Buffalo messed up big time not supporting Jack's Choice of surgery.
I don’t know if it’s that simple.
AFAIK The GM doesn’t make the decision as to what surgery Eichel gets. Their team of doctors does.
I don’t know if the GM could override his doctors and tell a player what type of surgery he needs to get even if he wanted to. It could set a dangerous precedence. Imagine if a GM could decide what type of surgery a player gets instead of the doctors.
I am unaware of a situation where the GM overrode the doctors decisions with regards to a major surgery.
The only one that I can think of is the McDavid situation. But it was different because his chosen route was NOT to have surgery and do rehab instead.
Also, there’s the issue of What would that do to Eichel’s injury insurance on his contract, if the GM overrode his team doctors and approved a surgery they are obviously strongly against?
The Sabres head doctor is one of the top spine surgeons in the country and was one of the innovators of artificial disc replacement surgery.
https://buffalospinesurgery.com/dr-andrew-cappuccino
Eichel had to see multiple doctors before he found one that was willing to do ADR. And even Eichel’s chosen doctor said he wouldn’t recommend ADR on an NFL player because of the hits they take (he tried to say they are different than in the NHL but I don’t see where an open field hit is any different than an open ice hit. Hits in hockey may be even more violent. Higher speeds + hard ice, etc).
There are many doctors who are against ADR for pro athletes in contact sports. From a panel with multiple spine surgeons: (they were all against ADR in pro athletes)
Spine and Sports: A Roundtable Discussion
Dr. Hecht: Let’s discuss some challenging management scenarios, beginning with a professional football player with a C4 to C5 posterolateral disk herniation with weakness in his deltoid who has exhausted all conservative care. What kind of surgery would you perform?
Dr. Vaccaro: I would perform an anterior cervical decompression and fusion (ACDF) using an allograft bone and a cervical plate. I would allow him to return to play 6 to 9 months after that procedure after he has completed rehabilitation and has full range of motion (ROM) and his strength back.
Dr. Watkins: My recommendation is a one-level anterior cervical fusion using allograft and a plate. I use a cortical allograft packed with autogenous cancellous bone from the iliac crest.
I would not recommend a total disk replacement. I think the unknown factors of artificial disk replacement preclude its use in high-performance athletes, and certainly not in those in sports that potentially involve head contact, including those playing in the National Basketball Association (NBA), National Hockey League (NHL), and Major League Baseball (MLB) players.
I would not perform a foraminotomy and posterior disk excision. The potential risk of instability and reherniation is too high in this athlete.
Dr. Dossett: I would also perform an ACDF with autologous iliac crest graft and a plate.
Dr. Hecht: I agree with the ACDF with allograft and instrumentation. I would not do a foraminotomy or disk replacement in a football player with a disk herniation. Would total disk replacement in this scenario be appropriate for a player in any other sport?
Dr. Vaccaro: If the player were involved in a noncontact sport, I would perform a disk replacement if the patient preferred it after I explained the risks and benefits. In athletes involved in sports that involve significant contact, I would avoid disk replacement.
Dr. Hsu: Although both foraminotomy and ACDF have been successful for National Football League players, they both have their challenges. ACDF can lead to adjacent segment degeneration and ultimately a two-level fusion that is currently incompatible with return to play.
Posterior foraminotomies also lead to problems because it’s been shown that up to 50% of professional athletes may require surgery at that index level in their lifetimes. ACDF probably has better long-term results in football players, but total disk arthroplasty is not indicated at this time.
Dr. Hecht: Even though there is adjacent segment degeneration after ACDF (2.9%/year), there is also an overlooked rate of adjacent segment degeneration after foraminotomy (1.8%/year). I would not perform a cervical disk replacement in any athlete with a risk of contact or collision. The success rate after ACDF is so high that I do not see any good reason to introduce this yet unknown risk of device failure in contact sports.