"Due to Ciprian Tatarusanu's lumbar spine problems, national team coach Victor Piturca decided to call up Manchester City keeper Costel Pantilimon," the Romanian federation said in a statement.
Tatarusanu, 27, has kept his place in the squad with team doctors trying to help him recover in time for the first leg match in Athens on Friday.
Romania, determined to end a 16-year absence from the World Cup finals, play the second leg at home four days later.
Piturca was criticised by local media and fans for leaving out Pantilimon, who at 2.03 metres (6 ft 8 in) is the tallest player in the Premier League, despite the keeper's impressive performances in recent weeks.
The coach has included veteran Bogdan Lobont, yet to play for his club AS Roma this season, and FC Astra keeper Silviu Lung, who has played only twice for the national team.
Tatarusanu's injury is another blow for Piturca after captain Vlad Chiriches was ruled out of the playoffs with a fractured nose.
Local media, however, reported there was still a slight possibility for the Tottenham Hotspur defender to play with a face mask in the second match in Bucharest.
(Writing by Angel Krasimirov; editing by Amlan Chakraborty)
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