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Surgeon Scott Spann faced a long road to recovery following cycling accident

Pam LeBlanc
pleblanc@statesman.com

One moment Scott Spann was flying down Loop 360 on his road bike, head tucked, wheels spinning.

The next, the Austin orthopedic surgeon was sprawled on the pavement, unable to move, struggling for breath.

"At the moment of impact, I knew I was a quad," he says five-and-a-half years after slamming his bike into a car parked on the side of Loop 360.

He'd crashed into the rear window of the vehicle, which had no one inside, then rolled to the ground. His face burned where he'd hit the car and road, but below that he felt nothing.

His thoughts swirled.

Would he ever walk again? Perform surgery? How could he support his wife and three children?

He was embarrassed, too, about his role in the wreck. He'd seen the car in the distance, but miscalculated how far he was from it.

Like that, Spann had gone from spinal specialist to patient.

Today Spann, 52, admits he's an adrenaline junkie. Obsessive? Definitely.

A former rugby player who once entered a bull-riding competition as a joke during college, he likes pushing his body to the fraying edge.

He was born into a family of athletes. He played football and tennis in high school, then focused on competitive swimming. He swam for the University of Texas, where he became a four-time All American and seven-time NCAA champion. (Two of Spann's children, Alexi and Scott Jr., are elite swimmers today.)

He likes snow skiing, Harley-Davidson motorcycles and hunting big game, especially animals that "at least theoretically have the opportunity to hunt me back," he says. The stuffed heads of an elephant, giraffe and cape buffalo he shot on safari in Africa decorate his Westlake medical office. He loved the intensity of cycling and quickly grew almost obsessive about it, riding at least five days a week.

"I don't remember not having those sort of desires to do the most, be the best," Spann says.

The lifestyle, though, has taken its toll.

Spann broke his back in a car accident in 1999. He broke his hip during a high-speed downhill skiing accident in Vail, Colo., in 2003. In all, he's had 14 orthopedic surgeries, including three knee repairs.

So when he found himself lying numb on the side of Loop 360 that September day in 2005, he knew what he was in for.

Memories of caring for two teenagers who had been paralyzed, work he did as part of a high school internship at a spinal cord injury rehabilitation center in Florida, flashed through his mind.

"I literally started talking to God, saying ‘If this is it, it's been an unbelievable ride and I've probably lived six times the life of normal folks, but if you see fit to give me a chance, I will do my very best with what I have hereafter.' "

He believes divine intervention played a role in what happened next.

The first people on the scene were a doctor and his wife. The next was the head of the emergency room at St. David's South Austin Hospital.

Spann knew he was severely injured. He managed to tell those first people on the scene not to move him. He knew if his spinal cord swelled inside the framework of his spine, it could choke itself off, permanently paralyzing him. On his way to the emergency room, he asked to be given methylprednisolone, a sometimes controversial treatment of steroids that must be injected within four hours to minimize inflammation in the spinal cord.

Spann had injured the second through seventh cervical vertebrae, near the top of his neck. Although the spinal cord was bruised and crushed as it absorbed the impact, it wasn't completely severed. Even though Spann couldn't move, he did feel some sensation in his limbs.

At University Medical Center Brackenridge, doctors stabilized him, then watched and waited. Two days after the accident, they operated, fusing the spinal column in five places and relieving pressure caused by swelling. He spent several days in intensive care and about 10 days in the hospital.

His body was battered, scraped and bruised. He tore ligaments in his knee and later required knee reconstruction surgery.

He remembers a member of the clergy visiting him. "He would come in and say prayers, and remarkably there would be some alteration nearly immediately," Spann says. "I know it sounds hokey, but that's the way it was."

Doctors advised him to enter a rehabilitation hospital in Houston next. Instead, he asked to be released. His wife, Beth, a former nurse, took him home. She didn't know what to expect. He could sit in a wheelchair if he was strapped in and pull himself forward, but that was it.

"But I also know Scott, and I know how tough he is and how hard-working he is," Beth Spann says. "Scott perseveres beyond perseverance, and he just has a mindset and a focus and a determination that is rare. He challenges himself much harder than anyone could challenge him."

