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What's next for Manning? Noted doctor explains the situation

Dr. Wellington K. Hsu, an assistant professor at Northwestern University with a joint appointment in the department of orthopaedic surgery and department of neurological surgery, spoke with on Thursday to shed light on the path facing Indianapolis Colts quarterback Peyton Manning, who's recovering from his third neck procedure in 19 months.

Dr. Hsu has been recognized as an international leader in the operative treatment of cervical and lumbar degenerative disorders, motion-sparing technology and spinal cord injuries, and he has published a number of studies focused on NFL, NBA, MLB and NHL players.

The Colts confirmed Thursday that Manning underwent single level anterior fusion surgery (which usually involves making an incision in the front of the neck, removing soft disk tissue between the vertebrae and fusing the bones together with a graft). Being a quarterback, will Manning face special challenges?

The quarterbacks in my study did quite well after this particular surgery that Peyton Manning had. Quarterbacks fare pretty well compared to other positions because they can predetermine their movements. Defensive backs and linebackers need to react differently. (QBs) don't rely on neck range of motion as much as a defensive back or linebacker. ... The wide receivers in my study also did pretty well after neck fusion. It really depends on position when it comes to prognosis.

Was this an injury that Manning could have possibly played through?
You can play through it if it's just pain. I don't know Peyton Manning's case specifically, but if it led to weakness that was affecting his arm velocity, surgery would be needed to get back to his normal level of play.

The Colts haven't set any timetable for Manning's return. When can the team reasonably expect to see him back on the field?
In general, depending on his surgery, depending on the graft he had, most surgeons would let him get back to training in six to eight weeks. And depending on rehab, another four weeks after that -- plus or minus a week or so -- he could be back on the field. That's a general timetable I would give for a high-level athlete like Manning.

Is Manning facing any additional risks when he does return?
There's never been a reported risk of catastrophic injury after this surgery, but there is a risk of having a problem develop at another level. Assuming he had one level fused, other areas of the neck could be affected by arthritis. There is only a 5 percent risk of a second operation in a player's career.

Manning doesn't seem to be in unchartered territory. Is that fair to say?
This is a pretty common surgery in professional and NFL players, and they do better than what many people think. I've heard people say it's really hard to get back from a neck injury, how if you have surgery, you don't come back, but that's simply not true. I think Peyton, being the stalwart that he is, playing the position that he does, has a very, very good prognosis for coming back.

The Associated Press contributed to this report.

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