Josh Johnston, DC

Advanced post-graduate training in the interpretation and clinical application of MRI, CT, and advanced radiographic studies. Emphasizing evidence-based diagnostic imaging, trauma assessment, clinical triage, and interdisciplinary patient management. Training includes correlation of imaging findings with the mechanism of injury, neurological presentation, and biomechanical forces. The credential signifies advanced competency in spine imaging interpretation, documentation, and trauma-informed clinical decision-making

covering the identification and interpretation of radiographic findings, including idiopathic skeletal hyperostosis, intercalary bones, calcified ligaments, cervical ribs, calcified thyroid, lamina and pedicle fractures, fracture and column displacement, atlanto-dental intervals, and upper cervical instabilities. Emphasis was placed on clinical correlation and management strategies.

focusing on raindrop lucencies, mandibular fractures, tracheal alignment, airway and lung assessments, hilar masses, and rib metastasis destruction. Coursework included advanced techniques in diagnosing and understanding pathological implications for clinical care.

Anatomy, Alignment, Joint Spacing, and Normal Spinal Curvatures. Coursework completed with a focus on the interpretation of soft tissue windows, four vertebral zones, cortical borders, and the detection of fractures, retropharyngeal spaces, and ligamentous ossifications

Identification of Pathological Findings Including Ligamentous Ossifications, Retropharyngeal Spaces, and Fractures. Training emphasized alignment abnormalities, joint spacing analysis, and the evaluation of cortical borders and soft tissue structures through X-ray imaging.

Cervical Radiculopathy, Biomechanical Failure, and Chiropractic Outcome Assessment. Focused on diagnosing and managing cervical radiculopathy caused by central disc protrusions and ligamentous instability using advanced imaging techniques and evidence-based chiropractic care.

Case Analysis of Anterior Cervical Disc Fusion Involving C5 and C6. Explored the role of motion radiography in identifying ligamentous injuries and assessed post-surgical outcomes of anterior cervical disc fusion procedures

CT-Based Assessment of Sternum Fracture, Spinal Degeneration, and Biomechanical Motion Analysis in the Presence of MRI contraindicated Discussion focused on the clinical decision-making framework for imaging selection high speed 73yoa female, including CT-based identification of sternal fracture, vacuum sign at multiple lumbar levels, and coronal/sagittal assessment of multilevel degenerative disc disease with thoracolumbar scoliosis. Case demonstrated the application of AI-assisted quantitative motion analysis (QMA) to evaluate intersegmental motion, center of sagittal rotation deviation, and global range of motion deficits in the cervical and lumbar spine as a CT-only alternative to MRI-based assessment

Presented a personal injury case involving a 73-year-old female with acute sternum fracture following a high-impact motor vehicle collision, complicated by MRI contraindication due to a retained legacy pacemaker lead. Discussion focused on the clinical decision-making framework for imaging selection, including CT-based identification of sternal fracture, vacuum sign at multiple lumbar levels, and coronal/sagittal assessment of multilevel degenerative disc disease with thoracolumbar scoliosis. Case demonstrated the application of AI-assisted quantitative motion analysis (QMA) via the spineCAMP platform to evaluate intersegmental motion, center of sagittal rotation deviation, and global range of motion deficits in the cervical and lumbar spine as a CT-only alternative to MRI-based assessment

Anatomy, Alignment, Joint Spacing, and Normal Spinal Curvatures. Coursework completed with a focus on the interpretation of soft tissue windows, four vertebral zones, cortical borders, and the detection of fractures, retropharyngeal spaces, and ligamentous ossifications

Identification of Pathological Findings Including Ligamentous Ossifications, Retropharyngeal Spaces, and Fractures. Training emphasized alignment abnormalities, joint spacing analysis, and the evaluation of cortical borders and soft tissue structures through X-ray imaging

covering the identification and interpretation of radiographic findings, including idiopathic skeletal hyperostosis, intercalary bones, calcified ligaments, cervical ribs, calcified thyroid, lamina and pedicle fractures, fracture and column displacement, atlanto-dental intervals, and upper cervical instabilities. Emphasis was placed on clinical correlation and management strategies

focusing on raindrop lucencies, mandibular fractures, tracheal alignment, airway and lung assessments, hilar masses, and rib metastasis destruction. Coursework included advanced techniques in diagnosing and understanding pathological implications for clinical care

