Manning missed last season after the fusion surgery. He had had another surgery the previous May to fix a bulging disk. The fusion was to remedy a nerve problem that had weakened his right (throwing) arm.Wellington K. Hsu, a spine surgeon and assistant professor at Northwestern University, says the fused area should not be vulnerable. "In fact, his neck is probably stronger now than it was before the surgery because he has a solid, bony fusion," Hsu said.
Rick Sasso, an Indianapolis spine surgeon who, like Hsu, was not involved in Manning's treatment, agrees. "As long as the fusion was solid, that segment is very protected," he said.
Sasso says the surgery Manning had, known medically as a "single level anterior fusion," is common. He estimates he has performed about 1,500 of them.
"It's one of the most routine operations we do now as spine surgeons. We do it as an out-patient. Most out-patients go home about four hours after the operation is done,' Sasso said.
They don't typically go on to play in the NFL, but it does happen.
Both say that doesn't preclude Manning having a disk problem in another level of his spine. "That has been known to occur. That is called adjacent segment degeneration," Hsu said.
Said Sasso: "A lot of it is genetic. … We're born with the genes that have a higher propensity for these disks to wear out."
In 2010, Hsu published a study of 99 NFL players who had sustained herniated disks: 53 had surgeries and 46 opted for non-surgical treatments. Hsu found players who had surgeries had higher return-to-play rates and longer careers than those who had not.
According to his study, 38 of the 53 players who had surgery returned to play for 29 games over an ensuing 2.8-year period that was analyzed.
In 1998, then-Florida State quarterback Chris Weinke had spinal fusion surgery. He returned in 1999 to lead Florida State to an undefeated national championship season. He won the Heisman Trophy in 2000 and played in the NFL from 2001-2007.
"Peyton's issue is weakness of the muscle, and that doesn't always happen," says Hsu. "So that made his (outcome) more unpredictable as well."
Then there is the nerve issue.
"The question is whether his nerve was compressed for too long and whether it's got a chance of getting better or not and whether it is getting better," Sasso said.
Manning's father, Archie, recently told The Indianapolis Star that Peyton has been throwing fine for two months and "looked like Peyton."
What does Hsu expect from Manning moving forward?
"From all the reports of him throwing and how the X-rays and MRI look — it's a pretty popular topic among my circle — I think he's going to be back," Hsu said. "It will remain to been seen whether he will be as strong and good as he was during his MVP years.
"But I've been telling everybody that he is going to come back, and he will be one of the elite quarterbacks."
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