By Matt Dolloff, CBS Boston

BOSTON (CBS) — Rob Gronkowski’s latest back surgery, his third since 2009, raises serious questions about his health that transcend football. His herniated disc may not be career-threatening in and of itself, but back injuries have a bigger impact on athletes than almost any other. Gronk could be one big hit away from getting to the point where his future in the NFL is in doubt – if it isn’t already.

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But assuming Gronk makes it back next season at 100 percent with the desire to continue playing, his latest injury also leaves major unanswered questions about his future with the Patriots.

There’s no question that, when on the field, Gronk is one of the most dominating physical forces in the NFL. At the tight end position, he may already be the greatest to ever play. But he is treading dangerously toward a path that is similar to that of NFL Hall-of-Fame running back Earl Campbell, who was virtually unstoppable when healthy but whose punishing running style eventually cut his career short due to various injuries.

The Patriots have had a fully healthy Gronkowski at the end of the season through the playoffs just one time since his rookie year in 2010. That was in 2014, when they won Super Bowl XLIX and Gronk caught a touchdown pass from Tom Brady in the game. In 2011, Gronk was active at the end of the season but was severely hampered by a high-ankle sprain, and in 2015, he was reasonably healthy but was playing through minor knee and back injuries. Every other postseason since 2010 has been spent on the shelf.

Again, there’s no understating Gronk’s value when he’s on the field. But that’s exactly the issue: when he’s on the field. At what point is his on-field dominance not worth the injuries and lack of dependability to stay healthy by January? At what point does the onerous amount of maintenance off the field begin to outweigh his elite performance on it?

Albert Breer of MMQB.com asked that very question when he joined 98.5 The Sports Hub’s Toucher & Rich, and later Zolak & Bertrand, on Friday. He is wondering when the end could come for Gronk in New England – and whether that may even come after the current season.

“Look, this is the greatest tight end I’ve ever seen. This guy is playing the position at an unprecedented level. We may not see another guy like him at that position for a long time,” said Breer. “But we also know how [New England] operates. … When the level of maintenance it takes to keep the guy on the field, to keep him happy, all that different stuff, starts to surpass performance, you know that’s when … they say goodbye.”

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As it always does with the Patriots, Gronk’s uncertain future also includes a financial component to it – for both sides. Gronk is due a $4.25 million base salary in 2017; even half a season and no playoffs would make Gronk worth that price for the Patriots. But would it be worth it for Gronk himself to put his body and long-term health at risk for that?

This could lead to a new round of financial discussions and perhaps even a holdout for Gronk, but as far as the Patriots are concerned, maybe they’d even prefer Gronk to sit out the start of the season if it gave him a better chance to be healthy at the end. It wouldn’t exactly be financially necessary to cut bait with Gronk, as it would only save the Patriots $1 million against the cap – which is why things will really get interesting in 2018, when Gronk’s salary would jump to $8 million.

Another added wrinkle is the presence of Martellus Bennett, whom the Patriots are reportedly making a priority to sign long-term in the offseason. It would be hard to pay Bennett more than Gronkowski, but that would be a virtual certainty if he is re-signed beyond 2016. Bennett has played through injuries of his own and been one of the team’s most consistently reliable players on the field, and even has the personality to match Gronk off the field. Has Bill Belichick found an affordable (and dependable) alternative to Gronk that makes him feel comfortable moving on from No. 87?

Whatever the Patriots end up doing with Gronk within the next year and beyond, it will certainly be among the toughest decisions Belichick has ever had to make. The only decision that will be harder will be Gronk’s own decision of whether he wants to continue playing. A third back surgery, unfortunately, begins to make those questions materialize.

Gronk’s future in football would usurp any questions about his prospects of merely staying in a Patriots uniform. But for the first time in his career, his future in New England looks largely uncertain, if not bleak.

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Matt Dolloff is a writer for CBSBostonSports.com. Any opinions expressed do not necessarily reflect that of CBS or 98.5 The Sports Hub. Have a news tip or comment for Matt? Follow him on Twitter @mattdolloff and email him at mdolloff@985thesportshub.com.