Wasps lock Joe Launchbury has been ruled out of England's autumn Tests with a nerve irritation in his neck.
The 23-year-old has been replaced by Leicester's Graham Kitchener.
Launchbury is a regular starter in Stuart Lancaster's second row along with Northampton's Courtney Lawes.
Bath's Dave Attwood and the uncapped George Kruis of Saracens are the other locks in the squad as England prepare for their opening match against New Zealand on Saturday.
Kitchener, 25, is also uncapped but captained England against the Barbarians in June 2013.
Head coach Lancaster said: "It's obviously disappointing but it's important for Joe, England and Wasps that he has the appropriate rest and recovery period and we are confident he will be back in the New Year."
London Irish hooker David Paice, 30, has also been added to the squad as cover for Dylan Hartley and Rob Webber.
The loss of Launchbury is a further blow to England's already depleted forward options.
As well as fellow second-row Geoff Parling, front-rowers Alex Corbisiero, Tom Youngs, Mako Vunipola and Dan Cole, and flankers Tom Croft and Tom Johnson, have also been ruled out of the November Tests through injury.
England take on South Africa, Samoa and Australia at Twickenham following their meeting with the world champions.
Forwards: Joe Marler (Harlequins), Matt Mullan (Wasps), Kieran Brookes (Newcastle Falcons), Henry Thomas (Bath), David Wilson (Bath), Dylan Hartley (Northampton Saints), David Paice (London Irish), Rob Webber (Bath), Dave Attwood (Bath), Graham Kitchener (Leicester Tigers), George Kruis (Saracens), Courtney Lawes (Northampton Saints), Calum Clark (Northampton Saints), James Haskell (Wasps), Ben Morgan (Gloucester), Chris Robshaw (Harlequins, captain), Billy Vunipola (Saracens), Tom Wood (Northampton Saints).
Backs: Danny Care (Harlequins), Lee Dickson (Northampton Saints), Richard Wigglesworth (Saracens), Ben Youngs (Leicester Tigers), Owen Farrell (Saracens), George Ford (Bath), Stephen Myler (Northampton Saints), Brad Barritt (Saracens), Luther Burrell (Northampton Saints), Kyle Eastmond (Bath), Jonathan Joseph (Bath), Henry Slade (Exeter Chiefs), Billy Twelvetrees (Gloucester), Mike Brown (Harlequins), Alex Goode (Saracens), Jonny May (Gloucester), Jack Nowell (Exeter Chiefs), Semesa Rokoduguni (Bath), Anthony Watson (Bath), Marland Yarde (Harlequins).