I'm linking the discussion portion of a retrospective cohort study that was done on NFL athletes who had cervical disc herniations and the treatment they received.
http://www.medscape.com/viewarticle/741729_4
Here are some of the numbers:
*A total of 99 NFL athletes were diagnosed with cervical disc herniations for this study.
*53 of these 99 players chose to have surgery, either an anterior cervical fusion or a posterior foraminotomy.
*46 chose more conservative measures.
*38 of the 53 players (72%) in the surgery group returned to play for an average of 29 games over 2.8 years.
*21 of the 46 players (46%) in the nonsurgical group returned to play for an average of 15 games over 1.5 years.
*Performance scores pre and post surgery were not statistically significant.
*Age at diagnosis was a negative predictor for career longevity after surgery.
The flaw to this study is that they did not take into account confounding variables such as concominant cervical stenosis and cervical spondylosis, which could have had an effect on the results of the study.
In looking at Peyton Manning, there are some confounding variables that could effect his return to play that we do not know a lot about at this point. For one, his age is certainly a negative predictor for his career longevity after surgery. His age along makes me believe that the best case scenario for him will be the average return to play numbers, which is 29 games over a 2.8 year period. That's where I get my stance that at best, Peyton is a 2-3 year option.
Second, there is talk of Peyton having bone spurs in his neck both pre op and post op, which may mean that he has cervical spondylosis as a concominant problem. Cervical spondylosis is essentially arthritis of the neck. The cause of this is the degeneration, or water loss of the discs in the neck. This causes excessive pressure on the facet joints which can also form arthritis. When the cartilage wears away completely, you get bone rubbing on bone. Your body's response to this is to make more bone. This is where the term facet hypertrophy comes from for those of you who have read xray reports on the cervical spine. Also though, that excess bone that is made is also the cause of the formation of bone spurs. Bone spurs are just extra bone in an area.
Third, another thing this study does not take into account is multiple surgeries. Peyton has had at least 2 posterior foraminotomies prior to having the anterior fusion, and he may have had a third posterior foraminotomy that there isn't much publicity about. Therefore, we do not know how this will effect the end result which is his return to play or how it will effect his career longevity. My guess is, and this is just my opinion being a medical professional, is that multiple surgeries with minimal to no response prior to the anterior fusion has to be a negative predictor of not only his return to play, but also his career longevity.
In conclusion, this study reinforces what my stance has been on this. If Peyton does return to 100%, I feel that the most we can expect from him is 2-3 years of play. However, I think with the possible confounding variables that Peyton's return to play is much more in question than most want to believe. Because of this, it will not surprise me if he's not able to return at all, or if he returns, he will end up having another procedure in a year and then retiring. Based on the medical facts, I see very little chance that Peyton returns and plays into his early forties, giving the Dolphins the 4-5 years that some on here think he will play.
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Marco, Fin-Omenal and Tone_E like this.
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1-no studies of multiple injuries, making this one of dubious value
2-no direct knowledge of Mannings' condition, making this of dubious value
3-a general study to predict what a specific athlete will do is beyond dubious in value
Rod Woodson coming back to play in the SB after an ACL..never been done in one season
Wes Welker coming back from an ACL in one offseason to catch 100 passes never been done in one season
Ricky Williams rushing for 1k yds at his age, had been done twice before in the history of the NFLdolfan22, MonstBlitz, finyank13 and 1 other person like this. -
Nice post, with some good content.
But in the end it, I just see it as the ramblings of someone who desperately doesn't want Manning in a Dolphins uniform and will find anything he can to post to try and a support his desire.dolfan22 likes this. -
If you want to ignore medical facts, that is fine. I don't ignore medical facts though. I base my practice around them. Everything I do in medicine is evidence based.PSG and eltos_lightfoot like this.
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Just to get a feel of what you are saying here, is that there is a first time for everything so we should sign Manning? Other than that i have no idea what those two ACL injuries and RW rushing for over 1k at his age has anything to do with anything about Manning.
The delima for the Dolphins is that by the time FA rolls around will they know if Manning is healthy enough to play as a starter at a high level in order to sign him, if he isnt is he far enough along to take a chance that he will be by TC? And do they wanna take that chance of bypassing Flynn or drafting a young guy?
I dont know if i wanna sign a guy with the idae that there is a first time for everything. -
The irrelevance of medical studies concerning general groups of players is fairly clearly demonstrated, the productivity level of a player at any age is also not particularly suited to a general study, it looks good, it proves nothing concerning an individual player.
For example it could easily be argued that since Manning has had this procedure before there is no other player as expert as he coming back from it's effects, -
This is just shortsighted. I read the OP as a realistic look at the situation. KB even went as far as saying that Manning would be good for 2 seasons at best. Now, keeping with realistic outlooks, 2 years does next to nothing with regards to building for the future.
Sent from my iPhone using TapatalkFin-Omenal likes this. -
It probably was shortsighted, I completely agree.
But it's the way I feel. Probably more to do with the poster than the post.
When someone is constantly beating the same drum, after a while it all becomes white noise.... -
Like I said, it was a nice post, with good content.
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Every case is different......like concussions.....
nobody knows what Manning's case is like, so to speculate what his is......irrelevent...
when he gets released, I am sure team's doctors will check him out and have the medical records to determine what his case is like... -
This is the type of quality post I miss from being in the club, perhaps sometime before the draft, I will find the $$ to re-up.
