We are just a short two days away from the Buffalo Bills vs Detroit Lions showdown at the new Bills stadium. I’m going to assume the progress on the new grass sod is going well.
The current weather forecast shows the possibility of rain leading up to the game. As an agronomy ignoramus, I don’t know if that helps or hurts the grass field situation.
As a fan attending the game, I hope the skies are clear as I would hate to have to cover up my new Lions Rivalries jersey with a plastic poncho. You REALLY won’t be able to tell the actual color of the jersey with a poncho over it. It’s actually silver, I swear…
Isiah Pacheco, RB - Back nerve injury
A report by Ian Rapoport shed some light on Pacheco’s injury…
As I had feared when he was placed on IR, Pacheco’s back injury was indeed serious. This injury originally occurred around August 20. Based on Rapoport’s report which forecasts a possible return in early December, Pacheco may have only recently had surgery, as 12 weeks from now is December 8.
It’s common to see if back symptoms resolve with conservative (non-surgical) treatment first. So Pacheco may have given the back about 2 to 3 weeks to try to improve, before deciding to go forward with surgery.
Surgery to remove a “body” almost certainly involves the spine, which was my suspicion when he went on IR. When Rapoport says “body”, it’s a generic term that could mean any anatomic part of the spine that is pressing on the nerve. I don’t think it necessarily refers to the vertebral body as shown in the anatomic diagram below.
I agree with xylo that bone, disc, or cyst are possibilities.
As far as the exact surgery, a laminectomy and/or microdiscectomy are possibilities, as reader Matt McManus points out…
A microdiscectomy could have a return in the 12-week range… if everything goes well.
See my earlier story where Sam LaPorta speaks about his microdiscectomy recovery…
As LaPorta mentioned with his surgery, back surgery to relieve nerve symptoms is tricky and uncertain. Will the nerve compression be successfully addressed by the surgery? How fast will the nerve heal up? Will the nerve symptoms fully resolve?
Pacheco will have to overcome these hurdles in order to return this season. Even if his back symptoms resolve, his conditioning and strength will need to build up again.
How did Pacheco injure his back?
The report implies that he hurt it while rehabbing from his MCL. While possible, I do wonder if there is more to the story. Was he training too hard? Was there a pre-existing issue that was exacerbated or just found out?
Detroit Lions Midweek Injury Report (Line +5)
🔴No practice (NP)
🟡Limited practice (LP)
🟢Full practice (FP)
*Current Starter
🔴*Christian Mahogany, LG - Hip
Projection: Out. Potential RTP in 2-3wk.
Yesterday, Dan Campbell stated: “I don’t think this is something serious, long-term.” If Mahogany avoids IR before the game, that would be excellent confirmation that this is not a serious injury. He’s almost certainly out for Thursday though.
🔴*Blake Miller, RT - Knee
Projection: Lean out
As you saw on my postgame injury report, Miller was rolled up on, which can cause a high ankle sprain and knee MCL sprain. While it sounds like the injury is minor, the NP today is not a good sign for Thursday’s availability. The short week may force him to miss a game. If he can get up to a LP on Wednesday, then he might have a chance.
🟡*DJ Reed, CB - Foot
Projection: Uncertain
A surprise LP midweek can have a range of possibilities. From a minor injury that caused some limitation in practice, to a serious injury that forced him to leave practice. As of now, there are no details.
As Nick on X pointed out, the Lions had a walkthrough today, so the hope is Reed couldn’t have suffered anything too serious.
If Reed has a NP tomorrow, concern levels will rise. If he has a LP or better tomorrow, then that is extremely reassuring.
🟡*Juice Scruggs, C - Knee
Projection: In
I did not see an injury during the game and Scruggs played 100% of snaps. Two LPs this week is a good sign for his availability.
🟢Christian Izien, S - Groin
Projection: In
Two FPs has him in vs the Bills.
Notables Unlisted
🔴Cade Mays, C - The Lions’ original starting center is on IR with a wrist fracture. Projected RTP: Week 5-7.
🔴Isiah Pacheco, RB - On IR with back surgery. Projected RTP: December, at best.
🔴Kerby Joseph, S - On PUP with left knee. Projected RTP: Uncertain.
🔴Brian Branch, S - On PUP with right Achilles. Projected RTP: Week 5-8.
Buffalo Bills Injury Report
For the comprehensive updates on the Buffalo Bills’ health and injuries, visit Dr. Kyle Trimble at BangedUpBills.com or on his Substack - Banged Up Bills. Like me, Dr. Trimble is a big fan of his team, which allows for a level of insights, depth, and care that most won’t have.
Both of us are rooting for a clean game… and a rematch in the Super Bowl.
So far, my food adventure in Buffalo is going well…
Mostly well, anyway…
Not sure I agree on Miller. No missed games in college and speaking positively about it to reporters makes me lean IN.
Have a blast at the game!
I wouldn't be surprised if Pacheco didn't play a game this season. This is what happens when you try to gamble on a guy who is injury-prone. And boy is he.
No Miller and no Reed would be rough.
It'll be interesting to get your take on the new stadium, hopefully you've got good seats. And hopefully the Lions don't get blown out, lol. This game is going to be a real litmus test.