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He didn't actually hurt his back. Vince had finally given up on him after losing money for half a decade. Shawn was devastated he didn't just fall out of favor of his boss but also his lover.
Attitude era would have played out the same. Maybe HBK would have jumped to WCW and shit up their locker room even more. If he did that he would have spiralled out and finally died of a drug overdose, so it would have actually had a bigger impact on the ruthless aggression era. We would have never got his comeback, where he finally got out of his own way and by the power of Christ actually became the decent wrestler everyone pretended he was in the 90s.
