On Thursday, Ryan O’Halloran of The Buffalo News reported that Buffalo Bills WR Jake Kumerow underwent a microdiscectomy recently. This was disclosed during locker clean-outs on Monday according to the article below.
This news is notable due to the fact that Kumerow was never on the injury report for a back issue all season. It’s also worth noting that he was never questionable or had to miss time due to a back injury in his career from what I have found. He did note that this was not due to one hit, but more that it slowly happened over time.
This was very likely in his lumbar section of his spine. This would also be the same procedure that OT Spencer Brown had last May during OTA’s. This kept him out during a portion of training camp.
Looking for clues this past season, Kumerow sat out of mandatory mini-camp back in June as seen below.
Kumerow was listed as having soreness during the first week of training camp, but a body part was never specified. This would not have clued anyone into what was going on at the time.
He was able to play during the season without issue until a left high-ankle sprain in Week 3 forced him to injured reserve for four weeks. He was able to return in Week 8 and play three more games before going back on injured reserve for the remainder of the season. The second injury was sustained in the Week 10 matchup against the Minnesota Vikings. He did re-injured the ankle and the thought was that it needed more time to heal, but that was not the full case.
Kumerow spent the remainder of the season on injured reserve, not publicly available to practice with the team. Other than sitting out practices, there wasn’t anything else that suggested the specifics or extent of the injury.
Further diving into the article, Kumerow stated that he was 13 days removed from surgery on that Monday. This put his operation day on January 10th, right after the regular season concluded. The team likely was waiting to see if a post-season return was possible and once they realized it wasn’t, they elected for the surgery despite him being eligible to return from injured reserve.
To understand what a discectomy is, the anatomy must be reviewed.
The Anatomy
In the spine are a series of vertebrae that house the spinal cord, which connects to the brain and allows control for all aspects of function, including muscle movement, sensation, vital organ use, and all other systems of the body. The vertebrae are comprised of cervical, thoracic, and lumbar vertebrae.
Between each vertebra lies an intervertebral disc, which allows the vertebra to move while providing stability. Without these discs, movements such as bending over would not be possible without serious injury to the spinal cord.
Within the discs are three portions: the annulus fibrosis, the nucleus pulposus, and the endplate. The annulus is the firm outer portion of the disc, which connects to the endplate that attaches to the vertebral body. The nucleus pulposus sits inside the disc, which is a jelly-like substance comprised of water and collagen fibers.
A bulging disc occurs when there is a force through the spine either through compression, sudden flexion, or rotation. This could force the annulus fibrosis to partially tear and cause the nucleus pulposus to herniate out and push against either the spinal cord or nerve root of a specific nerve. In a bulging disc, the annulus is partially torn, putting pressure on the structures but not outright herniating into the spinal cord or nerve root. In turn, this could cause a common complaint known as sciatic pain, named for the nerve that runs down the leg.
Physical therapy, epidural injections, and temporary cessation of the offending activities are typically recommended as first lines of treatment, but in severe or non-responsive cases, surgery may be required. This is when a portion of the disc that bulges out is trimmed away, along with possibly bone, in order to take the pressure off the surrounding areas. Typically, the incisions are small and the surgery is not invasive.
The spine must be slowly loaded and motion limited in order to maximize healing in the area and prevent any further disc bulging or herniation. Even after the surgery and proper rehab, there is still a possibility that the disc could suffer recurrent disc herniations, which could cause further back pain and limitations.
Outcomes
Lumbar discectomies take 8-to-12 weeks to fully recover from with most players returning to play. 15 percent do require another procedure if there is another herniation at another level or if the first disc re-herniates.
Other articles indicate that the failure rates can range anywhere from 5-18 percent, which can cause recurrent lumbar disc herniations within the first year. It’s not noted which level required the microdiscectomy, however, my guess is at L4-L5 and L5-S1. These levels typically have the highest rate of injury and can cause radiculopathy down the leg, causing pain and weakness.
Career Outlook
Those that require a discectomy are able to return 78 percent of the time to an NFL field, compared to 59 percent of those that don’t have the surgery. Plenty of players have had this procedure and been able to return to full participation without a decline in function. There may be complications such as other levels of herniations or fusions later in life, but not always assumed.
This isn’t an injury that should force Kumerow to retire and he should be nearly a full-go for OTA’s should he return with the Buffalo Bills.
Kumerow’s injury is the latest in the various injuries that many players work through in the season that the general public has no idea about.
I wish him the best in his recovery and a return to football for the 2023 season.
Top Photo Credit: Troy Babbitt-USA TODAY Sports