Cervical Radiculopathy, Biomechanical Failure, and Chiropractic Outcome Assessment. Focused on diagnosing and managing cervical radiculopathy caused by central disc protrusions and ligamentous instability using advanced imaging techniques and evidence-based chiropractic care

Case Analysis of Anterior Cervical Disc Fusion Involving C5 and C6. Explored the role of motion radiography in identifying ligamentous injuries and assessed post-surgical outcomes of anterior cervical disc fusion procedures

Identification of ancillary lesions on spinal MRI frequently includes findings unrelated to the primary spinal complaint, requiring careful differentiation between benign and malignant processes. Common benign lesions vs malignant lesions may represent primary tumors or metastatic disease, requiring urgent medical evaluation. Primary & secondary tumors

Spinal MRI studies can incidentally reveal asymptomatic abnormalities. Early identification of malignant or metastatic pathology may significantly alter patient prognosis, treatment planning. The literature supports that chiropractors and spine specialists interpreting advanced imaging must recognize ancillary lesions and distinguish benign from potentially life-threatening pathology to ensure appropriate triage and collaborative medical management

Advanced training included identification and interpretation of metastatic disease patterns involving the brain parenchyma, vertebral bodies, epidural space, and leptomeninges utilizing MRI and advanced neuroimaging protocols. Emphasis was placed on differentiating benign versus malignant lesions, distinguishing primary from secondary tumors, and recognizing intra-axial versus extra-axial intracranial pathology as well as intramedullary versus extramedullary spinal tumors

Specialized instruction addressed central nervous system and spinal infections, including the radiographic hallmarks of discitis, osteomyelitis, epidural abscess, intracranial abscess, meningitis, and post-surgical infectious complications. Imaging criteria, enhancement characteristics, tissue signal patterns, and clinical correlation to distinguish neoplastic lesions from infectious and inflammatory processes. Multidisciplinary collaboration, advanced medical management, competency in differential diagnosis, MRI interpretation, and evidence-based clinical decision-making for complex spinal and neurological disorders

Advanced education included the evaluation and interpretation of concussion and mild traumatic brain injury (TBI) utilizing MRI, CT, and advanced neuroimaging principles. Training emphasized recognition of subtle imaging findings associated with concussion, including indicators of diffuse axonal injury, hemorrhagic versus non-hemorrhagic lesions, and delayed or evolving radiologic changes that may not be immediately apparent following trauma

Coursework focused on correlating traumatic imaging findings with patient presentation and neurological symptomatology to improve diagnostic accuracy and clinical decision-making. Instruction further differentiated acute, subacute, and chronic traumatic changes while distinguishing structural injury from functional neurological disturbance. Specialized emphasis was placed on identifying imaging-negative concussion presentations versus imaging-positive traumatic brain injury and understanding the clinical implications of each. This advanced training strengthened competency in the assessment of traumatic neurological disorders, differential diagnosis, and appropriate referral and co-management of patients with brain trauma

Diagnosing and demonstrative reporting of the spinal cord, nerve root, thecal sac, disc recurrent meningeal nerve, myelomalacia, myelopathy, fracture, chemical radiculitis, and connective tissue pathologies, and osseous compression of nociceptors. Collaborative care with medical specialists on spinal pathology

Identifying and diagnosing spinal disc pathologies: bulged, herniated, protruded, extruded-comminuted, extruded-sequestered. MRI sequence protocols: T1, T1 fat saturation, T2, T2 fat saturation, STIR, proton density, fast spin echo, echo gradient, coronal, sagittal and axial. Triage of disc pathologies and collaborative care

dentifying and diagnosing spinal segmental lesions in the facet, joint capsule involving ligamentous mechanoreceptors, and spinal proprioceptors. The central segmental motor control mechanism with upper motor neuron involvement with disparate efferent effects and demonstrative diagnostic tools to differentially diagnose the primary lesion. The statistical outcome of treating biomechanical spinal lesions

