The injury bug has hit the WWE again, with Jason Jordan set to miss WrestleMania and an undetermined period of time after seeking a surgical solution to his neck issues. So what happened?
Jordan (real name Nathan Everhart) underwent surgery on Feb. 5 to address a disc injury in his neck, according to WWE.com. The procedure was performed by WWE medical director Dr. Joseph Maroon -- a clinical professor and neurosurgeon at the University of Pittsburgh Medical Center (UPMC).
Prior to surgery, Jordan had been experiencing significant pain that was not responding to conservative treatment. "It was decided to do a minimally invasive operation to decompress the nerve, to allow it to heal," Maroon said.
Specifically, the type of procedure performed on Jordan is called a minimally invasive posterior cervical microdiscectomy. So what exactly does this mean? It's much easier to take it one word at a time, starting from the end and working backward.
A microdiscectomy is a procedure in which a fragment of intervertebral disc is removed.
Cervical refers to the neck region of the spine (the first seven vertebrae beneath the skull). In other words, this was a microdiscectomy performed in the neck area. While a specific level was not reported in Jordan's case, most cervical disc injuries occur in the lower part of the neck (between the fifth and sixth or sixth and seventh vertebrae).
Posterior indicates the surgery was done approaching the spine through the back of the neck. In some types of spine surgery, such as an anterior cervical discectomy and fusion (ACDF), the procedure may be performed by entering through the anterior (front) part of the neck.
Minimally invasive means the procedure is considered relatively less invasive than a full "open" procedure. In a posterior cervical microdiscectomy, the surgeon makes an incision on the back of the neck, moves the muscles aside to access the vertebral level in question, removes a small portion of bone to visualize the disc and nerve root and then removes the fragment of disc that is causing the issue.
As far as the recovery goes for an athlete following this type of procedure, the timetable can vary significantly depending on the condition of the nerve. With a microdiscectomy, it may take only two to four weeks to heal from the surgery itself. The neurological recovery, however, can take anywhere from a few weeks to several months. Nerve tissue heals at a very slow rate and is largely unpredictable, making it challenging to try to issue a timetable for an athlete like Jordan.
In some cases, the compression and irritation caused by the disc fragment results in severe pain. In others, there may be a decrease or complete loss of sensation resulting in tingling and/or numbness. There can be motor compromise as a result of compression as well, causing the athlete to experience weakness in the muscles supplied by the nerve. The upper extremity is supplied by nerves that have their origins in the neck, so pain/tingling/numbness and weakness in the shoulder/arm/wrist and hand area are the most common symptoms for athletes with cervical disc injuries.
When a high-level athlete has an injury such as this with no specific timetable, it's only natural to look at other athletes in the same sport who have had similar injuries for comparison. WWE's Daniel Bryan underwent a similar procedure in May 2014. That surgery also was performed by Maroon. Bryan's neurological recovery took several months, however, and he did not return to the ring until January of the following year. Bryan was able to wrestle for several months, but his career ultimately came to an end in April 2015 as a result of concussion-related issues.
A number of NFL athletes also have undergone cervical discectomy and returned to play, but a recent study indicated the majority of those athletes underwent a fusion surgery. One reason may be the longer potential durability of the fusion procedure; there remains a risk of recurrence of disc herniation with a microdiscectomy.
Several WWE superstars also have opted to go the fusion route to repair disc injuries in their necks over the past 20 years, including Stone Cold Steve Austin, John Cena, Edge and Nikki Bella -- all of whom eventually returned to in-ring action.