Week 17 fantasy injury update: Tony Romo

There’s certainly been a whirlwind of news surrounding Dallas Cowboys QB Tony Romo’s injured back over the past 24 hours. Amid conflicting statements as to whether Romo’s season is decidedly finished, one thing is clear: He has a serious spine condition which will not be 100 percent resolved by Sunday.

The question then becomes whether he could hypothetically function well enough to play in a game that will determine the NFC East title. Here are a few considerations to keep in mind:

1) ESPN’s Chris Mortensen has reported that Romo has a herniated disc that will require surgery. It is worth noting that not all disc injuries require surgery; in fact, the majority resolve on their own with time. One of the key factors in determining the need for surgery is neurologic compromise. In essence, if a nerve is being compromised to the degree where the athlete is experiencing sensory loss or motor (muscle) weakness, particularly if it is progressively worsening, then surgery may be the treatment of choice to prevent lingering nerve damage. The goal is to determine whether a herniated disc is actually compressing the nerve root or whether it is inflammation associated with the disc injury that is causing problems for the nerve. If inflammation is the issue and the inflammation can be adequately treated, the nerve may respond positively and surgery may not be necessary. If the disc material is directly compressing the nerve, then surgery may be required to remove it.

2) If in Romo’s case inflammation is the primary culprit, then the primary treatments he is undergoing now are specifically aimed at addressing that inflammation. On Tuesday, ESPN Dallas reported that Romo received an epidural injection, a steroid injection directed in the area surrounding the inflamed nerve root in the hopes of reducing inflammation and pain. Epidurals vary widely in their rate of success and the speed with which they take effect. Sometimes a series of injections is required but that generally happens over a broader time frame than is available until the Cowboys’ next game (versus the Eagles on Sunday). Romo would have to demonstrate significant improvement, not only as far as pain, but more importantly, as far as neurologic function (sensation and muscular performance) in order to safely return to the field.

Ultimately, time may not be on Romo’s side. Being the competitor that he is (let’s not forget he has played with broken ribs), it’s understandable that he wants to have every opportunity to see if he can recover to the point of being able to play this weekend. And he certainly does not need to be rushed to surgery unnecessarily. In fact, depending on his exact signs and symptoms and how he responds to this early treatment, even if he does not play this weekend it isn’t necessarily a foregone conclusion that he will have surgery. That said, if there are hallmark indicators for surgery, there will be little time wasted in moving him toward that next step.

We will wait until this season ends and the treatment course for Romo is more formally outlined before projecting into next year. In the meantime, fantasy owners with games this weekend should plan on plugging in an alternate quarterback since Romo, should he even get the opportunity to take the field, may not be able to hold up for an entire four quarters.