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Surgery Not A Career-Ender For Nfl Players With Cervical Disk Herniation


Gonzo

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http://www.aaos.org/news/aaosnow/nov10/clinical2.asp

Nearly 3 out of 4 (72 percent) of NFL players who were treated surgically for CDH returned to play and continued to play in an average of 29.3 games over a 2.8-year period after surgery.
“What was surprising was that the position you played mattered,” Dr. Hsu said. “Defensive backs seemed to be overrepresented in the population.” Outcomes for the defensive backs were significantly poorer compared to other positions. Among defensive backs who sustained CDH and were treated surgically, just half (6 of 12) returned to play. They participated in 17 games over a 1.85-year period. Of the 19 defensive backs who sustained CDH and were treated nonsurgically, just 7 returned to play, and their careers were limited to just 6 games in less than 1 year.
Surgical treatment was defined as “a 1-level anterior cervical discectomy and fusion (ACDF), posterior foraminotomy, or indeterminate”

Considering these numbers aren't controlled for who is receiving the surgery (career backups/special teamers vs. hall of fame ironman starting QBs), that the 72 percent of players returning includes the dismal numbers for defensive backs, and that (not included in this summary article I've linked but in the actual peer reviewed article itself) punters and quarterbacks have the best rate of return in the study, there should be some optimism that Manning can return and play at a high level.

It's possible Manning will never play again. But I don't think it's very likely.

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Thanks for posting! A number of people have said they don't think he will play again, but they talked about it from personal experience. No disrespect to those people, but the body of an elite athlete is very different from an average person.

The only other article I've read regarding this was an interview of a doctor and he had said most players are symptom and pain free after the surgery. Personally, i can't wait for next season. If Peyton played the way he did through nagging neck pains, imagine how he will be when he is pain free!

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Is that not the whole point of performing the surgery in the first place? I doubt NFL players are having elective surgery on the spine because the scars look cool...

You can aleviate the pain by having the surgery but you may not regain the full nerve regeneration and the arm strength needed for being a laser rocket throwing QB in the NFL. I honestly don't think anyone will know what Manning will be able to do until after the season ends and I do think that Maning will push his bonus back just to give the team time to figure out if he will be healthy again or if they need to take that next QB. We all want to hope that Manning makes it back but we all know how this team operates under secrecy and it is possible the fans will have no idea up to the day of the draft. I wish him well because I want to see his talent on the field in a Colts uni for another 4 years or so but I also hope he can lead a normal life after the game too.

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You can aleviate the pain by having the surgery but you may not regain the full nerve regeneration and the arm strength needed for being a laser rocket throwing QB in the NFL. I honestly don't think anyone will know what Manning will be able to do until after the season ends and I do think that Maning will push his bonus back just to give the team time to figure out if he will be healthy again or if they need to take that next QB. We all want to hope that Manning makes it back but we all know how this team operates under secrecy and it is possible the fans will have no idea up to the day of the draft. I wish him well because I want to see his talent on the field in a Colts uni for another 4 years or so but I also hope he can lead a normal life after the game too.

You can aleviate the pain by having the surgery but you may not regain the full nerve regeneration and the arm strength needed for being a laser rocket throwing QB in the NFL. I honestly don't think anyone will know what Manning will be able to do until after the season ends and I do think that Maning will push his bonus back just to give the team time to figure out if he will be healthy again or if they need to take that next QB. We all want to hope that Manning makes it back but we all know how this team operates under secrecy and it is possible the fans will have no idea up to the day of the draft. I wish him well because I want to see his talent on the field in a Colts uni for another 4 years or so but I also hope he can lead a normal life after the game too.

Completely agree. But the point of the study is that 72% of all NFL players undergoing surgery for CDH (including the ACDF procedure performed on Manning) evidently recover enough to allow a return to action. Considering that the cause of the pain and weakness is damage or at the very least significant pressure on the nerves impacted by the herniated disc is the reason why surgery is performed in the first place it's very reasonable to infer that some form of nerve regeneration is the reason why those players could return to play again.

It's still very possible that Manning just won't heal in the way that many players are able to. A little more then a quarter of players don't. I just wanted to share an unbiased peer reviewed article on the subject of Mannings surgery to bring a bit of optimism to this otherwise bleak and dreary season.

