Why Smith over Jack

[waldoputty]

Hi, first post because I know 2 PhDs who work in nerve regeneration (wish the best for the player who appears to be a nice kid).

Here is what the 2 PhDs said:
1. As Fuzzy said, recovery is dependent on the degree of injury. If it is a 2nd degree injury, then most likely a complete recovery. If it is a third degree injury, then may be a partial recovery.
2. When they say the nerve went to sleep, that means that part of the nerve cell is dead. However, the nerve cell is not totally dead. Recovery means the nerve cells will grow back into the area using the exising nerve fiber as a guide. There are real risks here, but nerve regeneration always happens with peripheral nerves like this case. However, how complete the recovery depends on how severe the damage - will the nerve reinnervate at the right places. If there is blockage from scar tissue in more severe injuries, there is serious trouble. The 2nd degree/3rd degree situation is not complete blockage.
3. The key is the surgeon who performed the surgery works for the cowboys and understands better than anyone the degree of damage. He discussed it in layman terms as stretched but not elongated. That is where we are getting the 2nd degree (3rd worst case) injury estimate from. You got to think that the surgeon gave the thumbs up in this.
4. If regeneration does not achieve the desired results, additional measures might be possible.
5. The surgeon did not go into detail about what he did. There are a number of options to help regeneration (such as use of different cells or temporary guides to promote regeneration). Those are medical information that is doctor-patient confidential though.

Bottom line:
There are risks. But looks like at least a partial recovery. Additional surgical measures are available.
The key information we are hearing is that the player is talking about tingling feelings - I dont think he would be able to make that up or likely to lie about the tingling. According to the 2 PhDs, tingling means regeneration is ongoing. Of course, no one knows if there will be a complete recovery. But you got to figure that these doctors have done many cases and probably have some success % in mind. He did say quite likely for a good recovery though no exact success % was mentioned.

What is the difference between the medical risk vs. someone like Spence with an addiction risk?
I guess at least Spence can probably play the first 4 games...

 

[FuzzyLumpkins]

Nice googling.

No neurosurgeon will say complete recovery. I've never met one that will at least. Nerves are just too delicate. He has a good chance of recovery and that's great. I hope he does. But I still disagree with drafting him at 34.

What makes you qualified to speak for a neurosurgeon?

Axonotmesis is what it is.

nerve injury characterized by disruption of the axon and myelin sheath but with preservation of the connective tissue fragments, resulting in degeneration of the axon distal to the injury site; regeneration of the axon is spontaneous and of good quality.

http://medical-dictionary.thefreedictionary.com/axonotmesis

Of course no doctor worth his salt is going to guarantee anything but this is the doctor near 4 months postop looking at the new images and reaffirming the same prognosis.

 

[FuzzyLumpkins]

Hi, first post because I know 2 PhDs who work in nerve regeneration (wish the best for the player who appears to be a nice kid).

Here is what the 2 PhDs said:
1. As Fuzzy said, recovery is dependent on the degree of injury. If it is a 2nd degree injury, then most likely a complete recovery. If it is a third degree injury, then may be a partial recovery.
2. When they say the nerve went to sleep, that means that part of the nerve cell is dead. However, the nerve cell is not totally dead. Recovery means the nerve cells will grow back into the area using the exising nerve fiber as a guide. There are real risks here, but nerve regeneration always happens with peripheral nerves like this case. However, how complete the recovery depends on how severe the damage - will the nerve reinnervate at the right places. If there is blockage from scar tissue in more severe injuries, there is serious trouble. The 2nd degree/3rd degree situation is not complete blockage.
3. The key is the surgeon who performed the surgery works for the cowboys and understands better than anyone the degree of damage. He discussed it in layman terms as stretched but not elongated. That is where we are getting the 2nd degree (3rd worst case) injury estimate from. You got to think that the surgeon gave the thumbs up in this.
4. If regeneration does not achieve the desired results, additional measures might be possible.
5. The surgeon did not go into detail about what he did. There are a number of options to help regeneration (such as use of different cells or temporary guides to promote regeneration). Those are medical information that is doctor-patient confidential though.

