Andrews faces long recovery as surgery ruled out

Daniel Andrews is facing long-term rehabilitation that will undermine his ability to return quickly to work.

Victorian Premier Daniel Andrews at North Melbourne Ambulance station making an announcement of increased mental health support. Picture: NCA NewsWire / Andrew Henshaw

Daniel Andrews is facing long-term rehabilitation that will undermine his ability to return quickly to work, but spinal surgery for his fractured vertebrae has been ruled out for now.

The Victorian Premier fractured a vertebrae in his thoracic spine during a crushing fall after a long weekend spent at a rental holiday home on the Mornington Peninsula. The government was stunned on Wednesday when it emerged that Mr Andrews’ injuries were worse than expected, with potentially months of recovery ¬required to deal with his fractured T7 vertebrae.

This vertebrae is in the middle of the chest between the seventh and eighth pairs of ribs, helping support the ribcage, spinal cord and chest muscles.

The recovery will be further hampered by multiple broken ribs after Mr Andrews slipped on wet steps on Tuesday morning before work.

The Premier is in intensive care after being transferred to The Alfred hospital trauma centre overnight on Tuesday, when doctors expressed alarm about the potential long-term nature of his injuries.

On Wednesday night, associate professor Steve McGloughlin, director of ICU at The Alfred, said Mr Andrews was in a stable condition.

“Mr Andrews is comfortable and his pain is well-controlled,” Professor McGloughlin said. “A multidisciplinary team, including intensive care, trauma and orthopaedic specialists, has developed a treatment plan, together with the Andrews family.

“Mr Andrews has sustained some serious injuries, and his condition is being monitored closely. At this stage there is no immediate plan for surgery.”

The initial medical assessment was focused on his broken ribs, and concerns that he might have a punctured lung, but the focus switched to his fractured vertebrae after scans showed a significant issue, given fractures in this part of the back can take months to heal.

The Premier’s injuries sustained in the fall were described as “very serious”.

“It’s clear he’s got a massive road ahead of him,” a friend said.

The fracture occurred when he fell heavily on his back, without time to break the fall, friends said, exposing the vertebrae and ribs to a punishing blow.

Deputy Premier James Merlino is set to become Acting Premier over the short-term and will guide the state government’s pandemic response.

Consultant orthopaedic and trauma surgeon Annette Holian earlier said such injuries could be treated with either surgery or a brace, with the possibility of screws being used to deal with the injury. “We try and get people up and moving rather than lying in bed,” she said.

Daniel Andrews meets paramedics at North Melbourne Ambulance station. Picture: NCA NewsWire / Andrew Henshaw

She added that while some spinal fractures were more suited to a brace, with a chest injury as well it was important for people to be upright, favouring a surgical option with screws holding the bones in place.

“If there’s metal work it can hold you together upright while healing and allow (the patient) to be mobile,” she said. “The healing might take just as long (as with a brace) but if you’re up and moving it’s better in the long term.”

Dr Holian said spinal injuries could take three months to heal.

She said Mr Andrews’ injuries would require good pain management, possibly including injections to block the nerves around the ribs. State Environment Minister Lily D’Ambrosio said that Mr Andrews was “in good spirits”.

The elevation of Mr Merlino to Acting Premier and the nature of the injuries mean he could be running the state for weeks or even months.

Prime Minister Scott Morrison has wished Mr Andrews a swift recovery, adding that he and the Victorian Premier “get on very well”.