News: PFT: DeMarcus Lawrence might need more back surgery, but not now

[xwalker]

Blown out, herniated ---- same thing. Romo had a microdiscectomy, for extraction of impinging fibrous disc material.

The disc simply provides cushion between the vertebrae. At least half of all disc herniations do not require surgery. Surgery is required when the disc has degenerated enough to allow displacement of one vertebra vs another, thereby causing nerve impingement, or if extruded disc material causes nerve impingement. The impingement may lead to deterioration of the nerve and the subsequent musculature, and therefore needs to be addressed.

Blown out is my description of being herniated past the point of being repairable.

My Mom had a simple herniated disc and she has a incredible and instant relief with arthroscopic type surgery.

A guy I know has a disc that can't be repaired and will require spinal fusion or disc replacement.

 

[xwalker]

He is consistently out of shape. Bad habit if you have a back injury, as strengthening the core muscles is the only conservative care for back injuries. Not a good outlook. I would draft his replacement asap.

Lawrence is out of shape?

 

[JoeyBoy718]

DE is thin. I'd love to see Gregory and Irving become a dominant duo on both sides. I think they have the most potential out of anyone on the line. But Gregory can't get out of his own way and Irving has yet to consistently show he can be elite.

 

[Szczepanik]

Lawrence is out of shape?

Weren't the reports that he came back from his suspension out of shape and had poor conditioning?

 

[xwalker]

Blown out, herniated ---- same thing. Romo had a microdiscectomy, for extraction of impinging fibrous disc material.

The disc simply provides cushion between the vertebrae. At least half of all disc herniations do not require surgery. Surgery is required when the disc has degenerated enough to allow displacement of one vertebra vs another, thereby causing nerve impingement, or if extruded disc material causes nerve impingement. The impingement may lead to deterioration of the nerve and the subsequent musculature, and therefore needs to be addressed.

Where do you weigh in on Tapper's back issue (Pars Defect, Spondylolysis)?

I've researched that a bit and it seems that not everybody in the medical community is on the same page about it.

From my research, (I'm going to put this in layman terms) it appears that in some patients (usually young people) that it can be a stress fracture that never heals because they are always active. In some cases, a period of non-actively sometimes combined with a back brace can allow it to heal. In other cases, the "gap" in the fracture is too wide to heal on it's own but surgery with screws can resolve the issue.

If it has progressed too far then other issues occur (disc moves out of place) and that is a much bigger issue than just the defect itself. There is also the issue of unilateral vs bilateral. With unilateral only 1 side is fractured and the "gap" is likely not severe; whereas, with bilateral both sides are fractured and the "gap" with continue to widen with the disc eventually moving out of place.

 

[xwalker]

Weren't the reports that he came back from his suspension out of shape and had poor conditioning?

I didn't see them (Not saying that it's not true).

I did see some people here speculate that he was out of shape because he is noticeably bigger this year than last year.

 

[Teague31]

Don't think we can count on him or Gregory going forward.

 

[JoeKing]

Two years ago the Cowboys were a good pass rush away from a SB appearance. I'm going to keep my fingers crossed that DLaw, Randy Gregory, David Irving and the rest of them boys are ready to dominate. Good health to you!

 

[Daillest88]

Two years ago the Cowboys were a good pass rush away from a SB appearance. I'm going to keep my fingers crossed that DLaw, Randy Gregory, David Irving and the rest of them boys are ready to dominate. Good health to you!

Thank god for Irving, and Mayowa has improved Alot since getting out of the dog house like most have said we need to get us a DE or 2 in the early rounds. If we trade Romo I'd rather trade him with our first to move up and get a top Defense end in the draft. That 32 dime package can be amazing with a pass rush

 

[Doc50]

Where do you weigh in on Tapper's back issue (Pars Defect, Spondylolysis)?

I've researched that a bit and it seems that not everybody in the medical community is on the same page about it.

From my research, (I'm going to put this in layman terms) it appears that in some patients (usually young people) that it can be a stress fracture that never heals because they are always active. In some cases, a period of non-actively sometimes combined with a back brace can allow it to heal. In other cases, the "gap" in the fracture is too wide to heal on it's own but surgery with screws can resolve the issue.