Identifying and diagnosing Osteoarthritis in hand, wrist, elbow, shoulder, foot, ankle, knees, hips on X-ray. Identifying and diagnosis erosive arthritis and Rheumatoid Arthritis on X-ray, MRI imaging, and ultrasound MRI in the hand, elbow, knee, and spine, Psoriatic and Lupus, crystallin Arthropathy, gout, Calcium Pyrophosphate Dihydrate Deposition Disease (CPPD). Diagnosing of ankylosing spondylitis of the spine was also identified

CT hounsfield units and diagnosing tumors

Determining and documenting the history of proximate cause, how to demonstratively document pain, weakness, and numbness using evidence-based protocols. The demonstrative documentation of MRI spine pathology and being able to differentially diagnose previous vs current pathology in prognosing permanencies

Spinal disc morphology of lamellar tracts and fiber orientation, the non-uniformity of discal zones with the chemical content of each. How Proteoglycans and Aggrecans are integral in disc hydration and age-dating pathology. Understanding the vascularization of the osseous end-plate, cartilaginous end-plate, and disc from birth through puberty is essential to accurately diagnosing disc pathology. Being able to relate disc herniations to end-plate fractures with central herniation and clinically correlating it to chronic back pain

Interpreting and utilizing X-ray and MRI findings in creating demonstrative documentation. Advanced identification of spinal disc lesions, herniations, bulges, protrusion, extrusion, and fragmentations through computer graphics. Identification and demonstrative documentation of vertebral motor unit pathology and reporting demonstratively using computer graphics

Utilization of thin slice acquisitions with T2 Fat suppressed, STIR, proton density, T1 and T2 sequencing for advanced identification of spinal disc lesions, herniations, bulges, protrusion, extrusion, and fragmentations

Ethical, collaborative relationships with medical PCPs and specialists using advanced documentation and accurate reporting of imaging and advanced imaging. Creating a collegial relationship when conflicts arise in concluding accurate diagnosis to allow consensus and the evidence to determine final diagnosis

Understanding the utilization of CAT Scan slicing and the reformatting when using bone and soft tissue windows. Correlating MRI to CAT Scan when either creates an unclear conclusion to render a complete image of the morphology of the indeterminate pathology. Understanding the physics of CAT Scan and the radiation levels with different types of CAT Scan technology

Understanding the morphology and physiology of connective tissue at the cellular and extra-cellular levels in building a foundation to understanding the function and interaction of ligaments, tendons, muscles, and bones, Identifying connective tissue pathology and the repair process with a foundation of r permanent aberrant sequella

Understanding the concepts of normal vs. pathological movement of vertebral motor units in accurately concluding diagnosis on biomechanical pathology when considering excessive motion. An evidence-based approach to determining translation, angular deviation and rotations beyond pathobiomechanical limitations in the spine

An evidence-based approach to concluding accurate diagnosis, prognosis, and treatment plan, Eradicating the non-specific back pain dogma utilizing X-ray digitizing based on literature standards, Creating treatment plans with identifying the primary spinal lesions using evidence-based tools

Understanding and including all historical elements; current history, past history, family history, and social history when documenting a 9920X. The application of time for coding

panel discussion chiropractors and neurosurgeon share practical strategies for improving communication, improving referral decisions, and building stronger interdisciplinary relationships that lead to better patient outcomes. Understanding each profession's role in patient care, common barriers to provider collaboration, conservative care versus surgical intervention, clinical examination and neurological assessment, imaging strategies and referral considerations, learning from other specialties

Demonstrative Documentation of Disc Herniation and MRI Physics, Understanding the documentation requirements to demonstratively show spinal disc lesions in reporting pathology. Understanding the physics of a nucleus resonating in T1 and T2 weighted imagery.