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I don't think there is any doubt that the surgery is one that can be returned from...my only fear and the fear of others is that the nerve regeneration continues to be an issue. The fact that it has taken a few months now for Peyton to regain the "nerve strength" that he had before and by all reports this is still the issue keeping him out of games. Everything we do in April and for the future of this organization depends on this one question. If Peyton isn't healthy by this spring the FO needs to address QB first in this years draft and let Peyton have a chance with another team of his choice that is willing to pay him. We all love Peyton...it's not personal...it's just business.

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I suppose it's worth adding that the details always matter.

It matters not at all that a patient has a disc bulge, as this is usually painless or at most causes only brief pain; one worries about the presence/absence of nerve or spinal cord compression that results. Nerve compression can cause pain, weakness, or numbness in either arm in various areas; spinal cord compression is usually painless but more serious and can cause numbness, weakness, or clumsiness. When a patient is schedule for surgery it is always after consideration of symptoms, duration, goals of the patient, etc... balanced against risk and potential benefit.

Ultimately the pre-surgical symptoms (and duration) and the physical requirements of the player's position will have a high predictive value for a player's return. The bummer here is manning has weak triceps in his right arm and he is obviously a right-handed pro quarterback. The stats you listed are helpful and valid, but difficult to apply in manning's situation. Manning will be fine and have a good quality of life after this surgery as a civilian, but we all hope he can come back as a quarterback, so we just have to wait and see how he throws.

For what it's worth, these stats are not necessarily unbiased (everybody has bias to publish, for example), but I'd agree the bias is probably low. It's also hard to apply them to manning because he has had 3 separate surgeries, and the listed stats quote a single surgery, it seems. His 3 surgeries involved either 2 or 3 separate levels, as I'm led to believe by articles and rumors (unreliable); his fusion was obviously just at 1 level.

On that note, it can't be long now until he should be allowed to start some low-impact drills and throwing. Let's all watch for any comments on his throwing velocity/range as he likely will be allowed to practice between now and the next 4-6 weeks, I'll bet. I have a hard time believing he'll do this completely privately, considering his statements most recently.

Thanks for infusing some science/literature into the discussion, of course!

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I don't think there is any doubt that the surgery is one that can be returned from...my only fear and the fear of others is that the nerve regeneration continues to be an issue. The fact that it has taken a few months now for Peyton to regain the "nerve strength" that he had before and by all reports this is still the issue keeping him out of games. Everything we do in April and for the future of this organization depends on this one question. If Peyton isn't healthy by this spring the FO needs to address QB first in this years draft and let Peyton have a chance with another team of his choice that is willing to pay him. We all love Peyton...it's not personal...it's just business.

Just a simple question is if Peyton can't play for the Colts why would he be able to play for another team? I have seen this posted many times and don't understand the reasoning of those statements. Just wondering what answers this will bring I guess.

I for one think that if Peyton can't play 100% and play with the Colts he just might decide to retire.

Edited by Susie Q
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I am confused....

Your post title says "Surgery Not A Career-Ender For Nfl Players...."

But your text says "Nearly 3 out of 4 (72 percent) of NFL players ....returned to play"

So ... sounds like it WAS a Career-Ender for 28% of them.

What am I missing???

That means that the probability is on your side after such a surgery. You don't define the rule by exceptions.

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I am confused....

Your post title says "Surgery Not A Career-Ender For Nfl Players...."

But your text says "Nearly 3 out of 4 (72 percent) of NFL players ....returned to play"

So ... sounds like it WAS a Career-Ender for 28% of them.

What am I missing???

His point is most players come back from it. Frankly a 72% recovary rate for this type of surgery is good news. Colts fans should take what they can get at the moment and not try to be little people who are trying to give Colts fans some hope.

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I love this comment to the article:

Voodoo Chicks2 hours ago

You people are acting like this is a news bulletin! It's just a tweet out of the brain of some bored analyst I've never heard of and more than anything else it illustrates the dangers of twitter (not to mention the internet). If Manning is planning on retiring ,why isn't he on IR?

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