DMN Blog: Joe DeCamillis won't be with Cowboys staff at combine

[WoodysGirl]

5:22 PM Thu, Feb 18, 2010 | Permalink | Yahoo! Buzz
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Joe DeCamillis won't join the Cowboys coaching staff at the NFL scouting combine as he seeks to alleviate the persistent pain in his neck and back.

DeCamillis has flown to Atlanta for a consultation with the Shepherd Center, one of the top rehabilitation hospitals in the country for patients with spinal injuries. The special teams coach anticipates his program will begin next week when the staff is scheduled to leave for Indianapolis.

"It might be my impatience, but I want to do all I can to get some of this pain to go away,'' said DeCamillis, who fractured four vertebrae in his lower cervical and upper thoracic spine in the collapse of the Cowboys indoor practice facility. "With another set of eyes, maybe they can do something.

"Hopefully, they can give me some hope that will happen.''

 

[Hostile]

I hope they can help him. If they can't he might have to retire early.

 

[Gzus]

I hope they can help him. If they can't he might have to retire early.

Worse case he coaches games from the boxes. I really hope not tho. JJ will pay for whatever he needs done tho, he's liable for the accident so he'll pay up esp. now that the ST is kick arse.

 

[big dog cowboy]

ray:

Thinking about you Coach D!

 

[CCBoy]

At this stage, I don't think options are extinguished at all. I hope that is the case at least...

 

[Eskimo]

The position his neck has healed in is just horrific. The forces required to maintain his neck in that position will be put tremendous stress through any joints and put lots of stress on all the extensor muscles in the back of the neck and upper torso.

I'm not sure if it he had a multi-level fusion to put him in that position or not but I do feel really sorry for the guy.

I just went through borderline experimental spinal surgery myself - quite an ordeal.

 

[FuzzyLumpkins]

I hope they can help him. If they can't he might have to retire early.

It was in the upper portion of the neck and not near the labrum in the lumbar region. He should be fine. He has nerves that have been compressed for almost a year due to the swelling and now that the swelling is going down they begin to wake up. My brother in law described it as the feeling of a leg going to sleep but instead about 1000x more painful. He described it as every heartbeat being a pulse of pain.

He may be a tough SOB but the fact that he was able to go out and coach within months post op tells me his longterm prognosis is good but recovery from back surgery is a process and hes just not out of the woods yet.

 

[Boyzmamacita]

At this stage, I don't think options are extinguished at all. I hope that is the case at least...

I was so inspired by Coach D last season that I sometimes forgot about the terrible pain he was enduring. Add to that the emergency appendectomy and hernia and my heart just goes out to him. I'm praying for him.

 

[Eskimo]

At this stage, I don't think options are extinguished at all. I hope that is the case at least...

There are a variety of treatment options including epidural steroids (not a great chance of success with him), radiofrequency ablation of nerves (possibly of some benefit), there are now some experimental cervical artificial discs (usually can't be done after a fusion though).

 

[Eskimo]

It was in the upper portion of the neck and not near the labrum in the lumbar region. He should be fine. He has nerves that have been compressed for almost a year due to the swelling and now that the swelling is going down they begin to wake up. My brother in law described it as the feeling of a leg going to sleep but instead about 1000x more painful. He described it as every heartbeat being a pulse of pain.

He may be a tough SOB but the fact that he was able to go out and coach within months post op tells me his longterm prognosis is good but recovery from back surgery is a process and hes just not out of the woods yet.

Fusions usually take about two years for the allograft to take good and become strong.

 

[FuzzyLumpkins]

Fusions usually take about two years for the allograft to take good and become strong.

Indeed and the nerves do all kinds of painful things even after the fusion is set. My friend had a similar surgery due to a car accident and it was about 3 years post op when she thought she could start weening herself off the pain management doc.

Now she was a party girl and DeCamillis is a bucket of nails so I see him not needing that much time. But as the swelling goes down and nerves comeback alive, life is going to suck for Coach D. I will be sending him the good juju.

 

[Eskimo]

Indeed and the nerves do all kinds of painful things even after the fusion is set. My friend had a similar surgery due to a car accident and it was about 3 years post op when she thought she could start weening herself off the pain management doc.

Now she was a party girl and DeCamillis is a bucket of nails so I see him not needing that much time. But as the swelling goes down and nerves comeback alive, life is going to suck for Coach D. I will be sending him the good juju.

