Robert R. Cawley, D.O.
Dover, NH 03802
David Della Penta was in terrible pain in January of 2017. “I noticed I was losing muscle in my right arm. It got progressively worse, and by late spring I had a Bunsen burner feeling in my arm. It was unbearable,” says David, an avid golf player with a 3-handicap who had to lay down his clubs at the time.
David tried a cortisone shot for the pain. That didn’t work. He went for acupuncture, which yielded temporary relief, but was not a long-term solution. In September, he went to see Dr. Peter Dirksmeier, of Wentworth Health Partners Seacoast Orthopedics and Sports Medicine, who had previously treated him for a back problem.
Dr. Dirksmeier determined that the pain was emanating from a pinched nerve in the neck. “We concluded that he had a degenerative disc at C4-5, which was causing the neurological pain radiating down the back of his arm.” Not wanting to rush to surgery, Dr. Dirksmeier prescribed physical therapy as a first treatment step.
“The specialized spine physical therapists were very good, very attentive, but it just wasn't getting any better,” recalls David. “I’m a very athletic guy. I was going to be 70 and wanted to enjoy my life. That was more important than anything else."
So, after consulting with Dr. Dirksmeier, David agreed to anterior cervical discectomy and fusion (ACDF), a spine surgery to decompress the nerves and spinal cord. This involves removing the herniated or degenerative disc as well as the offending bone spurs that are causing the pain. “When we take a disc out, we have to fill that void,” explains Dr. Dirksmeier. “In David’s case, we opted to use a bone graft to maintain adequate space for the newly decompressed nerves and then create a fusion so that the top bone grows through the bone graft into the bottom bone.”
The replacement bone had to come either from David’s body or a cadaver. “The gold standard is to use the patient’s own bone,” explains Dr. Dirksmeier. “It heals the fastest and most reliably and that’s what we chose in this case. I told David that early on, pain from the bone graft harvest site would be his greatest discomfort after the surgery, but the pain gradually resolves and goes away.”
Prior to surgery, David went through the hospital’s Prehabilitation program, which helps patients prepare for orthopedic procedures. “I spent seven weeks with the cervical team. They were absolutely wonderful,” he notes.
The two-hour surgery took place in late December. “It was 7:15 in the morning,” recalls David. “Dr. Dirksmeier said, ‘Let’s go,’ and then next thing, I woke up in the recovery room. First thing I did was try to move my arm. It was pain free.”
“It’s a tried-and-true operation,” says Dr. Dirksmeier. “Among all of the spinal surgeries that we do, this is one of the ones that’s most predictably successful. Patient selection is the key. In the right patient, the outcomes of spinal surgery are fantastic.”
David’s recovery took about three months. “David is the dream patient,” says Dr. Dirksmeier. “He’s detail oriented and follows instructions to the letter. He’s recovered beautifully and can once again do essentially anything he wants, with comfort being his guide.”
“I could have gone anywhere in the world to have this done but I really like Dr. Dirksmeier. He’s an athlete, an Iron Man [a 140.6 mile race], so he understood my need to stay active,” says David, who lives in Dover and is a generous donor to the Wentworth-Douglass Foundation. “I’m a supporter of community hospitals. My wife and I want to do our part to make sure the hospital has the resources it needs.”
David returned to the golf course in late March. “I just had a grandson. Now, I can really enjoy my life again, and start throwing a baseball with him when he gets older.”
Seacoast Orthopedics & Sports Medicine has joined the Wentworth-Douglass family of physician practices – Wentworth Health Partners. With locations is Somersworth and Lee, SOS Med has been providing top-quality orthopedic care in the local community for more than 40 years. From athletic injuries in the young to degenerative conditions with aging, our goal is always to restore and maintain comfort and function for all patients.
To learn more about Wentworth Health Partners Seacoast Orthopedics & Sports Medicine, call (603) 742-2007 or visit sosmed.org.