James Pattinson's back was in such a bad state less than two years ago that the world renowned surgeon recruited to give him one last chance at a sustainable international career initially told the fast bowler that it was unlikely he would be able to help.

As Pattinson is rested from the second Ashes Test at Lord's in recognition of the fact that too often in the past he was used by Cricket Australia when either at a high risk of injury or too soon after rehab from a previous problem, he has revealed that the New Zealand surgeon Grahame Inglis, who had worked wonders for the likes of Shane Bond and Matt Henry with spinal surgery, was at first highly hesitant about operating.

"There was probably a month after I found out about my stressy in my L4 [vertebra] where we were umming and ahhing whether the surgery would be a success," Pattinson told The Final Word podcast. "We had opinions from over in England, people who'd done surgeries over here and the guy in New Zealand initially said 'I don't think I can really do much, your back looks like it's too far gone'.

"For me that was pretty tough news to take. Maybe I was going to have a one-day career, I might play a few T20s or one-dayers and first-class cricket I might never get back there. So there was a fair bit of contemplating over that month then eventually he said 'if you're willing to take the risk, if I can make a 15% difference it might be what you need to keep you on the park with a bit of management'.

"I was in constant talks with [Shane Bond] about how he felt before the surgery leading into it and then post-surgery as well, and Corey Anderson as well had it before me, he was another guy I shot off a few texts to and got his opinion on a few things. Having people go through that experience and be able to lean on them is great."

Inglis, who went on to conduct the 2017 surgery with another surgeon, Rowan Schouten, said at the time that this was very much a final roll of the dice to see if Pattinson could find a way back to playing long form cricket.

"Pattinson is the highest risk of the ones I've done. I've kept very tight criteria... and if you do that you get a good outcome and you finish up with a good reputation," Inglis told Stuff.co.nz in 2017. "In my opinion he's on the margin and it's a last-ditch attempt to try and keep him bowling. He's got multiple problems up and down his back and we're trying to pick off the one that's stopping him from returning."

The surgery turned out to be a success, and a steady path back to playing resulted in Pattinson bowling at close to his best in the opening Ashes Test at Edgbaston, before he was spelled for Lord's. The Australian captain Tim Paine admitted in explaining the decision that Pattinson had been used and abused at times as a fast bowler in the past, and there have been numerous instances of the eagerness to play him overwhelming more rational and data-driven decisions about his welfare.

It was a pattern that began as early as his second Test series in 2011-12, when Pattinson played the second of back-to-back Tests against India in Sydney despite warnings that his workload was placing him at a high risk of injury - a foot stress fracture was the result. In 2013, Pattinson bowled 51 overs in the first Test of the Ashes at Trent Bridge, and played immediately after at Lord's while Mitchell Starc was rested instead. Another 40 overs - with a brief turnaround because of Australia's first innings batting collapse - contributed greatly to the first of the back stress fractures that ultimately led to the surgery in New Zealand five years later.

Pattinson said that in his younger years it had been difficult to say no to the offer of playing, no matter how his body was feeling. The pattern culminated in an unhappy match against New Zealand at Hagley Oval in 2016, the most recent of his Tests before this tour, where he ended the match with back and leg stress fractures, plus a torn ab muscle.

"The great thing with having so many bowlers around now is if you are a bit sore before the game, we are in a position now where you can go the other way rather than push through it ... there are plenty of Test matches, we've got to look long term" Pattinson said. "For me, that's probably a big learning curve.

"I'd come in with a stress fracture in my fibula into the [New Zealand] series, I was basically playing with a broken leg and in that Test match I started to feel my back start to go. I was in a bit of agony at the time. I tore my ab as well in that same game. Everything that could go wrong did go wrong…at the time I knew it was my last Test for a while and I just wanted to get it over and done with as quick as possible because at the time I wasn't really in a great place."

Earlier in 2017, Pattinson had made a significant change of his own by declining to go to India for that year's Test tour as he did not feel his body was yet up to the rigours of Test cricket - something proven by the need for the back surgery later that same year. It helped that he was growing into maturity, marriage and fatherhood, and better able to speak for his own body.

"As a young bloke it's hard to say no sometimes," Pattinson said. "That's why we're always in constant communication now with the selectors after Test matches, how you pull up, how do you think you'll go this game, and that's the beauty of having so many bowlers available now and that's what they've been wanting for ages, that opportunity for bowlers not at 100% we don't have to risk that, we can have someone come in and do just as good a job. Looking back on those sorts of Tests, if I had my time again I probably would have taken longer at that stage."