Again, you do have to be clear about what you are talking about with spine injuries. There are multiple structures involed including:

The vertebra
The discs
The facet joints
Multiple ligaments and tendons
Multiple muscles
The covering of the spinal cord or meninges

The peripheral nerve roots that exit the spine as nerve roots and coalesce as the brachial plexus before further subidividing into trunks, cords and individual peripheral nerves

Then there is the spinal cord, itself

Not all injuries that injury the spine will have any component of nerve involvement at all.

We tend to split spine pain into peripheral nociceptive (mostly due to non-nerve injuries of the spine), nerve pain at the junctional level which is often mostly peripheral (meaning outside of the central nervous system) and central neuropathic pain (pain due to direct injury of the spinal cord itself).

Now all 3 of these pains are different and all 3 can be present in any individual. I'm not sure about Coach D but I am almost certain he has no central neuropathic pain, hard to say if there is any peripheral neuropathic pain but there is almost very certainly severe peripheral nociceptive injury due to physical damage to vertebrae, joints and discs.

 

[theogt]

I'm not a doctor, but I did stay a Holiday Inn Express last night.

 

[FuzzyLumpkins]

Again, you do have to be clear about what you are talking about with spine injuries. There are multiple structures involed including:

The vertebra
The discs
The facet joints
Multiple ligaments and tendons
Multiple muscles
The covering of the spinal cord or meninges

The peripheral nerve roots that exit the spine as nerve roots and coalesce as the brachial plexus before further subidividing into trunks, cords and individual peripheral nerves

Then there is the spinal cord, itself

Not all injuries that injury the spine will have any component of nerve involvement at all.

We tend to split spine pain into peripheral nociceptive (mostly due to non-nerve injuries of the spine), nerve pain at the junctional level which is often mostly peripheral (meaning outside of the central nervous system) and central neuropathic pain (pain due to direct injury of the spinal cord itself).

Now all 3 of these pains are different and all 3 can be present in any individual. I'm not sure about Coach D but I am almost certain he has no central neuropathic pain, hard to say if there is any peripheral neuropathic pain but there is almost very certainly severe peripheral nociceptive injury due to physical damage to vertebrae, joints and discs.

He had a fusion which typically includes plates screws and cages. There is going to be some damage to the myelin sheathing and swelling causes issues.

 

[Hostile]

In case anyone does not know all that Coach D is going through, this article is fantastic insight.

http://cowboyszone.com/forums/showthread.php?t=167040&highlight=decamillis

 

[jobberone]

He is a candidate for radiofrequency ablation. I would encourage him to manage the pain another way for the next year before accepting that modality.

 

[jobberone]

Does anyone know if he has hardware or did they do either an autologous or cadaver approach to the fusion?

 

[Future]

Worse case he coaches games from the boxes. I really hope not tho. JJ will pay for whatever he needs done tho, he's liable for the accident so he'll pay up esp. now that the ST is kick arse.

I don't think Jerry is liable. The people who built it should be the ones liable....I think.

It's kinda like the scoreboard. Jerry put it there sure, but the NFL OKed it, so they should have to pay for it to be moved. Jerry wanted the facility, but he didn't build it.

 

[ThreeSportStar80]

I pray he finds some relief, such an unfortunate situation!

 

[Eskimo]

He had a fusion which typically includes plates screws and cages. There is going to be some damage to the myelin sheathing and swelling causes issues.

Again, there are multiple types of "fusions". You can simply have instrumentation which can either be anterior or posterior or you can have more fusion in the form of bone grafting with various levels of corpectomy and discectomy. It is in some ways more art than science when you get into very complicated hybrid approaches with very badly damaged spines.

myelin sheathing is at the level of axons and very likely not to be injured is this implies quite an extensive nervous system injury. You are digging very deep by the time you get to this level. You would likely see a significant component of paralysis which is not obvious when you see him on the sideline.

It is hard to speculate on these things - they really do tend to show up quite while on early MRI if there is significant cord involvement.

Nerve and mechanical pain are different but it is not always as simple as saying one is worse than the other. I treat many patients with nerve pain who actually are managed quite well with medications. OTOH, I also have the converse of patients with very bad mechanical pain whose pain is not well controlled with medications.