Kevin Owens Neck Injury Reportedly "100% Legitimate"; Sources Say He Needs Surgery (WWE News)
That promo from Kevin Owens on SmackDown has WWE sweating over WrestleMania 41.

Kevin Owens announced on the latest episode of SmackDown that he needs neck surgery immediately and thus won't be able to face old tag-team partner turned rival Randy Orton at WrestleMania 41.
Naturally, KO's promo was greeted with suspicion from wrestling fans due to the ongoing story Owens has been working since turning heel. He's been spiking guys like Cody Rhodes, Sami Zayn and Orton with sickening piledrivers for months, which leads many to believe that this is a carefully crafted storyline designed to throw everyone off the scent so WWE can say, 'Ha! Gotcha!'.
PWInsider is reporting that this isn't the case - their WWE sources tell them that Kevin's neck issues are "100% legitimate" and that he needs surgery ASAP. Another source within the company described the situation as "awful", and that there's no word on exactly when Owens could return to the ring.
Right now, he's staring at neck fusion surgery.
PWInsider noted that they've been inundated with fan questions ever since SmackDown aired. People want to know whether or not this is part of an elaborate work, but they say "the reaction among those we've spoken to in the company has been sympathy and sadness for Owens, not that this was storyline".
WWE Needs A WrestleMania Contingency Plan For Randy Orton

If Owens does need surgery before 'Mania, then that means Triple H and his creative staff would need to come up with a hasty contingency plan for Randy Orton. Unfortunately, 'The Viper' really has nothing else going on of note on TV. Issues with KO have dominated his character's headspace since Kevin turned on him late last year and put him on the sidelines, and there's nobody else on the WWE roster who'd fit as a foe.
Revenge, which was supposed to come in Last Vegas on 19-20 April, will have to wait (if it happens at all).
Of course, again, there are many folks on social media streams who reckon this is all part of a master plan to toy with fan emotions. They believe that Owens, whether he's legit hurting and on WWE's injury list or not, will still work WrestleMania so he can take the planned punt from Randy then go under the knife.
That all depends on the severity of his injuries, and it looks like they're very serious. WWE might be left with no choice here. They might have to find a fresh opponent for Orton after all or leave him off the card completely. Neither scenario is particularly appealing when compared to the hot grudge match Randy was supposed to work in Vegas.
He did plant SmackDown GM Nick Aldis with an RKO before the segment concluded, but it's highly unlikely Orton vs. Aldis is on the slate for WWE's upcoming weekender.