A makeshift bedroom was set up in the gym of their home, and Spann went directly back into training mode. In swimming, he'd once marked his progress by the black stripes on the pool's bottom. In cycling, he focused on lane lines painted on the road. Rehab became his new goal.

"All of the sudden the lane lines were along hospital corridors," Beth Spann says. "His feat now was not to break a world record in swimming or ride 50 miles on bicycle; it was to walk to the end of that hall."

Spann started improving. He gradually regained some motor control of his upper right extremities. Then more. Muscles in his right hamstring started responding, too.

Progress was incremental. In the next few months he used a wheelchair, then a rolling walker, then a regular walker. Eventually he could get around with crutches, then a cane. Nine months later, he returned to the office part time, eventually assisting some of his partners in surgery.

Today, he has regained almost full body function. He works full time again, seeing patients at his offices at Westlake Orthopaedics Spine & Sports and performing surgery at the Hospital at Westlake Medical Center.

He still has permanent neurological damage. His gait is lurching. He's slower, less agile and tires more easily. His body aches after exercising. One foot drags a bit, and he has grip issues with one hand. He can't feel temperatures on the right half of his body below his chest. When a hot medical instrument brushed against him recently, he didn't notice until he smelled his skin burning.

"Sometimes I forget about it, other times it's all I think about," Spann says of his lingering symptoms. "While I wish I had recovered everything, I'm extremely ecstatic to have recovered what I have."

Doctors familiar with Spann's case say it's unusual, but they also say patients with spinal injuries are seeing fuller recoveries now than they once did because of advancements in treatment.

"Any high cervical injury (like Spann had) means there's a good chance the patient can't use his or her arms and may never breathe without a ventilator," says Charlotte Smith, executive medical director of rehabilitation for the Seton Healthcare Network. "He could have easily been a Christopher Reeve."

A few decades ago, it wasn't unusual for patients with similar injuries to die within 10 years of kidney failure or problems related to a sedentary lifestyle in a hospital bed. That's changing, along with advances in the use of stem cells to treat spinal cord injuries, doctors say.

Spann had considered stem cell treatment himself but decided he was showing enough recovery that he didn't need it. Today he's a supporter of the use of autologous stem cells — which are harvested directly from the patient, not a fetus — to enhance healing and repair of bones, cartilage and tendons. Those cells, he believes, could potentially regrow tissue and reconnect gaps in injured spinal cords.

Many people with injuries similar to those Spann sustained get only limited movement back, Smith says. Spann got much more.

"Absolutely stunning," is how Bill Watters, an orthopedic surgeon in Houston, describes Spann's recuperation.

He attributes part of the recovery to Spann's background as an elite athlete. "It's not so much that he carried a high function of muscular conditioning into injury, but he carried an attitude that an elite athlete carries around with him," Watters says. "You have to have a certain type of can-do attitude irrespective of the cards you've been dealt physically."

Spann admits he spent some time feeling sorry for himself after the cycling accident. Today, though, he mainly feels lucky that he's been able to continue working as a spine surgeon. Many of his patients are people like him — athletes and weekend warriors who have simply worn out their backs and necks.

"To not have it taken away is, in its own way, a gift," he says.

The accident and its aftermath have given him better insight into his own patients' struggles and have changed how he deals with them. Spann says he has a greater appreciation now of how neck and back pain affect a person's quality of life. He has more insight into his patients' struggles and fears, more patience and empathy.

But he also has less tolerance, he says, for patients who aren't working hard at their own recovery.

He stays fit by swimming in Lake Austin. He's gotten back on the bike, too.

And last June, he competed in a sprint triathlon in Carlsbad, Calif. He doesn't care that it took 45 minutes just to run the 5K.

Austin writer Joanna Cain has a book about Spann in the works, and a documentary company from New York City has expressed interest in his story.

It's a tale Spann believes will offer hope for what can happen with determination and work and faith.

pleblanc@statesman.com; 445-3994

Note: This story has been updated to correct Charlotte Smith's job title and employer.