Exactly two weeks ago, the Mets season took a turn for the worse when third baseman David Wright underwent a cervical discectomy and fusion procedure on his neck to repair a herniated disk. Mets fans and media alike rushed to the proverbial Panic City with proclamations that Wright was “finished” and that the Mets’ season would go by the wayside. In the midst of all the pandemonium, nobody bothered to actually learn what Dr. Robert Watkins did while operating on the Mets Captain.
Enter David Geier, a South Carolina based surgeon who specializes in orthopedic sports medicine. Before launching his own practice in a suburb of Charleston, Dr. Geier spent eight years as the director of sports medicine at the Medical University of South Carolina. He also worked with several professional teams across the country, including the St. Louis Cardinals, the St. Louis Rams, and the US women’s national soccer team. Here’s his medical explanation of David Wright’s injury, surgery, and recovery.
The purpose of a cervical discectomy and fusion procedure is to alleviate the pressure on a spinal nerve caused by a herniated disk; and in David Wright’s case, spinal stenosis as well.
To fully understand the procedure, we first need to understand the issue of a herniated disc. Cervical vertebrae are composed of about 80 percent water, giving their centers a jelly-like consistency. When a disc ruptures, the jelly-like center bulges through the annulus (a protective wall for the spinal cord) and puts pressure on the spinal nerve, causing pain.
The cervical discectomy and fusion procedure itself can be broken down into two parts.
“In a discectomy, the surgeon goes in and takes out that leaked disc material to eliminate the pressure on the spinal nerve,” Geier explains.
“Sometimes only a part of the disc needs to be removed, but in severe cases, a surgeon can remove the entire piece.”
A fusion is a more advanced procedure and is required only if there are more advanced problems in the area, according to Dr. Geier.
“You still have the disc material that’s leaked out, but you might have some arthritis changes between the bones or some instability, potentially even some abnormal motion after taking out the disc.”
The actual fusion part of the procedure is self explanatory.
“Essentially, you fuse the two bones together to restrict motion and therefore allow healing and uninhibited nerve function.”
Surgeons then replace the removed disk with either a bone graft from the hip or a cage device, before attaching a metal plate to the vertebrae above and below to provide stability.
The goal of the fusion is to prevent stress on the bone by limiting motion. This in turn aids bone healing and nerve function.
The actual procedure can be seen in an animated video you can view here.
In terms of returning to baseball, Geier was noncommittal on David Wright. He was insistent that recovery varies on a case to case basis, with factors such as age, fitness, and activity level playing a part.
“It’s so variable, that’s why nobody’s going to be able to give you a completely correct explanation, and nobody’s going to be wrong.”
It will take about four to six months for the bone in Wright’s neck to heal. Extensive physical therapy will also be necessary for him regain full nerve function. Wright would likely return to baseball activities at some point in the offseason before needing reps against live pitching. With recovery so unpredictable, Geier gives a broad time frame for a return.
“It could be anywhere from six months to a year.”