You could back up your Data folder (The folder not the Data folder contents) just copy and paste it to your desktop or another secure place that won't go away when you uninstall everything. You will also have to uninstall and re-install Steam as well. Once you have re-installed everything just copy your data folder back to Steam > Steamapps > Common > Fallout New Vegas. You might have to re-install Fallout mod manager or it will just crash on start-up. It did for me anyway. This also goes without saying, re-install NVSE. As for what NVSE does exactly, I really couldn't tell you, all I know it has been a nightmare to get working.