond to my calls or text messages.” 

“Dr. Goodwin is very professional. He made sure my care was his top priority. He sat down and made a connection with me.  You can tell he genuinely cares and takes pride in his work.”  

Stone was sent to a rehabilitation center and was told he’d be inpatient for two weeks and after just five days, he was able to go home.  

“This is a great story because it really is not about the surgeon at all. This is a story about a resilient young man who had a bad accident but stayed positive, and who was taken care of by a surgical team and a hospital that really prioritizes patient care. It took me several hours in the middle of the night to carefully put his spine back in place while protecting his spinal cord, but no one ever complained. Instead, I had an army of staff behind me fighting to get Stone back on his feet. And we won. Stone won.”  

Stone says that he may have had to give up demolition racing but he will continue to work on cars, restoring them. He is also looking forward to returning to work as an Ameren lineman within the next year.   

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