Eric Wood’s Neck Injury

Analyzing the neck injury that forced Eric Wood to retire and long term implications.

Disappointing news coming out of One Bills Drive Friday with the sudden announcement of C Eric Wood retiring from the NFL after nearly a decade. The cause of his retirement appears to be related to neck issues that were discovered during a routine end of season physical intended to assess issues players made need to address in the off season.

This determination was made by Dr. Cappuccino, who is the orthopedic spine surgeon, along with other doctors and team officials. For the 9th year pro’s long term health, it was ruled that retirement was best to avoid further damage. As detailed information has finally been released, it has been revealed that Wood is dealing with a bulging disc in the C2-C3 region following stinger’s during Week’s 5 & 6. Today’s post will identify why this is career ending and long term implications.

While it is incredibly disheartening hearing this news, I believe all fans would want the health of each and every player to be most important. To identify what occurred with Wood, the anatomy of the area must be understood. The cervical region of the neck is comprised of 7 cervical vertebrae that stack on each other which curve in concave fashion to allow for support of the head in an upright position. In between these vertebrae, with the exception of the first two levels, cervical discs act as as shock absorbers and allow for the vertebrae to articulate with each other in order to move freely. Ligaments attach the vertebrae together for support and passing through the vertebrae are arteries, the spinal cord, and nerves. Eric Wood suffered a disc bulge at C2-C3, the first disc after the C1-C2 junction. To help put this all in perspective, please refer to the pictures below.

05-2_Cervical_Vertebrae.jpg
Credit: backpain-guide.com

One of the issues that Eric Wood may have been dealing with that was described as wear and tear is cervical spondylosis. This occurs when the structural integrity of the vertebrae column becomes compromised and leads to instability within the region. This is is due to the cervical discs losing disc height which in turn reduce the space between, leading to laxity on the ligaments, causing further pressure on the discs. This can be the result of the aging process, trauma, or individuals that have to carry heavy loads on their head or shoulders. As a possible result of this condition, he stated he suffered a “stinger” in Week’s 5 & 6 and was evaluated without further treatment required. As cervical spondylosis progresses, this can cause other issues including degenerative disc disease, spinal stenosis, hypertrophy of the surrounding ligaments, subluxation of the vertebrae, along with both neural & vascular compression.

ds00697_im02193_mcdc_7_spondylosisthu_jpg.jpg
Credit: mayoclinic.com

As a result of the disc bulging out, this can create spinal stenosis. In the case of cervical spinal stenosis, the vertebral foramen, or space in which the spinal cord passes through, becomes narrowed. In the case of Wood, repeated trauma/progressive disc protrusion is what led to his disc pressing on his spinal cord as seen below. Other causes that could occur include ventral spondylophyte formation, thickening of the ligamentum flavum, or hypertrophy of the dorsal facets. While all these are confusing terms, these are all structures that surround the spinal cord that could reduce space and compress on the spinal cord as you place the head into various positions. To put this into a simpler perspective, imagine squeezing a hose; as you tighten or bend the hose, the flow of the water decreases. If the spinal cord is compressed, certain head movements can increase pain and limit mobility, placing even greater pressure on the spinal cord. This could affect areas below the spinal cord level or the nerve roots that branch off to the extremities. With compression over time, this could lead to temporary or irreversible damage based on severity.

cervical_stenosis_cause02.jpg
Credit: http://www.houstonmethodist.org

This is something that Wood was aware of after Week 5 and appeared to manage up to this point. However, incidence of previous spondylosis could cause and progress the stenosis.  As the veteran center has never appeared on the injury report with a neck injury during his career, this doesn’t mean that he never had neck pain. This is evident with the report of the stingers that was resolved which lead to his omission on the injury report.

Following the stinger, there are variations in the presentation of symptoms based on severity. One of the concerning but manageable issues include cervical radiculopathy. This is where the nerve is compressed either at the neck or a later exit point down the nerve’s path. This compression could cause pain, tingling, numbness, and weakness to travel down specific nerves in the shoulder or arm. This is common to see in the general population, but far from a pleasant sensation. Several of these symptoms are more prevalent in the lower cervical vertebrae.

