Experts anticipate long, difficult recovery for Tony Stewart

Jim Lowe has a rare perspective on the months of recovery and rehabilitation Tony Stewart faces after he suffered a burst fracture in his back while driving an all-terrain vehicle in Southern California last Sunday.

Lowe is a neurosurgeon. He also is a race car driver, having competed, in fact, against Stewart several years ago in the Rolex 24 sports car race at Daytona International Speedway.

Lowe, like several other doctors commenting on the sort of injury Stewart suffered, said Stewart faces a long, difficult recovery but that he should be able to race again at the same level as before his off-track accident.

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“The good news for Tony is that the long-term prospects are good,” Lowe, a Pennsylvania resident, told USA TODAY Sports. “If he had the sort of surgery that is typical in these cases, the fractured area was rebuilt with rods and screws and, after recovery and rehabilitation, should be even stronger than before.

“I feel like what happened was significant enough that Tony should miss a good chunk of the season, but the long-term outlook in these kinds of cases tends to be excellent. The likelihood of an injury at that same place is much less because it will be stronger.”

In a burst fracture, the bone “explodes” when pressed with a bigger impact than the body can absorb, Lowe said.

Lowe, who has raced with 2003 CART champion Paul Tracy as a teammate, said the next few months probably will be difficult for Stewart.

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“The typical patient wears a plastic brace for six to 12 weeks,” he said. “In my patients, I normally go with a brace 24 hours a day, seven days a week. The early recovery and rehabilitation is limited by that, but he still could do some rehab with walking and leg exercises.”

Typical patients with similar issues usually need a year to recover, he said, but race car drivers and other athletes “who see it as imperative to get back soon” might be back to more-or-less normal activities in six months.

Neel Anand, director of spine trauma at Cedars-Sinai Spine Center in Los Angeles, agreed that Stewart should be able to return to full-capacity driving “if he goes on to heal and rehab properly.

“He had an L1 spinal fracture. How bad it is, I really have no idea. A lot will depend on the severity and magnitude of the fracture as well as whether he has a neurological deficit or not.”

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Stewart had surgery Wednesday after flying home to Charlotte.

“If he had surgery, he had one of two things — instability because of the magnitude or severity of the fracture or there was a significant neurological issue (such as leg weakness),” Anand said.

The team has not released information on Stewart’s surgery, but its initial release about the accident stressed that he could move his extremities.

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Stewart probably will enter a rehabilitation program soon. After he suffered a compound fracture of his right leg in a sprint car crash in Iowa in August 2013, he went through rehab at OrthoCarolina, a Charlotte orthopedic clinic. The same clinic worked with Kyle Busch after his leg and foot injuries last February, and Busch returned to racing three months later.

Representatives of OrthoCarolina declined requests for comment on Stewart’s situation and an expected rehabilitation approach Friday.

Although stressing that he is not aware of Stewart’s situation, Anand said he would expect a two- to six-week program of rehabilitation for similar spinal injuries “plus healing of three to six months or even longer. The physical therapy would depend on the nature of the injury, but the work would be on mobility, core strengthening, pain relief and getting back to normal function.”

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Nicholas DiNubile, a Pennsylvania surgeon and a spokesman for the American Academy of Orthopedic Surgeons, told USA TODAY Sports that Stewart is “blessed to not be paralyzed” based on what he has heard and read about the accident.

“If he had had a spinal cord injury at that level (of the spine), he would have been paralyzed from the waist down,” DiNubile said.

A former team doctor for the Philadelphia 76ers, DiNubile said surgery for burst fractures typically involves rebuilding the damaged area with rods and screws and clearing out any bone fragments.

“Then you go with the brace to protect that system and wait for nature to make it solid again,” he said. “He would have limited activity the first couple of months, but later the rehab can get creative as long as it doesn’t interfere with the healing — things like working out in water or cycling.

“Once the fusion between the hardware and the bone is solid, you can go with harder core training, but you can’t push that.”

The team has said that Stewart will miss the opening part of the season, including the Daytona 500, but has not speculated on a timeline for his return.

Follow Hembree on Twitter @mikehembree