Developmental Spinal Stenosis and Spinal Trauma– one-hour educational course examining the anatomical, clinical, and medicolegal implications of developmental spinal stenosis in the cervical spine, the role of advanced imaging modalities in assessing canal diameter, differentiating congenital predisposition from trauma-induced exacerbation

discussion what providers need to know about comprehensive integrative pain management (CIPM). Presence and impact of chronic pain, what is CIPM, the CIPM toolbox. Challenges to implementing CIPM, misperceptions and stigma, lack of awareness and education. Workforce supply and demand, integration and cultural incompatibilities, CIPM implementation

decreases rates of injections, opioids and likely surgery. When to alter care path. Avoid doctor-patient treatment and goal misalignment.

MRI, CAT Scan, and X-ray interpretation of shoulder, elbow, wrist, hand, and fingers. Identifying arthridities in upper extremities.

MRI, CAT Scan, and X-ray interpretation of shoulder, elbow, wrist, hand, fingers. Identifying tumors, fractures, dislocations, and infections in joints, including the long bones attached to the joints

Mini-Fellowship in Musculoskeletal (MSK) Soft Tissue Imaging in Upper Extremities

MRI, CAT Scan, and X-ray interpretation of pelvis, hips, knee, ankle, foot, and toes. Identifying arthridities in upper extremities

MRI, CAT Scan, and X-ray interpretation of pelvis, hips, knee, ankle, foot, and toes. Identifying tumors, fractures, dislocations, and infections in joints, including the long bones attached to the joints

MRI, CAT Scan, and X-ray interpretation of pelvis, hips, knee, ankle, foot, and toes. Identifying soft tissue injuries in joints; labrum, meniscus, and ligament and tendon injuries

Joint Providership from the State University of New York at Buffalo, Jacobs School of Medicine

Using "reputation building" through effective documentation to develop relationships with MD PCPs, MD Specialists, ERs, and Urgent Care Centers. Using demonstrative evidence will eradicate the Non-Specific Back Pain "Dogma,” allowing chiropractic utilization to increase based on the evidence

The sequences also identify ancillary findings such as renal, ovarian, extradural, and intradural tumors. Careful evaluation of spinal MRIs can reveal critical pathologies beyond musculoskeletal issues. Analyzing the morphology of the abdominal aorta to determine potential stroke risks

Identifying and diagnosing spinal segmental lesions in the facet, joint capsules involving ligamentous mechanoreceptors, and spinal proprioceptors. The central segmental motor control mechanism with upper motor neuron involvement with disparate efferent effects and demonstrative diagnostic tools to differentially diagnose the primary lesion. The statistical outcome of treating biomechanical spinal lesions

dentifying and diagnosing spinal segmental lesions in the facet, joint capsule involving ligamentous mechanoreceptors, and spinal proprioceptors. The central segmental motor control mechanism with upper motor neuron involvement with disparate efferent effects and demonstrative diagnostic tools to differentially diagnose the primary lesion. The statistical outcome of treating biomechanical spinal lesions

creating a professional bio and CV, essential for establishing credibility in the medical-legal field. Incorporating outcome statistics from cases helps demonstrate your work's real-world impact, especially in the medical legal arena. Getting published in the National Institutes of Health (NIH) using research, peer review, and adherence to scientific standards and enhances your reputation by validating your work within the healthcare community and increasing your authority in the healthcare community field

Utilizing the evidence in the literature to age-dating spinal herniated discs and trauma. Including interpreting X-rays, MRIs in T1, T2, STIR and Fat Saturation sequences, and other imaging alongside understanding the evidence of joint pathology. Being able to collaborate with physicians or as a medical-legal expert. Accurate age-dating helps establish a prognosis for patient recovery. The process must be grounded in evidence-based rationale to ensure reliability. Mastering this skill enhances both clinical decision-making and legal credibility

Clinical Grand Rounds for a case involve assessing disc, ligament, and spinal pathology. The process includes establishing a diagnosis, determining the prognosis, and developing a treatment plan. Special attention is given to conditions such as cord edema, myelomalacia, myelopathy, and tethered cords. Utilizing follow-up examinations as a step in crucial in refining the diagnosis and treatment approach. Adjustments to the treatment plan are made as new clinical findings emerge. This ensures that patient care remains dynamic and responsive to evolving spinal conditions

Evidence-based studies in Modic Changes, Disc and Referred Pain, MRI and Cervical Musculature, Kinetic MRI Images, Neurological Innervation, MRI and Injury Mechanisms, Discogenic Pain, Annular Tears and Fissures, Asymptomatic Herniations.

