VOORHEES, N.J. — Sean Couturier underwent his second back surgery in eight and a half months on Thursday.
The procedure, stated as a back revision, was done at the Carrell Clinic in Dallas.
The first-line center, who has not played since December 2021, is expected to be out approximately three to four more months.
Couturier's ailing back has grown into a problematic and perplexing issue.
"I think there's finally a little bit more clarity," Flyers general manager Chuck Fletcher said Saturday. "Hopefully for Sean, there's some relief so he can feel better. Ultimately, we're still hopeful he can come back and play."
Last season, Couturier had back surgery in February, which knocked him out for the rest of the year.
"Going back to December when it happened, I don’t know, I think it was just a little bit of a wear and tear," Couturier said at his end-of-the-season press conference in late April. "Three, four weeks prior to that, I had some back pains; everyone kind of has those in the year at some point. But these ones just wouldn't go away.
"At one point, it just got so painful that I couldn’t really sleep at night."
After his surgery and rehab, the 29-year-old seemed poised for a full return to start the 2022-23 season. However, he felt concerning pain in his back just a handful of days before training camp.
Originally, surgery was not deemed necessary for the reinjury. Couturier had been skating this month in his rehab and was feeling better. But then things changed, taking him off the ice for further evaluation.
"Essentially they went into the same area and had to do some more repairs," Fletcher said.
By the end of last season, Couturier was practicing and feeling good heading into his offseason of training. On Sept. 13, though, he admitted to having "some setbacks here and there" during his summer workouts.
"With Sean, it's been a long road, even going back to June and July," Fletcher said. "He felt tightness, he felt some nerve irritation from time to time. He was told to continue to train. He felt better as the summer went along and then prior to camp, symptoms seemed to get a little bit worse, so we pulled him back.
"At that point, we tried to treat it nonsurgically, we got an epidural, it brought instant relief. For a couple of weeks, he felt great, really the best he had felt in a long time. That seemed to wear off and the symptoms came back again.
"So it's sort of been four or five months of this persistent nerve irritation and symptoms. After speaking with a few different specialists, it was decided to go back in and to repair it."
Fletcher called it "a frustrating process" for Couturier and the Flyers.
"These surgeries are not 100 percent, unfortunately. There's a 10 percent chance that they don't fit," the GM said. "Was he one of those 10 percent initially? Was there something that exacerbated things in the summer? I don't know, I don't know.
"In speaking with several specialists, it became pretty apparent that surgery was the only way to hopefully resolve this. And that's the one positive out of this. There's been so much uncertainty. I remember sitting at the draft in Montreal and reading the medical report and thinking, 'He shouldn't be at this place.'
"Finally we have some clarity and I think we're going to get Sean to a better place."
Do the doctors have a read on how the back injury could impact Couturier's career long term?
"I haven't spoken to [Dr. Andrew B. Dossett], I know our medical group has," Fletcher said. "I think he's confident this will really help Sean."
The Flyers have been hit hard by injuries, stemming back to early last season. They finished the year 25-46-11. Couturier was available for only 29 games.
"He really wants to play," Fletcher said. "I think he's hopeful that this will give him a chance to come back."
Up front, John Tortorella's club is currently without Couturier, Cam Atkinson (upper body), James van Riemsdyk (broken left index finger) and Patrick Brown (back). Van Riemsdyk underwent surgery Friday and is expected to be out approximately six weeks.
The Flyers are 5-2-0 entering Saturday's matchup at home against the Hurricanes (7 p.m. ET/NBCSP).
"This group has been resilient so far this year," Fletcher said. "Torts has done a great job bringing some accountability. I know the players are focused on what they're doing, they're buying in and we'll just have to continue to push forward."
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