There has been a rare but continuing string of catastrophic injuries caused by executing a takedown while in a guillotine.
in 2009 Zach Kirk shot for a double leg in the main event of an amateur show, and got caught in a guiillotine. When the fight hit the ground, Kirk's fifth cervical vertebra shattered, bone fragments ground into his spinal cord, and his muscles went limp forever.
In 2010 Braulio Estima was temporarily paralysed while shooting for a single leg.
In early 2010 Franco Lescano was training at Argentina's Tiger Gym for his MMA debut when he attempted a takedown while caught in a guillotine. The resulting injury left him paralyzed from the neck down, and he died 21 days later.
Less than a year ago, Devin Johnson a student at Urijah Faber's Ultimate Fitness was paralyzed, from the identical situation.
The rate of catastrophic injury rate for MMA is less than that for a number of physical activities, including cheerleading. However, catastrophic injury is possible, and with now multiple cases of permanent paralysis and a death resulting from a takedown while in a standing guillotine, trainers and athletes need to heighten their awareness.
Although MMA is regulated, the government cannot be relied on to prevent injury in our sport. It is up to the fighters, trainers, referees, and officials to develop on awareness that some aspects of the sport are exceptionally dangerous, and that catastrophic injury has resulted in the past, and in all likelihood will do so in future.
Driving into a double with the head trapped in a Guillotine can be fatal.
The Sacramento Bee has a moving multi-part series on how Devin Johnson is fighting back from the the injury.
During the ambulance ride to the medical center, Johnson's arm slid off the gurney. He became hysterical when he realized he could not lift it back to his side.
Inside the hospital, a team of doctors evaluated Johnson, including Dr. Kee Kim, UC Davis' chief of spinal neurosurgery and co-director of its Spine Center.
Johnson's head slamming the floor while bent in the chokehold broke his neck. The fighter fractured his fourth cervical vertebra, which dislocated and pushed into his spinal cord.
The human spine has seven cervical vertebrae running up to the base of the skull. Spinal cord injuries along these vertebrae can result in quadriplegia, meaning partial or total loss of function in all four limbs.
Typically, the higher the break on the neck, the greater loss of movement. Breaks along the fourth cervical vertebra, where Johnson's injury occurred, can affect breathing capabilities and can cause death by asphyxiation.
Johnson arrived at UC Davis unable to move his arms or legs, nor could he feel sensation when doctors poked and prodded his extremities.
Kim said the diagnosis was clear. Johnson had a complete spinal cord injury, vs. the less severe and more common incomplete injury that leaves some nerves in the spinal cord able to transmit sensory and motor information between the brain and body.
With the complete injury, Johnson's prognosis meant, barring a miraculous recovery, he would lose significant, if not all, function below his neck.
"We had to operate because his spine was unstable," Kim said. "My expectations were not high. We didn't want him to have additional injuries to his spine. We were trying to stabilize him so his breathing wouldn't be a problem."
The surgery took five hours. Kim removed a spinal disc from the front of Johnson's neck and put in a cadaver bone graft with a plate and screws. Needing additional support, Kim used screws and rods on the back of Johnson's neck to create a permanent neck brace.
The surgery was a success by medical standards. But for Johnson's loved ones, even optimistic scenarios were devastating. They only wanted to hear of a full recovery.
"My prediction was that he would never walk again," Kim said.
Quadriplegics with complete spinal cord injuries usually see most of their improvements within the first year of their recovery and some minor improvements in the next year.
"That's typically the cap," said Kim, the neurosurgeon.
Johnson's one-year anniversary is in May.
In the past months, he's been engaged in a different kind of fight.
He fights to maneuver his wheelchair around his one-bedroom apartment near American River College. He fights to figure out a new career path. He fights to keep from succumbing to dark thoughts about the things he will likely never do again.
His new life comes with a full-time caregiver who provides support for daily tasks such as showering. The little things, like helping himself to a glass of water, can also require assistance.
"It sucks having to ask for stuff," Johnson said. "That's the worst part of this life. I was completely independent before."
His weeks are filled with appointments – physical therapy, a research study, group counseling.
But he has hope. While he can't walk, he's regained limited use of his trunk, arms and hands. He sees the statistics of young men who suffered similar injuries and knows he's beating odds.
Kim said Johnson's recovery is "by far one of the most remarkable recoveries (I've seen)," adding that his youth and physical fitness contributed to his healing.
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