Identify and oral examination of 60 MRI sequences (over 2500 images) of disc bulges, circumferential, radial, and transverse fissures, varices, and herniations inclusive of the following types: protrusion, extrusions (sequestered and migrated/comminuted extrusions). MRI sequencing for accurate interpretation with contemporary nomenclature and reporting.

Clinically correlate history, clinical findings, and advanced spinal imaging to conclude an accurate diagnosis, prognosis, and treatment plan in an evidence-based paradigm that passes a peer-reviewed panel. The case presented must emanate from contemporary practice utilizing accepted guidelines for sequence acquisition and collaboration if clinically indicated.

An overview of the evaluation and management process inclusive of utilizing electronic medical records to conclude evidenced-based conclusions with the utilization of macros. The importance of adhering to an academic standard and considering co-morbidities.

Concluding a chief complaint, history and what needs to be considered in a physical examination. This covers in dept the required elements for chief complain, history of present illness, review of systems, and past, family, and/or social history. This module also covers the following components of a physical examination: observation, palpation, percussion, and auscultation.

Coding and Spinal Examination: Detailing 99202-99205 and 99212-99215 inclusive of required elements for compliant billing. It reviews the elements for an extensive review of systems, cervical and lumbar anatomy and basic testing. The course also covers the basics of vertebra-basilar circulation orthopedic assessment.

Neurological Evaluation: Reviewing complete motor and sensory evaluation inclusive of reflex arcs with an explanation of Wexler Scales in both the upper and lower extremities. The course breaks down testing for upper and lower motor neuron lesions along with upper and lower extremity motor and sensory testing examinations.

Documenting Visit Encounters: Forensically detailing the S.O.A.P. note process for visit encounters and discussing the necessity for clinically correlating symptoms, clinical findings and diagnosis with the area(s) treated. It also details how to modify treatment plans, diagnosis, document collaborative care and introduce test findings between evaluations.

Case Management and Treatment Orders: This module discusses how to document a clinically determined treatment plan inclusive of both manual and adjunctive therapies. It discusses how to document both short-term and long-term goals as well as referring out for collaborative care and/or diagnostic testing. It also includes how to prognose your patient and determine when MMI (Maximum Medical Improvement) has been attained.

Diagnosing and Triaging, Developed proficiency in differentiating mTBI from more severe presentations through evidence-based neurological and cognitive assessments. Trained in identifying red-flag symptoms requiring urgent imaging or specialist referral. Acquired expertise in correlating patient history, mechanism of injury, and exam findings for accurate classification. Focused on optimizing patient outcomes through early identification and appropriate interdisciplinary care coordination.

Medical decision-making (MDM) or total time spent on the date of the encounter. Each higher-level code reflects increasing complexity of history, examination, and MDM, or greater total time. MDM criteria include the number and complexity of problems addressed, the amount and/or complexity of data reviewed, and the risk of morbidity or mortality from patient management. Compliance with CMS and payer requirements.

In-depth overview of traumatic brain injury in concussion. Dispelling the myth of a “mild traumatic brain injury.” Triage protocols and the potential sequela of patients with traumatic brain injuries.

Gross traumatic brain injuries from trauma and significant bleeding with both epidural and subdural hematomas. Numerous case studies reviewed inclusive of neurosurgical intervention and postsurgical outcomes.

Multiple case studies of gross traumatic brain injuries from trauma requiring neurosurgical intervention and also discusses recovery sequela based upon the significance of brain trauma. Concussion protocols in traumatic brain injury short of demonstrable bleeding on advanced imaging.

