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Covering sports injuries from the perspective of a certified athletic trainer and backed by analytics.

Understanding Michael Porter Jr.’s Back Surgery

The hype surrounding the 2018 NBA Rookie Class has steadily increased with the start of the college basketball season. Marvin Bagley III is dominating for the top-ranked Duke Blue Devils and Deandre Ayton has been a double-double machine for the #2 Arizona Wildcats. International prospect Luka Doncic has made his way up draft boards after an impressive showing in Eurobasket while University of Texas freshman Mohamed Bamba continues to be an intriguing prospect. However, the competition for the top overall selection took a hit Tuesday when it was announced Missouri forward Michael Porter Jr. will miss the remainder of the 2017-18 season after undergoing back surgery. The injury is significant and will play a major role in Porter’s eventual NBA home.

Porter has not played since making an early exit in Missouri’s season opener against Iowa State. The Tigers were tight-lipped surrounding the specifics regarding the injury, simply referring to it as leg injury. However, the team has now confirmed Porter will undergo a microdiscectomy on the area between the L3 and L4 vertebrae of his lower back.

Porter is dealing with a herniated or bulging disc. To better understand this injury, imagine a jelly-filled donut. The baked dough on the outside of a jelly donut is in comparable to the annulus fibrosis, the thicker, outer portion of a vertebral disc. Inside the annulus fibrosis is a softer center known as the nucleus pulposus (the jelly). When stress or pressure is applied to the disc, the nucleus pulposus can bulge out in a way like jelly squirting out of a jelly donut if you were to squeeze it in your hands. This bulge can irritate nerves in the back, resulting in shooting pain and radicular pain in the lower extremities.  In Porter’s case, the pain could potentially radiate onto his thigh and down into the knee. This may clear up why the injury was initially labeled a lower leg problem.

A microdiscectomy is performed to remove the material that is impinging on the nerves. The surgery is minimally invasive with a small incision made along the midline of the back. By performing the procedure in this manner, the ligaments and the muscles are left untouched accelerating the recovery process.

His long-term outlook remains less clear. There have been cases of players undergoing disc-related surgeries and still performing at a high-level. Danilo Gallinari and Al Harrington both went on to have productive NBA careers after back surgery while Dwight Howard remains a looming presence after a microdiscectomy in 2012. However, a quick look through the InStreetClothes.com NBA Injury Database reveals that nearly three out of every four players to undergo disc-related surgery report additional back problems at some point during their career with several players requiring a subsequent procedure.

Fortunately, there are several factors playing in Porter’s favor. To start the location of his injury is less than significant than if it were to have occurred a level or two lower. A 2008 study reported that upper level lumbar herniations have a better treatment effect than those in the lower lumbar and sacral region. Furthermore, it is believed that age at the time of surgery could be utilized as an indicator of a player’s ability to recover from disc-related injuries and surgery. Porter will turn 20 years old eight days after the 2018 Draft.

For now, Porter will focus on his recovery before determining the next phase of his basketball career. His medical status will no doubt influence his draft stock but players like Joel Embiid and Harry Giles have proven there is always a team willing to invest in talent.