Israel Surgeons Reattach Boy’s Head To Neck After Internal Decapitation

"We fought for the boy's life," said Dr. Ohad Einav, the orthopaedic surgeon who performed the surgery with Dr. Ziv Asa and a huge operating room and intensive care team.

Hadassah Medical Centre doctors reattached a 12-year-old boy's head to his neck in an exceptionally uncommon and complicated procedure following a terrible accident in which he was hit by a car while riding his bicycle, the Jerusalem hospital reported on Wednesday. Suleiman Hassan, a Palestinian from the West Bank, was taken to Ein Kerem's Hadassah hospital's trauma centre, where it was revealed that the ligaments anchoring the posterior base of his skull were seriously injured, causing it to become separated from the top vertebrae of his spine, Times of Israel reported. Bilateral atlanto-occipital joint dislocation is also known as internal or orthopaedic decapitation.

The injury is extremely uncommon in adults, and much more so in children.

"We fought for the boy's life," said Dr. Ohad Einav, the orthopaedic surgeon who performed the surgery with Dr. Ziv Asa and a huge operating room and intensive care team. The procedure was performed in early June.

“The procedure itself is very complicated and took several hours. While in the operating room, we used new plates and fixations in the damaged area… Our ability to save the child was thanks to our knowledge and the most innovative technology in the operating room,” Einav was quoted by the Times of Israel in its report. 

Einav, who returned to Israel a year ago after completing a fellowship at trauma centres in Toronto, believes that this uncommon injury had occurred previously in Israel. He is one of just a few surgeons in Israel that specialises in trauma surgery for spinal injuries, as far as he is aware.

Hassan was just sent home with a cervical splint and will be closely watched by Hadassah specialists.

“The fact that such a child has no neurological deficits or sensory or motor dysfunction, and that he is functioning normally and walking without an aid after such a long process, is no small thing,” Einav said.

Only 16 of the 2006 kids with spinal cord injuries that Children's Hospital of Philadelphia treated between 1983 and 2003 experienced occipital joint dislocation, according to a 2003 report.

“The injury is extremely rare, but we do know that because children between ages four and 10 have heads that are large in relation to their bodies, they are more susceptible than adults,” Einav said.

Those who experience internal decapitation have a dismal survival rate. The damage usually leads to death. There is evidence that kids do better than adults, but there isn't enough information to compare kids to teenagers yet.

According to a 2021 review of research on pediatric and teenage injury, 55% of patients do not survive the original injury, hospital transfer, surgery, and rehabilitation.

According to the hospital, Hassan's father stayed by his side the whole time he was recovering from surgery.

“I will thank you all my life for saving my dear only son. Bless you all. Thanks to you he regained his life even when the odds were low and the danger was obvious. What saved him were professionalism, technology and quick decision-making by the trauma and orthopedics team. All I can say is a big thank you,” he informed the medical staff, Times of Israel reported.