Spine surgeons, who rely on devices made by companies such as Medtronic ( MDT) and Johnson & Johnson's ( JNJ) DePuy, have started attacking a high-profile study that questions the value of back surgery. "All patients hear is that back surgery is not necessary," says Brian Subach, a prominent spine surgeon in Virginia. "This study has really done more harm than good." With millions of Americans suffering from back-related problems, the spine industry keeps introducing new treatments that promise meaningful pain relief and lucrative financial returns. But research studies have offered mixed conclusions about the true value of back surgery, including some that show patients faring much better with surgery than with more-conservative care. At first glance, the government's latest spine study -- a massive effort known as Sport -- seems to show little difference between those two treatment groups. That study has, in turn, sparked a unique controversy. Industry-funded studies, tainted by perceived financial conflicts, have long been viewed as fair game for critics. But this time around, the government's own $15 million study -- while lauded as a "landmark" effort by some -- has come under heavy attack by leading spine experts.
Even Jeffrey Goldstein, a clinical investigator for the Sport trial, has his misgivings. In particular, he worries about publicity surrounding the study. "The headlines on the news were, 'Oh, my aching back!'" Goldstein says. "But this was not a back-pain study at all."