Bottom line:
There are risks. But looks like at least a partial recovery. Additional surgical measures are available.
The key information we are hearing is that the player is talking about tingling feelings - I dont think he would be able to make that up or likely to lie about the tingling. According to the 2 PhDs, tingling means regeneration is ongoing. Of course, no one knows if there will be a complete recovery. But you got to figure that these doctors have done many cases and probably have some success % in mind. He did say quite likely for a good recovery though no exact success % was mentioned.

What is the difference between the medical risk vs. someone like Spence with an addiction risk?
I guess at least Spence can probably play the first 4 games...

Would scar tissue formation show up on imaging like MRI 3+ months postop to see if it is indeed third degree?

 

[darthseinfeld]

Hi, first post because I know 2 PhDs who work in nerve regeneration (wish the best for the player who appears to be a nice kid).

Here is what the 2 PhDs said:
1. As Fuzzy said, recovery is dependent on the degree of injury. If it is a 2nd degree injury, then most likely a complete recovery. If it is a third degree injury, then may be a partial recovery.
2. When they say the nerve went to sleep, that means that part of the nerve cell is dead. However, the nerve cell is not totally dead. Recovery means the nerve cells will grow back into the area using the exising nerve fiber as a guide. There are real risks here, but nerve regeneration always happens with peripheral nerves like this case. However, how complete the recovery depends on how severe the damage - will the nerve reinnervate at the right places. If there is blockage from scar tissue in more severe injuries, there is serious trouble. The 2nd degree/3rd degree situation is not complete blockage.
3. The key is the surgeon who performed the surgery works for the cowboys and understands better than anyone the degree of damage. He discussed it in layman terms as stretched but not elongated. That is where we are getting the 2nd degree (3rd worst case) injury estimate from. You got to think that the surgeon gave the thumbs up in this.
4. If regeneration does not achieve the desired results, additional measures might be possible.
5. The surgeon did not go into detail about what he did. There are a number of options to help regeneration (such as use of different cells or temporary guides to promote regeneration). Those are medical information that is doctor-patient confidential though.

Bottom line:
There are risks. But looks like at least a partial recovery. Additional surgical measures are available.
The key information we are hearing is that the player is talking about tingling feelings - I dont think he would be able to make that up or likely to lie about the tingling. According to the 2 PhDs, tingling means regeneration is ongoing. Of course, no one knows if there will be a complete recovery. But you got to figure that these doctors have done many cases and probably have some success % in mind. He did say quite likely for a good recovery though no exact success % was mentioned.

What is the difference between the medical risk vs. someone like Spence with an addiction risk?
I guess at least Spence can probably play the first 4 games...

Thank you for the imput and wlecome to the board

 

[SportsGuru80]

Easy... He's a 6'3 230 lbs middle linebacker with the smarts of Luke Kuechly and unreal athleticism.

 

[Tabascocat]

Would scar tissue formation show up on imaging like MRI 3+ months postop to see if it is indeed third degree?

I am not sure about that part but some recent studies suggest that some damaged tissue is beneficial to the healing process as an insulator.

The keys to good regeneration are schwann cells and phagocytes/macrophages.

Been almost 20 years since I took neuroanatomy in med school but it is kind of coming back bit by bit

 

[texbumthelife]

Because without injury, Jaylon Smith is significantly better than Myles Jack.

 

[waldoputty]

Another point is EVEN IF Jaylon is making up the tingling feeling to get drafted, he probably would not be lying to his doctor, who works for the Cowboys : )


This is not from the PhDs. But from https://en.wikipedia.org/wiki/Magnetic_resonance_neurography :

Magnetic resonance neurography (MRN) is the direct imaging of nerves in the body by optimizing selectivity for unique MRI water properties of nerves. It is a modification of magnetic resonance imaging. This technique yields a detailed image of a nerve from the resonance signal that arises from in the nerve itself rather than from surrounding tissues or from fat in the nerve lining. Because of the intraneural source of the image signal, the image provides a medically useful set of information about the internal state of the nerve such as the presence of irritation, nerve swelling (edema), compression, pinch or injury. Standard magnetic resonance images can show the outline of some nerves in portions of their courses but do not show the intrinsic signal from nerve water. Magnetic resonance neurography is used to evaluate major nerve compressions such as those affecting the sciatic nerve (e.g. piriformis syndrome), the brachial plexus nerves (e.g. thoracic outlet syndrome), the pudendal nerve, or virtually any named nerve in the body. A related technique for imaging neural tracts in the brain and spinal cord is called magnetic resonance tractography or diffusion tensor imaging.

