A cane usually at his side, Gov. Mark Dayton moves more slowly these days as he keeps up the hectic schedule that comes with his title. He's now recovering from his second spinal surgery in three years aimed at correcting that.

Between managing the multibillion-dollar state government, and the stresses of dealing with a politically divided Legislature, add this to Dayton's burden: persistent back and hip problems that have made it harder for him to walk and stand in a job that demands constant public appearances, speeches and far-flung meetings.

Through his press office, the 68-year-old governor has stressed that he remains engaged in the job while he's on the mend. "I want to assure everyone that this procedure will not diminish either my capacity to fulfill my duties as a governor, or my passion for serving the people of Minnesota," Dayton said in a statement released Dec. 6, the day before his operation. The news release stressed he would be in "continuous contact with his commissioners and staff."

Dayton, who was still recuperating at the Mayo Clinic over the weekend, declined an interview request for this story.

The governor's office has always promptly publicized Dayton's medical procedures. Before last week, they included the previous vertebrae fusion surgery in Dec. 2012, and a nonsurgical procedure at Mayo in 2013 in which plasma was injected into his hip to help heal a torn muscle after he fell down several steps at the governor's residence.

The governor's surgeon is optimistic this latest procedure will bring more comfort.

"Long term, maybe he won't need a cane," said Dr. Jeremy Fogelson, the Mayo Clinic surgeon who performed both of Dayton's back operations. "And even if he does, maybe he'll be able to stand for longer periods of time."

'Up and walking'

According to Fogelson, Dayton suffers from spinal stenosis. The doctor, a 38-year-old neurosurgeon who specializes in complex spine surgeries, described it as a common condition, akin to arthritis, in which bone spurs that grow on the spine pinch nerves in the area. It's a common malady that frequently leads to weakness and instability in the legs, and is often treated with surgery, Fogelson said.

Dayton had the vertebrae fusion surgery on Monday morning. Fogelson said he might have to stay into next week despite Dayton's publicly stated hope of resuming a regular schedule by then. "He's up and walking multiple times per day," Fogelson told the Star Tribune on Thursday. "This morning he was working on his computer when I saw him."

People close to Dayton say he's as reticent in private as he is in public to talk much about his physical challenges. Three years from his self-imposed political retirement, Dayton still has much he hopes to accomplish in the job that is a capstone to his long and eventful political career.

"It's obviously something he's dealt with for some time now, but you wouldn't guess it because Mark's not one to complain at all," said Ken Martin, the state DFL chairman, a political ally who also counts Dayton as a friend. "I think he's managed despite having some serious back issues to do his job as governor, not just to do it but to do it exceptionally well."

Earlier in his career, Dayton won the 2000 U.S. Senate election in no small part on the strength of appeals to senior citizens about high prescription drug prices. Today he finds himself Minnesota's oldest-ever governor, though his age is by no means unique at the top of the political arena. Democrat Hillary Clinton, his choice for president next year, is 10 months his junior. Republican presidential front-runner Donald Trump is six months older than Dayton.

The Dayton administration has plenty on its plate: The governor has recently called for a special legislative session to extend unemployment benefits for mine workers on the Iron Range, where economic anxiety is once again on the rise. At the beleaguered Department of Human Services, one of Dayton's closest aides is taking over as commissioner. And the coming months are likely to bring a series of spending and policy proposals ahead of the regular legislative session, which starts March 8.

Within hours of Monday's surgery, after waking up from general anesthesia, Dayton was back in touch by phone and e-mail with senior staff members. Dayton's staff has learned that the avalanche of daily decisions that land on any governor's plate don't require his physical presence. Once he checks out of the hospital, meetings with aides and commissioners will shift back to the governor's residence, which had already become the place where Dayton spends most of his working hours while the Capitol building is closed for renovation.

Fewer public appearances

In terms of Dayton's responsibilities, the biggest casualty while he rebuilds leg strength will be his calendar of public appearances. It's why he opted to have both surgeries in December as the holiday season approaches, Fogelson said.

Following the 2012 surgery and the 2013 procedure, Dayton still stepped up to the demanding, high-profile work of two regular legislative sessions, a successful re-election campaign in 2014, and a protracted budget stalemate and special session earlier this year.

Fogelson said before the 2012 surgery, Dayton was finding it more difficult to stand in one place for extended periods of time.

"Essentially, he has had difficulty where, when he would stand, he would develop weakness in his legs," Fogelson said. "It's a common symptom, and it was making it hard to stand with all the hard work that he does."

In the 2012 surgery, Fogelson said, he fused two vertebrae that had shifted out of alignment in order to relieve pressure on Dayton's nerves. The surgery was a success, he said, but then two other spots on the spine — both above and below the repaired area — developed the same problem.

"He required the same surgery but in a different spot," said Fogelson, adding that Dayton started to see symptoms recur a little more than a year ago. He said those symptoms have run more to weakness in the legs than problems with severe pain, which he said has allowed the governor — a recovering alcoholic — to avoid relying on pain medication.

Dr. Nicholas Wills, a spinal surgeon at Twin Cities-based Summit Orthopedics, said Dayton's surgeries are a common treatment for people who suffer from instability due to spinal stenosis. It's more rare to have two such surgeries so close together, he said, but also not uncommon for people who initially have vertebrae fused in one area to later learn the problem has spread to other vertebrae.

"Spinal stenosis is part of the aging process, it's no different from gray hair or wrinkles," Wills said. "Some people are asymptomatic and some people are very symptomatic."

Special session on hold

Dayton's political rivals have been careful never to suggest he's not physically up to the job. His 2014 opponent, Hennepin County Commissioner Jeff Johnson, leveled numerous criticisms of Dayton's competence as governor but never raised the issue of his health.

On the day he had surgery, Dayton had been scheduled to meet with House Speaker Kurt Daudt and Senate Majority Leader Tom Bakk about the possibility of a special session. That meeting's on hold for now, just one of the countless obligations — public and private, large and small — that are part of being governor.

Just a little more than a week before his latest surgery, on Thanksgiving Day, Dayton showed up at the family celebration of state Rep. Joe Hoppe, a Republican who lives in Chaska. Hoppe issued the invitation, he said, because he personally likes the governor despite their party difference, and because he'd heard Dayton spent a previous Thanksgiving alone at the governor's residence.

"He looked great, he was in good spirits," Hoppe recalled. Dayton came after the meal and stayed for more than an hour, posing for pictures and chatting up Hoppe and his relatives about sports, the weather and public policy.

"He seemed fine, but I have seen him at events where he did look like he was in a little bit of pain," Hoppe said. "I can relate to that. I've had lower back issues myself."