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Peyton Manning: Cervical Fusion and Return to Play

After a hard hit in the middle of a game, it can be a long nerve-wracking moment when a player doesn’t immediately rise to their feet. In football, specifically, there is always a fear of a spine or neck injury after a bad tackle. Neck problems are quite common in football, whether a “stinger” or something more serious. But when the injury is severe and surgery becomes a necessary option, there is life after surgery – even in professional sports.

In mid-2013, a study was published of seven professional football players and eight professional wrestlers who underwent anterior cervical discectomy and fusion. All fifteen were cleared to play following the surgery. Thirteen returned to their respective sports in 2-12 months, and eight are still participating in the most recent season.

An earlier study from 2010 also showed that professional football players with cervical disk herniations who were treated surgically had higher return-to-play rates and longer careers than those who were treated non-surgically. Nearly 3 out of 4 NFL players treated surgically returned to play in an average of 29.3 games over a 2.8-year period.

Broncos quarterback Peyton Manning completed a record-breaking 34 passes in Sunday’s big game, although it did not help his team against the swarming Sea Hawks defense.  It is easy to forget that Peyton was sidelined for over a season due to serious cervical spine issues and multiple neck surgeries. In fact, his injuries were so severe that his brother Eli recently revealed that he “was pretty much convinced that [Peyton] was done” after his second surgery.  However, through revision surgeries and rigorous physical therapy, Manning was able to regain control of his career and help bring his team to the Super Bowl this year.



In early 2011 struggling to complete passes and suffering from the pain of a herniated cervical disc, Manning eventually underwent a decompressive surgery without fusion to take pressure off the nerve, known as a “posterior foraminotomy”. In the two weeks that followed, Manning continued to experience weakness and was beginning to lose grip in his right hand and underwent another decompressive surgery.

However, as time progressed his condition worsened. The 2008 Super Bowl MVP could barely throw the ball 5 yards. In July 2011, tests showed Manning had dangerous degeneration in his spine and underwent a third, similar  surgery, but Manning was unsatisfied with his improvement.

In September 2011, Manning sought a more complete solution, and underwent a single-level anterior cervical fusion. This approach allows a more complete decompression of the nerve, and less likelihood of re-herniation. And interestingly, a 1 level fusion often results in no noticeable difference in range of motion, even in a professional athlete.  His damaged disc was removed from his spinal cord, a bone graft filled the space, and the vertebrae were welded together with a plate and screws. This surgery often provides a high level of functioning after recovery – minimal or no loss of range of motion, no pain, and the ability to withstand high-impact physical sports, obviously a must for the star quarterback.



After months of intensive training and rehabilitation, Manning was able to join the Denver Broncos as a starting quarterback for the 2012 season. And, though in the end Manning couldn’t bring the Broncos to victory in the big game, during the 2013 season, he broke regular season records for yards passed, touchdown completions, first down passes, and games with over 50 points.

While cervical spine injuries can be frightening and severe, with the right plan, effective surgery, and rehabilitation, professional athletes and any patient has a good chance of excelling in their field and returning to a normal life. To read more about cervical spinal fusion, read my blog post about the topic here.