Tiger’s Second Microdiscectomy: Perhaps Not so Surprising?

Tiger Woods’s announcement late last week that he recently underwent a second microdiscectomy procedure came as a shock to many fans who’d noticed some improvement in his game during recent weeks. Wasn’t he on the upswing following his earlier back operation and rehab? Did something go wrong with the previous procedure? And, now that he’s off course for the rest of this year, does he have a shot of ever regaining his former glory on the greens? All of these are good questions without simple answers. But we’ll do our best to explain what the latest turn of events means for Tiger and his touring days going forward.

First – What is a microdiscectomy and why is it performed?

As spine operations go, a microdiscectomy is a fairly common, minimally invasive procedure that can be done in a short amount of time and with a nominal hospital stay. Tiger’s surgery was reportedly performed last Wednesday and he was back at home recovering by Thursday night.

The procedure, also called a microdecompression, is done to reduce pressure that is being put on a spinal nerve – usually by a herniated disk. Via a small incision in the midline of the patient’s back, the surgeon uses special instruments to pull the muscles away from the bony surface that covers the affected vertebra, which is called the lamina. He next cuts away a small part of the lamina so that he can access and remove the herniated disk material that is pressing on the nerve, vacuum out any debris that’s in the spinal canal, then replace the muscles and close the incision.

Tiger didn’t seem in that much pain the last time he played. Why would surgery be needed so quickly?

We’ve all seen Tiger in the throes of an agonizing back spasm that forced him to withdraw from play. But in his most recent tournament, his face didn’t register anywhere near that kind of pain. In fact, according to experts, the world’s former #1 was playing “his best golf of the year” during last month’s Wyndham Championship. Sure, he seemed a little stiff at times – and he acknowledged that his back was bothering him some. But he said he had mostly hip discomfort, and he had just signed on for the 2015 Frys.com Open in Silverado, Calif. Next thing you know, he’s pulled out of three upcoming events and won’t be back on the course this year.

Though Tiger offered few details about his condition, he apparently had a small disk fragment that was pinching a nerve in the same location in his lumbar spine where his earlier surgery had taken place. The problem was discovered during a regular checkup, and, since Tiger had previously undergone exhaustive, noninvasive therapies that didn’t work (leading to his first spine operation), his doctor indicated that another surgery was necessary. Given that the season was just winding down and Tiger hoped to be back in action by the beginning of 2016, he decided to have the procedure right away so he could immediately begin his recovery.

Why would a second discectomy be needed in the same place as the first one? Did something go wrong with the earlier procedure?

Tiger’s surgeon pronounced his second microdiscectomy “a complete success,” and there’s no reason to believe that the earlier procedure wasn’t just as successful. But there are two important things to keep in mind. First, while the procedure removes the initially damaged portion of a disk, that disk may continue to be problematic in the future. This is because it has lost some of its water content, and because uneven pressure on the compromised disk may lead to continued structural changes and instability. Second, the frequency and amount of pressure that’s put on the disks of a top-flight golf pro is considerable. In fact, it’s been estimated that a pro golfer’s swing may put the equivalent of up to 10 G-forces on the lower spine!

Tiger will be 40 by the time he attempts to return to competitive tournaments. How long will he need to recover, and how likely is he to regain his former level of play?

Tiger is scheduled to start his rehabilitation this week, and given the fact that he was able to return to the course approximately three months after his last microdiscectomy, his goal of getting back to golf in early 2016 seems reasonable. The vast majority of patients who have a second surgery to address a herniated disk do get good results, including substantial relief from both back and leg pain -- so that too is in Tiger’s favor. However, the fact that this is his second surgery in 18 months may reasonably prompt some added caution among Tiger’s closest advisors. There’s also the fact that being able to swing a golf club and being back in top golfing form are not the same thing – and at 40 years old, the repetitive, high- pressure twisting that a pro golfer exerts on his spine isn’t something to be taken lightly. So even if his rehabilitation goes as planned, it will probably be close to five months until Tiger plays his next competitive tournament.

In announcing his latest setback on his website last week, Tiger called himself “a fighter” and expressed optimism about the path that lies ahead. There’s certainly lots of work in store for him to get back to his most recent level of play – let alone to return to the top echelon of his sport. But we know better than to count him out at any age, and he will likely be dealing with far less pain going forward. That said, we wish Tiger the best of luck with his healing process, and hope to see him back on the road to victory before long!

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References

Tiger Woods Undergoes Second Back Surgery, Plans to Return in 2016 (9/18/2015). Retrieved from CBSsports.com: https://www.cbssports.com/golf/news/tiger-woods-undergoes-second-back-surgery-plans-to-return-in-2016/

Roundup: Tiger’s Done for 2015 After Second Back Surgery (9/18/2015). Retrieved from GeoffShackelford.com: http://www.geoffshackelford.com/homepage/2015/9/18/roundup-tigers-done-for-2015-after-second-back-surgery.html

When Lumbar Disc Herniation Occurs a Second Time (n.d.). Retrieved from EOrthopod.com: https://eorthopod.com/news/when-lumbar-disc-herniation-occurs-a-second-time/

Tiger Woods: A Peek Into His Disc Dilemma(n.d.). Retrieved from Spineline: http://spineline.net/tiger-woods-a-peek-into-his-disc-dilemma/

What Is The Real Timetable for Tiger Woods’s Comeback? (n.d.). Retrieved from GolfDigest.com: http://www.golfdigest.com/story/what-is-the-real-timetable-for-tiger-woods-comeback