- Associated Press - Thursday, September 8, 2011

INDIANAPOLIS (AP) - Peyton Manning underwent more neck surgery Thursday, the third time in 19 months, and will miss not only the opening game but possibly the entire season.

Losing Manning for any stretch of time is a huge blow to the Colts and throws the race for the AFC South wide open. The four-time NFL MVP hasn’t missed a game in 14 NFL seasons, with 227 consecutive starts, including postseason.

“Rehabilitation from such surgery is typically an involved process,” the team said in a statement, calling the procedure “uneventful.”

The Colts said there would be “no estimation of a return date at this time. We will keep Peyton on the active roster until we have a clear picture of his recovery process.”

Team owner Jim Irsay tweeted that the 35-year-old Manning would be out “awhile.”

The Colts could have put Manning on injured reserve to open a roster spot, but it would have meant not playing at all during a season that ends with a Super Bowl at Lucas Oil Stadium in downtown Indianapolis.

Manning underwent an anterior fusion procedure to treat a nerve problem that still bothered him after his previous surgery, on May 23. Such a procedure 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. The goal is to ease pain or address a disk problem.

Recovery typically takes at least eight to 10 weeks, said Dr. Victor Khabie, co-chief of the Orthopedics and Spine Institute at Northern Westchester Hospital in New York. He did not treat Manning, but is familiar with the procedure and how athletes recover from it.

“It could be season-ending, seeing the piggybacking off of another surgery,” Khabie said. “But the athletes I’ve known over the years, I never count out because they are such great competitors and such great healers.”

If Manning recovered in 10 weeks, he could be back for a Nov. 13 game against Jacksonville, the week before the Colts have a bye.

Dr. Andrew Hecht, director of spine surgery at Mount Sinai School of Medicine in New York, doesn’t believe the injury will prematurely end Manning’s career.

Hecht, who works with the New York Jets and New York Islanders, said the biggest risk is healing. He said it typically takes three months for the fusion to occur, though some people heal faster.

“The odds are that he’ll end his career when he wants to end his career,” Hecht said.

Manning, who signed a five-year, $90 million contract in July, also had neck surgery in February 2010. This, however, has been one of the most frustrating offseasons of his career.

The 4 1/2-month lockout prevented him from working out with team trainers and he couldn’t negotiate a new contract with the Colts during that time. He started training camp on the physically unable to perform list, which prevented him from working out with teammates until Aug. 29.

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