Man has no memory of a freak accident that fractured his spine
It was Friday night and Vamsi Polisetty was headed to Las Vegas for the weekend. But his bus was late.
LOS ANGELES — It was Friday night and Vamsi Polisetty was headed to Las Vegas for the weekend. But his bus was late.
The 33-year-old software engineer from Costa Mesa, Calif., waited at the Crowne Plaza Los Angeles International Airport, a 16-story tower less than a quarter-mile from the terminals. While waiting, Polisetty ambled into the lobby; he perused the gift shop, he might have used the restroom, and he people-watched.
Then, he stepped back outside.
Those are his last memories before waking up inside the emergency room at Ronald Reagan UCLA Medical Center with doctors telling him he had been in an accident. With pain medications muddling his senses, he assumed he must have been on the bus to Vegas and it crashed.
But he had never stepped aboard.
At about 8:30 p.m. Sept. 18, Alesia Ann Duffy, a 51-year-old woman from Venice, Calif., plummeted from the hotel's 11th floor, landed on Polisetty's back and died.
The impact knocked him out and broke his spine — a vertebra in his lower back fractured and slipped out of position. It slid 4 centimeters to the right, 4 centimeters down, 6 centimeters forward.
That Polisetty was even alive was improbable.
Most people who dislocate their spines, as he had, die. The force required to break the spine also typically ruptures organs, inflicts irreversible brain damage and causes spinal shock.
It's an injury most commonly associated with violent car crashes and high-impact sports.
Maria Komissarova, a Russian ski cross racer, fractured and dislocated her spine during a training run at the 2014 Winter Olympics in Sochi, Russia, when she landed directly on her knees coming out of a jump. She has spent more than a year in rehab, a recovery described as arduous and painful. Once a gold medal hopeful, she was given a 90 percent chance of regaining her ability to walk.
Like Komissarova, Polisetty had lost feeling and movement in his legs.
Doctors needed not only to realign his spine but to relieve the pressure that the displaced vertebrae had put on his spinal cord, which was pinched and stretched — and they had to act quickly.
Thirty years ago, a doctor might have delayed five days to let swelling subside, said Dr. Michael Steinmetz, director of Cleveland Clinic's Spine Health Center, but evidence now points to treating some spinal cord injuries as soon as possible.
"It was thought you could make people worse if you operated on them right away," Steinmetz said. "What has changed is our ability to make a rapid diagnosis and move them to an OR — that's the best chance for recovery if the nerves are being squashed."
Through the haze of painkillers, Polisetty was just conscious enough to consent to surgery and within one hour of being admitted to the hospital, he was in the operating room with orthopedic spine surgeon Dr. Sina Pourtaheri and two residents.
Pourtaheri, 32, had never before performed this surgery.
The three men would spend the next two hours, working in 20-minute increments, pulling, pushing and directing the spine back into place using screws, rods and clamps.
"You get exhausted," Pourtaheri said. "You have to use a lot of force to bring it back."
After the surgery, they wrapped Polisetty in cold blankets, lowering his body temperature to try to reduce swelling that could further damage his spinal cord, a technique that is still being researched.
It was after surgery that Polisetty learned what happened the night of his injury.
First responders told the physicians — who in in turn informed Polisetty — that Duffy had jumped to her death. The Los Angeles County coroner has since ruled her death accidental.
"I did not see her coming from the top," Polisetty said. "That's good, because there's no trauma or anything."
Before going into surgery, Polisetty had asked the surgeon if he'd still be able to use his hands to type. Had the impact been higher on his back, his arms might have been paralyzed, too.
But not only will Polisetty still be able to work and play on computers, Pourtaheri said he is confident Polisetty will eventually walk again.
"He was in the ICU for three days and had very good neurological recovery, so that supports doing these soon and treating them as emergencies," Pourtaheri said. "The only question is if he will use a cane — that's a slam dunk."
Pourtaheri and Polisetty reunited recently for a checkup at UCLA Spine Center in Santa Monica. Wearing plaid pajama pants and with his hair a little scruffy, Polisetty lay on an exam table. His father and brother-in-law, who are now helping care for him at home, also were crammed into the small room.
As the smiling surgeon watched, Polisetty raised his left leg and wiggled his ankle.
"I think I was lucky," he said.
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