A Miracle of Restoring the Severed Head and Body — Shanghai Changzheng Hospital Pushes the Boundaries of Spine Surgery
A Terrifying Accident
Recently, Mr. Zhang was struck on the neck by a mechanical arm, suffering instant high-level paralysis and loss of consciousness, followed by cardiac arrest. After approximately three minutes of emergency CPR, he regained weak vital signs. During transfer to a local hospital, his blood pressure plummeted to a dangerously low 50 mmHg, prompting immediate fluid resuscitation. Imaging revealed an extremely rare, large-gap cervical spine dislocation with complete disruption—severe spinal cord contusion and tearing of critical neurovascular structures—an injury likened to “internal decapitation.”
Life-Threatening Complications
A massive hematoma had formed at the fracture-dislocation site, with both vertebral arteries occluded due to injury. The right vertebral artery was completely ruptured but sealed off by displaced tissue and clot, while the left vertebral artery was stretched thin, barely maintaining cerebral blood flow. Any dislodgement of the clot could cause 1–2 liters of hemorrhage within seconds, leading to death. The posterior cervical skin was extensively damaged, making posterior surgical access highly prone to infection. Significant cerebrospinal fluid leakage further heightened the risk of fatal intracranial infection. His condition was so unstable that even advanced imaging posed a threat—any movement caused his blood pressure to collapse.
Multidisciplinary Decision-Making
Upon emergency transfer to the Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital), an orthopedic core team—Professors Yuan Wen, Chen Huajiang, and Wang Xinwei—immediately convened a multidisciplinary group with leaders from the Emergency Department, Intensive Care Unit, and Anesthesiology. The patient’s family implored the team to attempt surgery, “even if there is only the slightest chance.” After evaluating the unprecedented risks, the experts decided to proceed and developed detailed contingency plans for every possible intraoperative crisis.
The Innovative “Satellite Plate” Technique
Professor Chen Huajiang pioneered a novel approach—satellite plate-assisted staged anterior fixation, which combines existing materials and surgical methods for the one-time anterior repositioning of extremely unstable cervical vertebrae and reconstructing strong stability. There is no precedent for this internationally; traditional cases often rely on posterior surgery, but in this instance, the risk is too high to use a posterior approach.
A High-Stakes Operation
On June 18 at 1:00 p.m., the surgery began. Upon exposing the anterior cervical soft tissues, the team encountered large hematomas and bulging prevertebral fascia obscuring the field. Using a fine needle, Professor Chen carefully identified cerebrospinal fluid and clot before clearing them, revealing the fully separated vertebrae. The gap was so large that initial steps involved bringing the segments closer together. After placing screws in the upper vertebra, the team employed spreaders, traction, and levering maneuvers to achieve reduction. Two “satellite plates” were then fixed across the vertebrae, with interbody cages inserted for reinforcement. All this was performed in a space less than three centimeters wide, demanding extreme precision to avoid secondary neurovascular injury. After three hours, complete anatomical reduction was achieved without any of the feared complications.
Recovery and Progress
On the day of surgery, Mr. Zhang was weaned off vasopressors and maintained stable vital signs. Under meticulous ICU care, his respiratory function steadily improved, ventilator settings were reduced, and no significant pulmonary infection occurred. He was extubated successfully, regained clear consciousness, and was able to sit up with family assistance. Neurological recovery showed early signs of improvement. He is now undergoing rehabilitation at a local hospital, having managed up to 36 hours off the ventilator, with continued improvement in upper limb and shoulder mobility.
Technology and experience Behind the Success
The case drew widespread attention from spine surgeons nationwide, many of whom had never seen such an injury survive surgical treatment. Shanghai Changzheng Hospital’s Department of Spine Surgery has been a leader in cervical spine research since the mid-1970s, performing over 14,000 spine operations annually and developing a comprehensive diagnosis and treatment system for spinal injuries. This extraordinary achievement was built on decades of accumulated surgical expertise, multidisciplinary collaboration, and a willingness to push into the “no man’s land” of spinal surgery.
