September 9th, 2011
02:29 PM ET

Inside Peyton Manning's surgery

The Indianapolis Colts will be playing without their star quarterback on Sunday, after Peyton Manning underwent surgery for a neck injury on Thursday. Manning had started every game in his 13-year career.

Colts president Bill Polian told SI.com Thursday afternoon that doctors believe there's a chance Manning, 35, could return to playing football again this year.

Manning had a procedure called a single level anterior fusion. That involves making an incision at the front of the neck, without cutting any muscles. The disc is removed from the nerve and spinal cord. The surgeon then fills the open disc space with a bone graft. The graft acts as a bridge between the two vertebrae, creating a spinal fusion. Metal plates and screws are often used to hold the bone graft and vertebrae together.

It's realistic for Manning to come back to playing in eight to 12 weeks, says Dr. Joseph C. Maroon, a neurosurgeon at the University of Pittsburgh Medical Center and neurosurgeon for the Pittsburgh Steelers. Maroon did not treat Manning, but has operated on five NFL athletes and five professional wrestlers.

"This didn't ruin his career - it saved it, because it's going to get him out of pain and stabilize his spine and he should make a full recovery," Maroon said.

People who have this procedure don't notice any loss of movement, and most go back to regular work within five to 10 days. They may have a sore throat for several days, but most do well within two to three weeks, Maroon said.

Manning had been suffering from a pinched nerve. He had two previous surgeries that appeared to be unsuccessful. Three reasons people have this kind of surgery are pain that doesn't go away, weakness to a specific muscle group or loss of sensation.

If the nerve is badly compressed before the surgery, however, specific muscle groups may be weaker than normal, but doctors would know about that beforehand. That would require a longer course of rehabilitation to help strengthen his muscles, Maroon said.

Last winter, two former Colts players had the same procedure, and the team says they have fully resumed their careers.

A 2011 study in the journal Spine found that after having a similar surgery, 40 players had come back to play in the NFL again.

"To say I am disappointed in not being able to play is an understatement," Manning said in a written statement. "The best part about football is being out there on the field playing with my teammates. It will tough not to be out there playing for the organization and our fans."

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