In Wood’s specific presentation, occipital headaches, often typical of migraine, with pain radiating to the eyes and behind the ears, blurring of vision, dizziness and nausea especially when attempting to lie down, numbness of the side of the neck, tension and “knots” in the neck and shoulder muscles, and swelling and stiffness of the fingers. He may have had several of these symptoms following the stinger which warranted further evaluation.

If Wood would have continued playing and ignored medical advice, he would be at risk of  developing cervical myelopathy as this is more severe in that actual damage to the spinal cord has occurred. This presents as bowel and bladder issues appear along with difficulty walking, coordination, and loss of strength, among other symptoms. Typically, those are emergency related symptoms and must be dealt with immediately. If Wood were to keep playing, he would be at higher risk to have this occur with the violent nature of the hits and further degeneration of the affected areas. The C2-C3 area is more severe as nerve roots branch off which affect head movement and assist in controlling breathing. Further damage to the area could include paralysis and/or death if not addressed immediately.

While all this does sound ominous, there are many options for conservative care. Physical therapy, chiropractics, and pain management including injections can manage the complaints for years. Primary focus on the area would to educate the patient on the condition and awareness of possible worsening symptoms. Other interventions include managing and reduce pain, maintain motion and strength in the area, and prevent further decline in the area. Personally, I have worked with a variety of patients with similar complaints with a variety of outcomes. Some have been able to resolve their complaints completely, some have significantly reduced their pain and have a strong understanding how to prevent further complications. Others have gone on to receive injections and surgery which in turn has improved their quality of life. Fortunately, through his decision to step away from the game of football, Eric Wood will not likely be bed bound and in a neck brace for the rest of his life. He will instead be able to participate in activities including exercise, avoiding strenuous, repetitive activities such as football and heavy weightlifting, and focus on raising his newborn son.

If Wood is to require surgery in the future, there are a variety of surgical procedures that can help to stabilize the affected area. This includes but is not limited to: spinal fusion surgeries and/or anterior cervical discectomy.  These procedures stabilize and partially remove the offending area to reduce pressure on the spinal cord. Right now, he may not require any surgery, instead altering activities to reduce further damage. If surgery is indicated, this will help with quality of life but would not allow him to safely return to football.

Severity of the neck complaints that are forcing Wood to retire early at least leaves him in good hands with Dr. Andrew Cappuccino.  If you recall, Dr. Cappuccino is best known for saving TE Kevin Everett‘s life during the season opener in 2007. To put into comparison how severe this Wood’s injury is, S Aaron Williams had similar issues with his neck in a lower level that were well documented, ending his career. It appeared that he was willing to continue playing, but teams knowing his medical history would not touch him for fear that the next big hit may kill him. Wood was not willing to take that risk and able to end on a high note with a playoff berth.

The next big question is who steps up and replaces him. Ryan Groy appears to be a natural fit as he can play multiple positions on the line and may be a stop gap until the Bills find their next player in the draft or free agency. I believe the Bills will address this position effectively as they have with other positions this past season. It is a shame that this occurred to such a great player, but, as many before Eric Wood have proven, time is the one opponent that no one can defeat.

I hope that you learned something today and helps put into perspective why Eric Wood is forced to end his career. Continue to check back with me on updates regarding Bills injury news! Thank you for reading and GO BILLS!!

Author: Dr. Trimble

My name is Dr. Kyle Trimble and I am, first and foremost, a Buffalo Bills fan!! When I am not cheering on the Buffalo Bills, I am a Physical Therapist. To give a background on myself; I was born and raised in Erie, PA, moved to Buffalo in 2006 to begin my studies at D'Youville College towards becoming a Physical Therapist at which time I became a devoted Buffalo Bills fan.  I graduated in 2013 with my Doctorate in Physical Therapy and moved home for several years. Moving back to the Buffalo area in 2016, I have gained extensive experience in outpatient orthopedics, skilled nursing, acute care hospital, and home care. Having obtained a significant wealth of knowledge that continues to grow, along with a undying fandom of the Bills, puts me in the unique position to educate my fellow fans about our great team. 
I am currently an injury spotter working with Dr. David Chao, Orthopedic Surgeon @ProFootballDoc based out of San Diego. In this role, I provide real time updates regarding injuries during the game. I hope you enjoy what I publish and I welcome any comments or questions you may have.
Disclaimer: My opinions are my own.  Any thoughts I have on the injuries is based on media reports, my knowledge of the injury, and speculation based on the information currently available.


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