ATLANTA — A reluctant Casey Cagle walked away Wednesday from his dream of being the state’s next governor.

With his voice choking and fighting back tears, Cagle said a degenerative spine condition in need of surgery and recuperation will keep him from running for Georgia’s highest office in 2010.

"I have received some very difficult medical news that is going to take me out of the governor’s race for 2010," Cagle said. "I have a very serious issue to my neck along with my spinal area that has caused nerve damage that will need to be repaired."

Cagle, a former football standout at Johnson High School who suffered a career-ending injury at Georgia Southern College, said he had been experiencing pain in his shoulder for years.

However, during the session, he said the pain intensified and spread to his chest and resulted in some paralysis in his left arm. Fearing he might be having heart problems, he sought medical treatment at Emory University Medical Center in Decatur. However, an MRI revealed the neck and spinal injury.

Cagle first tried physical and injection therapy to no avail.

A neurologist has recommended surgery for the 43-year-old Hall County native.

With his wife, Nita, and sons Grant, Jared and Carter behind him, Cagle announced his decision at a Wednesday afternoon news conference at the Capitol.

He called the decision to drop his gubernatorial bid "difficult personally for me."

"This is a challenge that I have to face and I will come through it," Cagle said of his health problems.

He declined to answer questions following his brief remarks.

A spokeswoman, Jaillene Hunter, would not elaborate on why Cagle felt he could handle the lieutenant governor’s race but not the one for governor. Both are statewide contests.

"He does feel up to running for lieutenant governor," Hunter said

State Sen. Lee Hawkins, R-Gainesville, said he had been concerned about the lieutenant governor’s health during the recently completed session of the General Assembly.

Hawkins, a dentist, said Cagle had complained about the nagging pain.

"He wasn’t feeling well but wouldn’t tell anybody," Hawkins said. "He told me he had been going to Emory and he had some pain that radiated down his left side."

Philip Wilheit, one of Cagle’s earliest supporters since his first bid for the state Senate in 1994, said in an e-mail from South America that he had spoken with Cagle about the condition before leaving on a vacation trip last week.

"Casey called me last week and we discussed his impending neck surgery," Wilheit wrote in an e-mail. "I know how focused Casey has been on the race for governor and we are all disappointed but I think he is making the best long-term decision. He still has my full support."

The surprise announcement immediately scrambled the crowded contest to replace Gov. Sonny Perdue when his second term expires in 2010. Cagle was considered a front-runner for the Republican nomination with the primary still more than one year away.

Cagle’s withdrawal from the race leaves three Republicans still in the field: Secretary of State Karen Handel, Insurance Commissioner John Oxendine and state Rep. Austin Scott, of Tifton.

Handel said she was "saddened" to hear about Cagle’s health and his withdrawal from the race.

"I hope his health issue is resolved quickly," she said in a statement.

Oxendine said he considered Cagle "a friend" and an "honorable opponent."

He also issued a call for support from Cagle’s backers

"I would consider it an honor to earn the support of my fellow Republicans who had initially chosen to support Casey Cagle," Oxendine said.

Scott could not immediately be reached for comment.

Cagle had raised the most money so far and his withdrawal could attract other GOP candidates to the contest, including Cobb County Commission Chairman Sam Olens.

On the Democratic side, Attorney General Thurbert Baker, House Minority Leader DuBose Porter and former Georgia National Guard Commander David Poythress have thrown their hats in the ring for governor. Former Gov. Roy Barnes is also considering the contest.

Cagle was elected lieutenant governor in 2006, the first Republican to win the seat in Georgia. A relative unknown, he won the seat after upsetting former Christian Coalition head Ralph Reed in a GOP primary.

Before taking over as the state’s No. 2, Cagle served 12 years in the state Senate.

Cagle’s decision to seek re-election as lieutenant governor complicates that race as well. Republican state Sens. David Shafer of Duluth and Eric Johnson of Savannah were set to face off to replace Cagle.

Both men on Wednesday wished Cagle a speedy recovery.

Shafer said that "we are re-evaluating our options in light of his decision."

Johnson noted that "the election is still a long way off and circumstances could continue to change."

"In the meantime, we will keep our options open," he said.