Thanks for your insight KB, and based on the study and the facts, I could see Peyton coming back and having career ending surgery next year after the season. Where would that get us? Smack dab in the middle of the 1st round again and 2 more years from getting another good QB IMHO.eltos_lightfoot likes this. -
No, this study is like comparing a similar drug to the one used in the study, not the same one, and it matters to the 25% of the participants that it did not work for...dolfan22 likes this.
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This is an excellent post. If someone chooses to ignore what the evidence says they shouldn't be surprised when it happens that way. There is a reason that evidence based medicine works.
Sent from my DROID BIONIC using TapatalkKB21 likes this. -
KB21
after Peyton Manning is signed & delivered
& we have the Lombardi Trophy in Miami,
what are you going to complain about?
Ryan Tannehill will never be another Peyton Manning? -
I'm really curious how Peyton Manning is going to deliever a Lombardi trophy when he is a shell of his former self, AND Miami doesn't surround him with players that can help him win immediately. That first round pick will not be used on Ryan Tannehill if Miami signs Peyton Manning. Miami will once again try to see if they can develop the late round find at quarterback instead of going all in on one in the first round. Miami signs Manning, that first pick will be used on a pass rusher.
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Ronald Regan's immortalized words:
there you go again... -
All I want from Manning is 2-3 good years; draft a true developmental QB to sit and learn behind Manning the same Rodgers did with Farve.
One thing that can't be understated is how a true professional football player prepares for the game he plays.MikeHoncho and the 23rd like this. -
Thanks for this informative post KB. Regardless of your personal interests, it provides some helpful perspective regarding his surgery, and what he may be dealing with.
I think the key is to take from it, what may relate to Peyton and his situation. For myself, it reinforces my own thoughts, and neither brightens nor dims expectation.
One thing I'd like to point out, perhaps only clearer if someone has already done so, are the average career lengths of players who have had this operation.
Career lengths obviously vary considerably by position in the NFL, and arguably those of healthy, top tier QB's tend to playout on the extensive end compared to most positions.
I didn't read the actual article, but is the author suggesting their careers ended as a result of a degradation of the surgically repaired condition, or simply ended?
If the average career length for starting caliber players is 6 years, and assuming on average most players develop the condition for surgery after playing 2-3 years, its near the end of most anyway.
If first round talents last on average nine years, it could play into their early retirement, however their numbers need to be averaged into the formula, as what percentage are 1st rounders. -
dolfan22 Season Ticket Holder Club Member
Perhaps we should listen to the person who is so adamant about his football scouting ability to nail this so accurately . I am surprised the NFL team that employs him lets him post knowledge they pay for on fan websites.
"I can guarantee you that he's not going to be a great quarterback in the NFL because he does not have the mental make up to be a great QB in the NFL. He's not a pure drop back passer, and that dooms him from the very beginning. You have to be a pure drop back passer to have any success in the NFL.
I've yet to see any of the Cam Newton nut huggers state the cons of drafting him, in particular his inability to read a defense or go through progressions. But you want to spend a first round pick on a guy who is at least 6 years away from even being remotely competent as a NFL quarterback, if he ever does become competent as a QB."
We all get you think the course of action is one way and that Miami would be foolish to consider signing one of the greatest players of all time . We also understand you "know" anyone that doesn't follow your direction is wrong , but let's be upfront here your stance on this could turn out to be as wrong as numerous other positions you have taken .
We all are wrong on some things , no worries , just make sure you don't believe you are the exception to that. Doctors are wrong every day , make the wrong prognosis , make wrong decisions, but you know more about Peyton's situation than the doctors working with him right? -
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Nice find, KB.
Not really concerned with the multiple foraminotomies as inasmuch as I am with those being combined with the fusion. Tough stuff for Peyton. I personally have not really followed his case, so I'll leave the details up to you. If his stenoses are concomitant (rather than from herniation), then he will surely continue to have issues for the rest of his life; which he will almost inevitably, anyway. Given the hardware, scar tissue, etc., on top of his pathology, I can see where this would certainly be a hard sell.
I am with KB here. I would love for Peyton to come to Miami (he is my all-time 2nd favorite QB behind Danny), but given the sitch, I am not entirely convinced. Some of you here may have had fusions (likely lumbar), and you can comment on the daily difficulties it can cause. And you're not an NFL player.
I would be all for Peyton coming here. And the link does support a longer career for NFL QBs after ONE surgery, but generally, QBs benefit from not taking the pounding of other positions. Only about 3 players received a second on which the link basically states it was on par with the gen pop statistics.
Spinal surgeries are, in a word, a ***** to deal with. It messes with the entire body's anatomical dynamics, especially with fusions. I would prefer non-operative treatment, but this Hsu is an orthopod/neuro, and those guys want to cut, cut, cut. Of course he is going to support his field study with remarkable conclusion.
Basically, I got out of this is link: Don't hire a corner with a history of c-spine surgery. -
The study is worthless, because the sample size does not represent a low impact position such as Quarterback. Had all 99 of the players been quarterbacks, then you would have something.
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the point everyone keeps forgetting: studies are fine, but Ross' pocket rocket for Manning will make all else irrelevant...if ROSS wants him, ROSS will get him..and if it doens't work he'll can both Ireland and Philbin even thought it was his desire to have Manning. I really feel this is a hell or high water situation...if it works, great, but i feel like we've been down this road before...............