England look set to be without Graham Onions for the entire international summer after he was ruled out for a further three months.
The Durham bowler has not played since January due to a back injury that forced him to return home early from England's tour of Bangladesh in March.
The 27-year-old, who picked up five for 38 on his Test debut against the West Indies, underwent scans on the problem and a review by a spinal specialist earlier this week, with the results showing an ongoing bone stress reaction.
Onions, who also underwent knee surgery in London on Thursday, has been advised to undergo a further 12-week period of rest and rehabilitation.
"I am naturally incredibly disappointed to miss the bulk of the domestic season and am still hopeful that with rest I can be back on the field nearer to the end of the summer," Onions said.
"The ECB medical team has been very supportive and all I can do is be patient, work hard on my rehabilitation programme and focus on my number one goal which is to be fully fit and available for selection for the Ashes tour to Australia."
Speaking after his side's victory over Kent at Canterbury, Durham coach Geoff Cook described the latest setback as a "minor tragedy" for the seamer.
"This time last year he was picking up wickets every time ball he got the ball in his hand," he told Sky Sports.
"He deservedly earned a call-up to the England team on the back of that and then he played a key role in the Ashes win last summer.
"It's a minor tragedy for him. It is for England cricket generally. It's taken a while to get to the bottom of the problem.
"He had been to-ing and fro-ing from clinic to clinic. He went to a major scanner in London and it looks like that has finally detected the source of the problem."
Onions has played in eight Tests for England and was part of the squad that claimed back the Ashes from Australia. He also played in four one-day internationals.