Q&A With Dr. Pinegar On Mark Stone’s Second Back Surgery

(Photo Credit: SinBin.vegas Photographer Brandon Andreasen)

Earlier this week in Denver, Mark Stone underwent his second back surgery in the span of less than nine months. The Golden Knights called the surgery successful and said Stone will be out indefinitely but is expected to make a full recovery.

Questions surrounding his health impact the team both in the short term and the long term yet there aren’t many answers to be had on a complicated situation. To help guide us through the most likely scenarios and outcomes regarding an athlete’s recovery from multiple back surgeries, we turn to our resident doctor, Dr. Caleb Pinegar of Crovetti Orthopaedics & Sports Medicine.

When you hear the term indefinitely in relation to a second back surgery, how does that read to you?

I think they’ve given up on this season and I think they are just looking at next season. I think they are just saying, “hey look, not happening right now.” They do use that term loosely, but with the surgery he had, it can’t be less than three months.

So you don’t think there’s much chance he plays again this regular or postseason?

Long shot.

There was a report from ESPN’s Emily Kaplan that this injury is a different back injury. When it’s described that way, do you think it means they are completely unrelated or just different areas of his back?

Your lumbar spine has five vertebrae. On the first injury, one of them was the symptomatic area. As we’ve discussed, once a person undergoes one surgery they become more susceptible to future issues on other levels. On his first surgery, the microdiscectomy, they probably just fixed that one spot. It sounds like now there’s an issue in a different spot and he likely had a different procedure. While it’s a similar surgery they might call it a different injury because each level affects a different part of the leg. That being said, they are almost certainly related to each other.

How many different back procedures are there that he could have undergone?

There are really not many and they all do the same thing just on different levels of the spine. You can decompress the root on the right, left, or center, which is removing pieces of disc material that is pinching on the nerve to the side or out the back of the space between the vertebra. Otherwise, if it were more serious, he could have had a laminectomy. That’s where you remove a large chunk of bone.

How do the recovery times vary on each different option?

It’s a bit longer on the laminectomy, but the other ones are all pretty similar.

And how long are we talking?

It should be similar to his previous surgery unless he had the laminectomy, in which case it would be much longer. It should be around three to four months.

Does this being his second surgery affect the recovery time on the next one?

It shouldn’t. As long as he rehabbed the one before and this is a different surgery, then no it shouldn’t. But, it makes me worry about all of the other levels. It seems possible his MRI shows he has mild to moderate degeneration of multiple discs and he just had severe enough symptoms last year and now severe enough in a different spot this year. What’s going to change to be severe enough next year? That’s worrisome.

So do you think it’s possible he’s been advised to stop playing hockey?

Probably not at that point. A simple low back disc herniation only puts a persons nerve in severe compromise in a very specific circumstance. These are not life-threatening injuries. But they can be career ending and they can frequently be quite painful and debilitating.

When does that point come?

The big question I have now is if he tweaks his back again, do they encourage him to hang it up? Because you don’t want to put a young guy through three back surgeries. If he tweaks it again, maybe they rehab it real well and say, “Mark, are you done?” He’s such a fun animated player and such an amazing part of the team, it’s so hard to see him going through this. And it’s also terrible to think, is this going to be a push to the end for him, it makes me worry.

When does that conversation about long-term lifestyle happen? Has it already?

I think it happens during his rehab. I don’t think they’ll push him to come back this year, at all. You’re going to rehab him really well and you have lots of time. Then at the conclusion of this you will say “Mark, do you really want to do this again next season?” And I’ll think he’ll have a real hard talk about it.

Stone’s second surgery was done by a different doctor than the first, how common is that, and does it indicate issues with the first surgeon?

Typically after visiting with the initial surgeon if the athlete wants other options they will seek out a second opinion. And most surgeons are happy to offer options so that the athlete is comfortable. After that second opinion and explaining the options, the athlete may prefer that the second specialist perform the operation instead. Perhaps something wasn’t done properly, or there is a more complicated problem than anticipated, or now due to additional injury there is simply more to do! The surgeons primary interest should be helping the athlete/patient get the proper help, regardless of who does it. 

Do you think we see peak Mark Stone again in his career?

I would anticipate you seeing them limit him and protect him more. It’s like LeBron James, you can’t give him that many minutes if you want him to be healthy. You’ve got to hold him back. When he’s in, he absolutely can be great, but you have to protect him more. I worry though that he may never fully be the same again, I really do worry about it.

No matter who you are, professional athlete or regular Joe, once you’ve tweaked your back, you forever have to pay super careful attention to how you address any substantial use of your back for the rest of your life because your susceptibility is higher. We were worried Mark would have to deal with this in a couple to a few years and it’s not even a year later. At some point, you really have to consider the long-term lifestyle of the person.

**Thanks again to Dr. Pinegar for always sharing his expertise on the injury situations surrounding the Golden Knights. Dr. Pinegar is a physician with Crovetti Orthopaedics & Sports Medicine located in Henderson and Summerlin. Read more about him and the practice here.**