Concussion etiology and cognitive sequela where gross bleeding has not been identified on advanced imaging. Significance of electroencephalogram testing in determining brain function and pathology (if present). Waveforms in electroencephalogram testing in both normal and abnormal scenarios.

Amplitude, conduction and conduction delays as sequela to traumatic brain injury to diagnose concussion and traumatic brain injury in the absence of gross bleeding and advanced imaging. Electroencephalograms and event-related potentials, brain response that is a direct result of specific sensory or motor events. It is a stereotype electrophysiological response to a stimulus and provides a noninvasive means of evaluating brain function. Multiple case studies, ensuing triage protocols pending the results.

Documenting Herniated Discs, Age-Dating Disc Pathology, and Connective Tissue Pathology as Sequella to Trauma. Herniated Discs and Connective Tissue Pathology, differentially diagnosing herniated discs and disc pathology vs. normal. Normal vs. Pathological connective tissues and age-dating herniated discs.

Documentation of Low-Speed Crashes in Determining Etiology of Serious Bodily Injuries, Documentation requirements during the evaluation, and management encounter to understand the etiology of spinal injuries. Having a complete understanding of the forces involved to conclude a differential diagnosis, while concurrent ruling out malingerers, if applicable.

An in-depth review of basic neuro-anatomy and physiology dermatomes and myotomes to both the upper and lower extremities and the neurophysiology of axons and dendrites along with the myelin and function of saltatory for conduction. The sodium and potassium pump’s function in action potentials.

Nerve conduction velocity testing, the equipment required and the specifics of motor and sensory testing. This section covers the motor and sensory NCV procedures and interpretation including latency, amplitude (CMAP) physiology and interpretation including the understanding of the various nuances of the wave forms.

Compound motor action potentials (CMAP) and sensory nerve action potentials (SNAP) testing and interpretation including the analysis and diagnosis of the wave forms. It also covers compressive neuropathies of the median, ulnar and posterior tibial nerves; known as carpal tunnel, cubital tunnel and tarsal tunnel syndromes. Interpretation algorithms to help understand the neurodiagnostic conclusions.

The EMG process, inclusive of test performance and the steps required in planning and EMG study. Spontaneous activity of a motor unit action potential, positive sharp waves and fibrillations, insertional activity (both normal and abnormal), recruitment activity in a broad polyphasic presentation and satellite potentials. Patterns of motor unit abnormalities including neuropathic demyelinated neuropathies along with acute myopathic neuropathies. This section also covers the ruling out of false positive and false negative results.

Overview of EMG and NCV Procedures, Results, Diagnoses and Documentation. The clinical incorporation of electrodiagnostic studies as part of a care plan where neuropathology is suspected. It also covers how to use electrodiagnostics in a collaborative environment between the chiropractor as the primary spine care provider and the surgeon, when clinically indicated. Sample cases, accurate treatment plans based upon electro-neurodiagnostic findings when clinically indicated.

Understanding future trends in chiropractic and clinical record-keeping is essential for maintaining professional excellence and delivering high-quality patient care. As healthcare evolves with new technologies and reimbursement models, clinical documentation must adapt to remain effective and compliant. This module provides a structured, step-by-step guide to creating accurate clinical notes, covering their purpose, context, key elements, practical tips, and relevant legal considerations. Mastery of these skills supports both regulatory compliance and the highest standards of patient care.

Instruction in the interpretation of MRI sequences, including sagittal, axial, T1, T2, STIR, and proton density. Trained students to accurately identify vertebrae, spinal cord, discs, nerve roots, thecal sac, posterior longitudinal ligament, epidural veins, and fat saturation pulses. Emphasized recognition of common pathologies such as bulges, herniations, protrusions, extrusions, myelomalacia, cord edema, and Schmorl’s nodes. Developed students’ practical skills in applying MRI findings to clinical decision-making.