If it has progressed too far then other issues occur (disc moves out of place) and that is a much bigger issue than just the defect itself. There is also the issue of unilateral vs bilateral. With unilateral only 1 side is fractured and the "gap" is likely not severe; whereas, with bilateral both sides are fractured and the "gap" with continue to widen with the disc eventually moving out of place.

A pars defect is considered a non-union, whether congenital or acquired. The vertebral pedicles interlock at each level, creating stability which is completely independent of disc dysfunction. This interlocking system only allows slight rotation at each level and prevents any subluxation or dislocation. (Popping one's back or neck is only an act of breaking the vacuum at that level, like popping the knuckles; it is not the reduction of a dislocation.) With the above-referenced non-union, the vertebrae are not prevented from being displaced to some degree, which may cause significant nerve compression. While not creating a condition of overt instability, severe stress and/or impact at that site may have serious consequences.

A pars defect prevents military service; I can't see how the rigors of pro FB would be wise unless internal fixation is performed.
He'd miss a year with that.

 

[xwalker]

A pars defect is considered a non-union, whether congenital or acquired. The vertebral pedicles interlock at each level, creating stability which is completely independent of disc dysfunction. This interlocking system only allows slight rotation at each level and prevents any subluxation or dislocation. (Popping one's back or neck is only an act of breaking the vacuum at that level, like popping the knuckles; it is not the reduction of a dislocation.) With the above-referenced non-union, the vertebrae are not prevented from being displaced to some degree, which may cause significant nerve compression. While not creating a condition of overt instability, severe stress and/or impact at that site may have serious consequences.

A pars defect prevents military service; I can't see how the rigors of pro FB would be wise unless internal fixation is performed.
He'd miss a year with that.

It seems that if his condition was severe that they would have sent him for surgery.

 

[Doc50]

It seems that if his condition was severe that they would have sent him for surgery.

There is really no mild vs severe; there is only union or non-union.

I'm sure he has tremendous strength in the paravertebral musculature, and he has come this far without a serious problem.
Maybe he has requested to sign a waiver that absolves the team from liability of injury at the site in question.

As a physician, I would advise against it, and I wouldn't let my sons play with it. (Unless repaired)

For clarification, this is not classified as a recent fracture, which will simply heal with time.

 

[xwalker]

There is really no mild vs severe; there is only union or non-union.

I'm sure he has tremendous strength in the paravertebral musculature, and he has come this far without a serious problem.
Maybe he has requested to sign a waiver that absolves the team from liability of injury at the site in question.

As a physician, I would advise against it, and I wouldn't let my sons play with it. (Unless repaired)

For clarification, this is not classified as a recent fracture, which will simply heal with time.

I don't see how these different images can be considered the same. Maybe you're trying to say that that surgery is required regardless, but I can't see how the middle image is the same severity as the far right image.

Image 1 Normal.
Image 2 Hairline fracture (Pars Defect, Spondylolysis)
Image 3 Complete Separation (Spondylolisthesis)




Unilateral fracture:

Bilateral fracture:

 

[Doc50]

I don't see how these different images can be considered the same. Maybe you're trying to say that that surgery is required regardless, but I can't see how the middle image is the same severity as the far right image.

Image 1 Normal.
Image 2 Hairline fracture (Pars Defect, Spondylolysis)
Image 3 Complete Separation (Spondylolisthesis)




Unilateral fracture:

Bilateral fracture:

As I mentioned previously, a pars defect is not an acute fracture. If an injury is sustained, and radiographs show that finding, it is an acute pedicular fracture, and should heal in 8 wks with proper alignment.

The incidental finding of a non-union, whether congenital or from a remote fracture, is considered a pars defect.

If there is enough ligamental laxity, a pars defect may allow spondylolisthesis, which I mentioned is a displacement of one vertebra relative to another, from which even 2mm of displacement may cause nerve impingement.

Any patient with spondylolysis may eventually regress to spondylolisthesis, hence the risk.