Injury-plagued Mets third baseman David Wright underwent a laminotomy procedure on his lower back on Oct. 5, one month to the day after having rotator cuff surgery on his right shoulder.
While the word "laminotomy" certainly sounds scary, invasive and -- at the very least -- career-threatening, in reality, it gives the 34-year-old Wright his best chance to get back on the field.
In May 2015, Wright was first diagnosed with spinal stenosis, a narrowing of the spinal canal that typically occurs in individuals over the age of 50. This bone channel encases the spinal cord, and its narrowing causes pressure on and inflammation of the spinal nerves, resulting in radicular -- or radiating nerve -- pain in the lower back, hips and legs.
Wright's condition is exacerbated by the fact that he was born with a narrower-than-average spinal canal and also had bone spurs as a result of 2011 stress fracture in his vertebrae, which put even more pressure on his spinal cord. It is also made worse by the fact that the spine, while built to withstand large amounts of compressive force, is not built to withstand the high amounts of axial rotation and rotational force -- or torque -- generated by the baseball swing.
For some comparison, a 2012 study done by Dr. Glenn Fleisig and colleagues at the American Sports Medicine Institute in Birmingham showed that baseball hitters get an average of 46 degrees of trunk rotation on each swing. Pitchers get 55 degrees, while a tennis forehand produces just 30 degrees of rotation. That extra rotation is taxing on both the spinal disks and the nerves of the spine.
"Rotation can cause irritation of the nerve in the foramen, or space between vertebrae," said spine specialist Dr. Andrew Cordover of Andrews Sports Medicine & Orthopaedic Center in Birmingham, Ala. "This can lead to radiculopathy, or sciatica, which is that pain that travels from the low pack into the legs."
After over two years of conservative treatments that included anti-inflammatory medication, steroid injections and physical therapy to strengthen the core and spine failed to relieve Wright's pain, the Mets and their ailing star looked to spinal surgery as a last resort.
The spine is made up of rings of bone, or vertebrae, that are stacked on top of each other and encase and protect the spinal cord.
"In the front of the spine are the disks and the vertebrae, stacked on top of each other," said Cordover. "Just behind that are your spinal nerves. Behind that is more bone, which we call the lamina. In a laminotomy, a piece of that bone is removed to get some of the pressure off the spinal nerves. 'Otomy' literally means, 'to put a hole in in.'"
With a laminotomy, the incision is small, recovery is typically quick -- less than three months, often with near-immediate improvement in symptoms -- and recovery rate is high. A 2011 Northwestern University study showed that 96 percent of baseball players who had a laminotomy between 1972- 2008 returned to play.
"Of course, when you remove bone as you do when you do a laminotomy, there is a risk that you can weaken the spine," Cordover said. "There can be some baggage down the road because you have removed some of that stabilizing bone."
So Wright's future will include nearly perpetual physical therapy and exercise to maintain the strength and stability of his core and his spine. However, his spinal surgeon, Dr. Robert Watkins in Marina Del Rey, Calif. -- who performed surgery to repair a herniated cervical disk in Wright's neck in June 2016 and also operated on such athletes as Peyton Manning, Wayne Gretzky, Dwight Howard and Rob Gronkowski -- literally wrote the book on spinal surgery rehab; "The Watkins Protocol" is used by physical therapists around the world.
Wright, though, is no stranger to rehab. He has played just 75 games since his diagnosis in May 2015, and for the first time in his career, did not play a single game in '17. Rather, he spent the entire year attempting to rehab his neck, back and shoulder. However, in late August, his rehab was shut down because of shoulder pain after three games with Class A Advanced St. Lucie.
Even if you're not a Mets fan, you can't help but feel for the guy. Wright, however, is motivated. He released the following statement shortly after his surgery:
"Throughout this entire rehab process, I have been driven to get back on the field as quickly as I can. That's why I had the shoulder surgery and that's why I underwent back surgery to reduce the risk of further issues going forward. With these two surgeries behind me, I hope to be able to put on a Mets uniform again as soon as possible. My desire to play is as strong as ever."
And with a little luck, his spine will be, too.