A Miracle of Restoring the Severed Head and Body — Shanghai Changzheng Hospital Pushes the Boundaries of Spine Surgery
A Terrifying Accident
Recently, Mr. Zhang was struck on the neck by a mechanical arm, suffering instant high-level paralysis and loss of consciousness, followed by cardiac arrest. After approximately three minutes of emergency CPR, he regained weak vital signs. During transfer to a local hospital, his blood pressure plummeted to a dangerously low 50 mmHg, prompting immediate fluid resuscitation. Imaging revealed an extremely rare, large-gap cervical spine dislocation with complete disruption—severe spinal cord contusion and tearing of critical neurovascular structures—an injury likened to “internal decapitation.”
Life-Threatening Complications
A massive hematoma had formed at the fracture-dislocation site, with both vertebral arteries occluded due to injury. The right vertebral artery was completely ruptured but sealed off by displaced tissue and clot, while the left vertebral artery was stretched thin, barely maintaining cerebral blood flow. Any dislodgement of the clot could cause 1–2 liters of hemorrhage within seconds, leading to death. The posterior cervical skin was extensively damaged, making posterior surgical access highly prone to infection. Significant cerebrospinal fluid leakage further heightened the risk of fatal intracranial infection. His condition was so unstable that even advanced imaging posed a threat—any movement caused his blood pressure to collapse.
Multidisciplinary Decision-Making
Upon emergency transfer to the Second Affiliated Hospital of Naval Medical University (Shanghai Changzheng Hospital), an orthopedic core team—Professors Yuan Wen, Chen Huajiang, and Wang Xinwei—immediately convened a multidisciplinary group with leaders from the Emergency Department, Intensive Care Unit, and Anesthesiology. The patient’s family implored the team to attempt surgery, “even if there is only the slightest chance.” After evaluating the unprecedented risks, the experts decided to proceed and developed detailed contingency plans for every possible intraoperative crisis.
The Innovative “Satellite Plate” Technique
Professor Chen Huajiang pioneered a novel approach—satellite plate-assisted staged anterior fixation, which combines existing materials and surgical methods for the one-time anterior repositioning of extremely unstable cervical vertebrae and reconstructing strong stability. There is no precedent for this internationally; traditional cases often rely on posterior surgery, but in this instance, the risk is too high to use a posterior approach.
A High-Stakes Operation
On June 18 at 1:00 p.m., the surgery began. Upon exposing the anterior cervical soft tissues, the team encountered large hematomas and bulging prevertebral fascia obscuring the field. Using a fine needle, Professor Chen carefully identified cerebrospinal fluid and clot before clearing them, revealing the fully separated vertebrae. The gap was so large that initial steps involved bringing the segments closer together. After placing screws in the upper vertebra, the team employed spreaders, traction, and levering maneuvers to achieve reduction. Two “satellite plates” were then fixed across the vertebrae, with interbody cages inserted for reinforcement. All this was performed in a space less than three centimeters wide, demanding extreme precision to avoid secondary neurovascular injury. After three hours, complete anatomical reduction was achieved without any of the feared complications.
Recovery and Progress
On the day of surgery, Mr. Zhang was weaned off vasopressors and maintained stable vital signs. Under meticulous ICU care, his respiratory function steadily improved, ventilator settings were reduced, and no significant pulmonary infection occurred. He was extubated successfully, regained clear consciousness, and was able to sit up with family assistance. Neurological recovery showed early signs of improvement. He is now undergoing rehabilitation at a local hospital, having managed up to 36 hours off the ventilator, with continued improvement in upper limb and shoulder mobility.
Technology and experience Behind the Success
The case drew widespread attention from spine surgeons nationwide, many of whom had never seen such an injury survive surgical treatment. Shanghai Changzheng Hospital’s Department of Spine Surgery has been a leader in cervical spine research since the mid-1970s, performing over 14,000 spine operations annually and developing a comprehensive diagnosis and treatment system for spinal injuries. This extraordinary achievement was built on decades of accumulated surgical expertise, multidisciplinary collaboration, and a willingness to push into the “no man’s land” of spinal surgery.