From Life-Threatening Spinal Injuries to Recovery: Rafael Rivera's Journey
10.28.2026

Days before Rafael Rivera Jr. planned to list his motorcycle for sale, he took a routine ride to the gas station. A husband and dentist, Rafael, had no idea how much his life was about to change.

After filling up the tank, he turned back into his driveway, entered his gate code and parked near his workshop. At least, that’s what he remembers. He never actually made that turn .

Rafael was hit from behind while he waited for oncoming traffic. The accident left him with life-threatening injuries, including a spinal cord injury, traumatic brain injury, and multiple fractures.

His treatment and recovery at Atrium Health Carolinas Medical Center involved a team of specialists, including Dr. Joseph Withrow of Carolina NeuroSurgery & Spine Associates (CNSA). Through SpineFirst, a partnership between CNSA and Atrium Health, patients like Rafael have access to specialized spine care close to home.

Rafael remembers very little from his time in the emergency room and his first few days in the intensive care unit.

“I recall my wife repeatedly informing me that I was in a motorcycle accident and that I was paralyzed,” Rafael said.

His injuries included an atlanto-occipital dislocation, a serious injury where the skull connects to the spine that Dr. Withrow described as often fatal or severely debilitating. Before Dr. Withrow could perform spinal surgery, an Atrium Health trauma team worked to stabilize Rafael's other life-threatening injuries.

“The fact that he was stable enough to undergo surgery is a testament to the trauma team,” Dr. Withrow said.

In the beginning, Rafael had little movement in his left arm and hand. Then he started to regain some function. It was limited, but it gave him hope.

By the time he entered rehabilitation, he was moving his arms nearly normally and had regained some sensation in his legs.

“The recovery he made in his upper extremity function was astonishing,” Dr. Withrow said.

Rafael credits his care team and his wife for helping him through some of his hardest moments.

“I’ve had an incredible support network of people caring for and encouraging me every step of the way,” he said.

Today, Rafael can walk with leg braces and assistance, which he calls “a small freedom.”

His recovery also included a second procedure to remove surgical hardware placed during his initial spinal surgery. Dr. Withrow had planned for this possibility when treating the injury at the top of Rafael's spine, hoping to preserve movement rather than permanently fuse the area.

Since the procedure, Rafael has noticed improvements in his breathing, swallowing and range of motion.

But he knows his recovery is far from over.

He has not yet returned to work as a dentist because much of the equipment he uses is operated by foot, but he continues to run his company while focusing on recovery.

Looking back, Rafael said he is especially grateful for the doctors, nurses, therapists and loved ones who have supported him.

His experience reflects the importance of coordinated care, from the Atrium Health trauma team who stabilized him to the specialized spine care provided by Dr. Withrow and the rehabilitation teams who continue to help him work toward his goals.

“My attitude is my greatest gift,” Rafael said. “Yes, I have bad days, and yes, many things are hard, but I won’t quit. I’m constantly moving the finish line,” he said, “and I don’t think I’ll ever be done!”