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    The Truth About Back Surgery


    So in 2004, Johnson underwent surgery to repair the disc. She'd had a similar operation 10 years before and thought this one would be just as helpful. It wasn't. She was still in a lot of pain, still telling friends she couldn't do things. Three years later, in 2007, Johnson was injured further when a drunk driver slammed into her car. Afterward, she suffered muscle spasms and flares of pain so intense she often had to go to the emergency room for heavy-duty drugs. Finally, a new doctor referred her to the Spine Center at Dartmouth-Hitchcock Medical Center in Lebanon, NH. After 14 full days in the functional restoration program, doing intensive physical therapy and learning psychological techniques for managing pain, she found relief. In fact, the turnaround was so great that in September Johnson moved to California, where she hopes to get back to coaching skaters. "It's what I love most," she says.

    Johnson's story wouldn't surprise Charles Rosen, M.D., clinical professor of orthopedic surgery at the University of California, Irvine, School of Medicine. "An enormous number of back surgeries don't give patients long-term relief," he says. There's even a term for what happens when an operation doesn't improve a patient's condition — "failed back surgery syndrome," said to be the only diagnosis named for a treatment that hasn't worked.

    It gets worse. This is an area of medicine that's been tainted by suspiciously cozy relationships between industry and doctors. In July, for example, Jeffrey Wang, M.D., was dismissed from his post as executive codirector of the UCLA Comprehensive Spine Center for not disclosing about half a million dollars in payments he'd received from companies whose surgical products he was researching. (The David Geffen School of Medicine at UCLA, where Dr. Wang is still on the faculty, is looking into the matter.) And in a 2006 settlement with the Department of Justice, medical-device manufacturer Medtronic agreed to pay $40 million to settle allegations that one of the company's divisions had paid kickbacks to doctors to induce them to use the division's spinal products. The company, which also entered into a five-year Corporate Integrity Agreement (to ensure that relationships with physicians are appropriate), has denied any wrongdoing or illegal activity.

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