Spine Care at Wentworth-Douglass Hospital: A Q&A With Dr. Peter Dirksmeier

Peter J. Dirksmeier, MD, is a spine surgeon at Wentworth Health Partners Seacoast Orthopedics & Sports Medicine. He specializes in both surgical and nonsurgical treatments for a variety of spine and hip conditions, including developmental, degenerative, pathologic, and traumatic issues.

"Most patients who come to us are in quite a bit of pain and unable to comfortably carry out routine activities of daily living, much less the things they enjoy," Dr. Dirksmeier says. "It's very satisfying to see how the treatments we provide here at the Wentworth-Douglass Comprehensive Spine Center truly help people improve the quality of their lives."

Dr. Dirksmeier answers questions about the comprehensive care patients receive at the Comprehensive Spine Center, including how its specialists work together to ensure each patient gets a unique treatment plan designed just for them.

What conditions are treated at the Comprehensive Spine Center?

We care for a diverse group of patients. Many of our patients have degenerative problems that are the result of wear and tear of the spine over time. Others have more acute injuries, like spinal fractures or herniated discs. We care for people of all ages, including elderly patients with arthritis or fractures due to osteoporosis, middle-aged people with spinal stenosis, which is a narrowing of the spinal canal, and young people with sports injuries. In addition, we care for patients who need surgery as well as very commonly patients with strains and soft tissue injuries.

We also specialize in treating patients who have had previous treatments for chronic spine problems that haven't worked.

What treatments does the Comprehensive Spine Center offer?

We offer a wide range of surgical and nonsurgical treatments for spinal problems. As the area's only fellowship-trained spine surgeon for most of the past 23 years, I've been at the forefront of minimally invasive spine surgery. This means you can get advanced operations close to home, including:

• Kyphoplasty to stabilize and reduce pain from spinal insufficiency fractures
• Microscopic decompression for spinal stenosis
• Lumbar and cervical disc replacements to replace damaged discs
• Laminoplasty to decompress multilevel cervical spinal stenosis resulting in symptomatic spinal cord compression
• Fusions to stabilize an unstable spine (both instrumented and non-instrumented) from the front, back, or side of the spine to include minimally invasive techniques when appropriate

We offer comprehensive nonsurgical care with a team-based approach. We have the largest outpatient physiatry group in New Hampshire and a wide network of subspecialty trained spine physical therapy (PT) providers.

Our center puts PT at the heart of our practice. Our physical therapists go through postgraduate training to learn the latest proven techniques in patient evaluation and manual therapies, with an emphasis on medical exercise therapy. We also have specialized athletic trainers and a hospital-owned health club where we emphasize and develop customized, independent self-management programs as patients transition from formal physical therapy.

Other integrated therapies available at the Comprehensive Spine Center include:

• Massage
• Dry needling to relieve muscle pain and tension
• Acupuncture to promote healing and pain relief
• Trigger point injections to deliver medication directly into tight muscle areas to reduce pain and improve movement

Our pain management specialists are experts in epidural steroid injections, medial branch blocks, radiofrequency ablation, and spinal cord stimulation when appropriate to reduce difficult-to-manage spine pain. We also offer behavioral health support, a weight management and nutrition program, and exercise training.

What sets the Comprehensive Spine Center apart from other orthopedic practices?

We apply a thorough process for every patient who comes through our door. We start by reviewing or ordering the necessary X-rays and images, taking a full health history, and conducting a complete medical exam to understand the problem you're experiencing.

Next, our team of specialists designs the best starting point for your treatment. Most patients are best served with an attempt to maximize a conservative treatment plan. As the medical director of the Comprehensive Spine Center, I'm always involved in helping to design treatment plans.

Many of our patients get better without any interventional procedures or surgery, thanks to our unique, multidisciplinary approach to spine care. Our team member specialists meet regularly for multidisciplinary conferences to discuss patients, review their imaging studies, and assess their progress and treatment response. This approach is especially helpful for patients who haven't responded well to previous treatment.

What advice would you give to someone who is having back pain?

Everyone will have back pain at some point. If the pain doesn't improve on its own and eventually go away, or if it's severe and debilitating, it's time to seek medical attention. Certainly, if you feel numbness, tingling, or weakness in your arms or legs, or if you're having trouble controlling your bladder or bowel movements, make an appointment as soon as possible.

If you've had spinal surgery, treatments, or PT before and were not happy with the results, we encourage you to come in for a consultation. Even if you don't think PT will work, you may be pleasantly surprised at the night-and-day difference our expert therapists and techniques can make.

You can reach us at 603-742-2007.