Our Services
A cooperative, interdisciplinary approach is used to diagnose and treat patients with spine and back-related health problems. Intensive rehabilitation, patient education, behavioral medicine strategies, and complementary medical therapies are used to enhance a patient's functionality and quality of life. To accomplish these goals the specific services of the Spine Center are:
Comprehensive Assessment for New Patients
Shared Decision Making
Physical Therapy
Surgery Second Opinion Consultations
Functional Assessment (for the Functional Restoration Program)
Comprehensive Assessment for New Patient
Each patient referred to the Spine Center is seen, when indicated by the interdisciplinary team, including the physician, nurse practitioner, physical therapist, nurse and social worker (case manager). A treatment plan is determined and can be initiated on the day of the evaluation. Diagnostic testing is utilized as necessary but is not routinely ordered.
Shared Decision Making
When indicated, patients participate in the Dartmouth-Hitchcock Shared Decision-Making Program. The Spine Center registered nurse will facilitate patient review of condition specific videotapes and brochures, and will assist the patient in identifying questions and issues related to their care for further discussion with the physician. Patients who have surgery as an option will be offered the opportunity to participate in this program.
Physical Therapy
Patients who may benefit from physical therapy will be scheduled to be seen by one of the McKenzie certified physical therapist in the Spine Center and/or by a physical therapist close to home.
Surgery Second Opinion Consultations
At the request of a referring physician or payor, patients will be seen for a second opinion by one of the Spine Center neurosurgeons or orthopedic surgeons for evaluation.
Functional Assessment
This comprehensive evaluation determines eligibility for the Functional Restoration Program (FRP). At the request of a physician, a patient is referred for a Functional Assessment, to include in part:
- National Spine Network Survey and Report
- Physical performance measurement and testing
- Psychological evaluation
- Job evaluation
- Medical clearance, including assessment of pain medication use
- Occupational therapy assessment of function
- Social worker assessment and coordination with employers and payors
- Interdisciplinary team meeting to determine disposition, including need for further evaluation
For those patients the team recommends for the functional restoration program, the social worker will work with the patient, employer and/or payor to facilitate the individual's enrollment in the program.
The FRP Team will recommend enrollment in accordance with these criteria:
- Patient is willing to commit to full time attendance on outpatient basis
- Pain persistent for three months
- Surgery and other invasive treatments ruled out
- No evidence exists of severe, untreated psychiatric condition
- No current drug or alcohol abuse
- No contraindicated medical condition
- Pain interferes with functioning and contributes to emotional distress
- Patient is physically and mentally able to attend and participate in program
- Patient is willing to learn pain management strategies
More information about the Functional Restoration Program
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