Case Study 17: Melbourne to Middlemore (NZ)

Royal Talbot Rehabilitation Melbourne to Middlemore Spinal Rehabilitation Unit, Auckland New Zealand

A 18 year old male from New Zealand was living in Melbourne for four months while playing in the local football league. During training he became injured when a player landed on his neck and he was admitted to the Royal Melbourne Hospital with a hyperflexion injury of the cervical spine with axial loading during March 2013. A Computer Tomography scan showed perched facet joint anterior listhesis of C4 on C5 and he was intubated and transferred to the Austin Hospital spinal intensive care unit.

Magnetic Resonance Imaging scan showed bilateral C4-5 facet joint dislocation with resultanting cord oedema and cord effacement and he immediately underwent a posterior C4/C5 stabilisation, decompression and Anterior Cervical Discectomy and Fusion.

He was extubated in April as he progressed to the spinal ward with an incomplete spinal cord injury with sensation to his arms and legs. Over the four week period he continued to demonstrate improvements with sensation and movement and he was transferred to the rehabilitation unit at Royal Talbot in early May. Initially he required assistance for all activity of daily living including: feeding, personal cares, bed mobility, hoist transfers and mobilised with the use of a powered wheel chair.

Three weeks after commencing rehabilitation he no longer required hoisting from bed to chair and he was able to operate a manual wheelchair.

As he required long-term family support and rehabilitation a decision was made to repatriate him home when clinically stable to fly. Medical Connect maintained contact with the patient throughout the acute and rehabilitation phase of his injury to determine his needs. Eight weeks after the admission he was clinically stable to fly home and was reunited with his extended family in Auckland.