Foundational principles of biomechanical lesions, starting with ligamentous pathology and extending to overall biomechanical dysfunction. Students will learn how ligament damage impacts spinal stability and joint function. The course explores the compensatory changes that develop into chronic biomechanical pathology. Emphasis is placed on the clinical relevance of these lesions for accurate diagnosis, effective treatment, and thorough documentation

This module examines the neurological impact of connective tissue injuries and biomechanical pathology. It highlights how structural damage can create effector organ dysfunction, leading to abnormal neurological signaling. The course traces the progression from localized tissue pathology to widespread central sensitization. Focus is placed on understanding the mechanisms that connect tissue injury to long-term neurological consequences.

This module develops the essential skill of “Evidence-Based” age-dating for herniated discs and spinal trauma. Students will learn to combine imaging interpretation from X-ray, MRI, and other modalities with clinical insights into joint pathology. Emphasis is placed on applying this expertise in collaborative medical and medical-legal contexts. The course also underscores the importance of evidence-based reasoning in establishing accurate patient prognoses.

he diagnosis and management of ligament pathology in acute and chronic patients. It reviews the evidence-based physiology of ligament morphology, trauma mechanisms, and resulting compensatory spinal changes. A master-level analysis addresses ligament anatomy, vascularization, neurological innervation, and tissue repair, emphasizing clinical relevance. The course also explores how ligament pathology drives patho-neuro-biomechanical lesions and informs the mechanisms of chiropractic spinal adjustments.

This module focuses on the screening and diagnosis of brain injuries, from concussion and mild traumatic brain injury (mTBI) to severe TBI and stroke. It emphasizes recognizing key clinical signs to support timely and accurate assessment. Participants learn essential triage protocols to ensure patients receive appropriate care. The course also introduces evidence-based strategies for distinguishing between conditions and minimizing the risk of delayed or missed diagnoses.

This course module provides an evidence-based framework for spinal diagnosis, focusing on accurate identification of specific pathologies rather than generalized labels like “non-specific back pain.” Clinicians are trained to integrate clinical assessment and imaging findings to establish definitive diagnoses. The module emphasizes collaborative management with medical specialists to improve patient outcomes. Participants learn to apply evidence-based reasoning to guide treatment decisions and strengthen interdisciplinary care.

This course module outlines the requirements essential for supporting long-term chiropractic care when needed and fostering collaborative relationships. It provides an evidence-based framework for spinal diagnosis, emphasizing precise identification of specific pathologies over broad labels such as “non-specific back pain.” Clinicians are trained to synthesize clinical assessments with imaging findings to establish accurate and definitive diagnoses. Strategies highlighted for collaborative management with medical specialists to optimize patient outcomes. Participants learn to apply evidence-based reasoning to guide treatment decisions while enhancing interdisciplinary communication and care coordination.

Beginnings and barriers to working within a large health system; optimization of patient care, communication strategy, clinical learnings. Collaborative model in practice, referrals, health system differences, chiropractic benefits. Lessons learned on integration, collaboration, and barriers; patient outcomes; pandemic effect. Collaborative requirements for working with MDs

Diagnosis and Clinical Triage, Developed advanced proficiency in differentiating concussion, mild traumatic brain injury, moderate to severe traumatic brain injury, and post-traumatic stress disorder through evidence-based neurological, cognitive, and behavioral assessments. Trained in the identification of red-flag signs and symptoms necessitating urgent neuroimaging and/or specialist referral. Acquired expertise in correlating patient history, mechanism of injury, symptom evolution, and examination findings to ensure accurate classification and risk stratification. Emphasis placed on early identification, appropriate interdisciplinary referral, and coordinated care to optimize patient outcomes and mitigate long-term sequelae

Documentation requirements for CPT® codes 99202–99205 are based on either the level of medical decision-making (MDM) or the total time spent by the provider on the date of the encounter. Progressively higher-level codes reflect increasing complexity of the patient’s condition, including the scope of history, examination. Ensure compliance with CMS and third-party payer requirements

Case Management of Traumatic Spinal Injuries, