DENVER -- It was the biggest game in Nuggets' history, so it might have been a bad omen that their top scorer was puking into a trash can 15 minutes before tipoff.

With subs J.R. Smith, Linas Kleiza and Chris Andersen combining for 40 points, 18 rebounds and six assists, Denver beat L.A 120-101 to win Game 4 and even the Western Conference finals 2-2 -- even though go-to-guy Anthony was laid low by a stomach virus that started bothering him late Sunday night. He needed IV fluids at halftime and, making matters worse, he also suffered a mild ankle sprain in the first quarter.

"I don't think I had my legs early in the game; I didn't feel like I had any energy," said Anthony, who shot just 3-for-15 and finished with 15 points.

Until the game started, his stomach bug was a state secret. Not even his teammates knew, and the Nuggets weren't about to make an announcement for L.A.'s benefit.

But it didn't matter because his teammates responded with a tidal wave of energy that swamped the increasingly weary-looking Lakers. Denver's frontcourt dominated L.A.'s on the glass, grabbing 20 offensive rebounds to the Lakers' nine, outscoring the Lakers 42-16 on dunks and layups, and winning seemingly every 50-50 ball.

That included an underrated but outstanding performance from center Nene, who grabbed six first-quarter rebounds and created two other team boards to keep the Nuggets ahead during a brick-filled first quarter. He also had six assists for the second time in three games and devoted just as much energy to sharing credit as he did to sharing the ball.

"Me? No, the team," said Nene. "We played smart, we played fast, and the shots we missed last game we got."

"We just didn't get to the ball," said Lakers coach Phil Jackson "If we were tired, it was noticeable tonight because their energy was better."

Denver also got a huge boost from its bench, with Smith having his first breakout game of the series (24 points in 28 minutes) and Kleiza chipping in 10 in just 13 minutes. Throw in 14 rebounds from Andersen and the disparity was glaring -- Jordan Farmar was the only Lakers sub to score more than six points.

"We feel like we've got a better bench, a longer rotation, and they look tired," said Kleiza. "We look fresher."

Going forward, Kleiza's point is one to watch closely. As the war of attrition takes its toll, it's fair to ask whether the Nuggets' superior depth and energy will wear out the Lakers.

Certainly, that's part of Denver's game plan. The Nuggets have kept attacking, kept pushing, kept sending players to the glass and playing physical in part because they feel L.A. will wear down as a result of playing 13 games in 25 days, or 14 in 27 if this goes to a seventh game. And with little production from the supporting cast, Bryant and Gasol have played huge minutes in nearly all of them. Those two were again brilliant Monday night, combining for 55 points, but had little company in the scoring column.

The Nuggets aren't exactly daisy-fresh either -- in addition to Melo's ankle, Smith and Renaldo Balkman also have battled minor injuries in this series -- but L.A. is the team that looks more worn down physically. Of particular note are the injuries limiting Lamar Odom and Trevor Ariza, neither of whom was of much use on this night.

Odom (back) finished with five points on 1-of-8 shooting and, in the ultimate irony, threw away an inbounds pass for a Chauncey Billups layup that basically ended the game. Ariza (hip and groin) was worse, with just three points and one rebound in 26 impact-free minutes.

Quietly, the Nuggets don't see fatigue as the only factor in their favor. They also believe they're much, much tougher (with the monumental exception of the guy wearing No. 24 in gold), and that it can work in their favor toward the end of this series -- much as it did for Boston in the Finals a year ago. It's no accident that coach George Karl said his team had prepared for this series more by watching Boston film than by watching Houston.

Of course, it was easier for the Nuggets to have more energy and effort Monday night. They were playing with an extra hint of desperation, since a loss would have effectively ended the series, and they were playing at home and at their preferred altitude. The Lakers had already taken care of business by winning Game 3 in Denver, so there was less urgency on their part -- with fatigue perhaps contributing.

"When you're tired, you say, OK, I don't have to get that ball or I don't have to get on the floor for this loose ball," said Bryant, "as opposed to taking every possession like it's the last possession like we did in the third game."

Denver's aggression occasionally went over the edge; the Nuggets picked up three technical fouls for a second straight game. Additionally, guard Dahntay Jones added another notch to his growing rep as a dirty player by appearing to intentionally trip Bryant as he made a cut down the lane. There was no call on the play but he'll likely hear from the league office about it, with the likely outcome being an after-the-fact flagrant 1, but a suspension is also possible. (The league will also review Andrew Bynum's flagrant foul on Andersen, most likely to rescind it.)

"It was a fine line," said Billups, who scored 24 points with nary a turnover. "So some of that you have to say, all right, you have to live with some of it. But at the same time, you've gotta be smart sometimes."

Nonetheless, Denver's aggression is proving to be an effective weapon against the Western Conference's top seed, and the next test is to see how well it travels. Having already won twice in the conference finals for the first time in franchise history, Denver still must win once in Staples Center to make a first-ever trip to the NBA Finals.

That's a tall order given that the desperation card will no longer be theirs alone to play. But having overcome one huge obstacle by pulling out a must-win game even with their top scorer ill, they may just be ready for the next challenge.

John Hollinger writes for ESPN Insider. To e-mail him, click here.

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