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)
Each patient referred to the Spine Center is seen, when indicated by the multidisciplinary team, including the clinician, 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.
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 clinician. Patients who have surgery as an option will be offered the opportunity to participate in this program.
Hear how shared decision making is used in our practice every day.
Patients who may benefit from physical therapy will be scheduled to be seen by one of the McKenzie certified physical therapists in the Spine Center and/or by a physical therapist close to home.
At the request of a referring clinician or insurance company, patients will be seen for a second opinion by one of the Spine Center neurosurgeons or orthopedic surgeons for evaluation.
This comprehensive evaluation determines eligibility for the Functional Restoration Program (FRP). At the request of a clinician, 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 insurance companies
- Multidisciplinary 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 insurance company 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
For more information, see the Functional Restoration Program.