There are numerous reports dealing with specialized uses of magnetic resonance neurography for nerve pathology such as cervical radiculopathy, guidance for nerve blocks,[18] demonstration of cysts in nerves,[19] carpal tunnel syndrome, and obstetrical brachial plexus palsy.[20]


Sounds like to me that existing technology can detect the scar tissue or other abnormalities.
Again, the key is the tingling feeling and we are already 4 months post-op and prognosis has not changed.

 

[btcutter]

What makes you qualified to speak for a neurosurgeon?

Axonotmesis is what it is.



http://medical-dictionary.thefreedictionary.com/axonotmesis

Of course no doctor worth his salt is going to guarantee anything but this is the doctor near 4 months postop looking at the new images and reaffirming the same prognosis.

I am not a neurosurgeon but do have access to them. This board is full of people from different fields with vast amount of knowledge.

There are risks. Quite a few people simply assume he will make a full recovery and be the same player he was before injury. It's just not so simple. I cheer for the kid to make full recovery. But in terms of drafting at 34. I disagree.

 

[FuzzyLumpkins]

I am not a neurosurgeon but do have access to them. This board is full of people from different fields with vast amount of knowledge.

There are risks. Quite a few people simply assume he will make a full recovery and be the same player he was before injury. It's just not so simple. I cheer for the kid to make full recovery. But in terms of drafting at 34. I disagree.

Your argument gives no indication that you have spoken with one or that you can articulate their reasoning.

 

[Cowboys20]

Unfortunately, neither player was worth the risk. Not only do you have to consider the recovery process of the injury but a possibility of injuring the knee all over again. Another point to consider is the player needs to overcome the mental aspect which is the worst part when it comes to knee injuries.

 

[Wolf2k5]

I can say that I personally wouldn't have made the pick at 34 but I also have no access to medical records.

 

[Dundalis]

Because without injury, Jaylon Smith is significantly better than Myles Jack.

Of course he is, if Jack isn't also without injury. If both aren't, Jack is the better prospect. I also am not sure why people are saying he's a mike, when he's clearly a will. He's physical, but he ain't no bulldozer, and doesn't shed blocks very well at all.

 

[RoboQB]

Nice googling.

No neurosurgeon will say complete recovery. I've never met one that will at least. Nerves are just too delicate. He has a good chance of recovery and that's great. I hope he does. But I still disagree with drafting him at 34.

Just how many neurosurgeons have you met with?

 

[Yakuza Rich]

Reminds of Darren Woodson, I think he was an LB in college.

Jack, if healthy, is a far better athlete than Woody was. I tend to agree with the scouts on this, but Jack would be ready to play SS from day 1 because he already has the cover skills for it. Woody took a year to learn it. If anything, Woody was a smart player which you need at the safety position. Does make me wonder if possibly the Jags are going to go Jack and Ramsey at the safety spots.





YR

 

[btcutter]

Just how many neurosurgeons have you met with?

In my life time or routinely? Now only if I run into them during meetings so it's not very often now since we are in different fields. In training years ago..routinely. All neurosurgeon start as medical students.

 

[speedkilz88]

It's really all speculation by our part. These are no secrets to other teams. If it were so simple wouldn't you expect another team to take that risk (which isn't so much given that much of this board feels that 100% recovery is imminent) at end of round 1.
We are listen to Smith's phone call and his interview with Bryan Broadus. He was NOT expecting to get pick so early. We could have easily moved down 10 spots picked up an extra 3 and still have him...maybe even in 3rd.
JJ is just a gambler. He can't help it. He just believe he is smarter than everyone else.

The only call they had to move down was Chicago at 56 which they deemed too far.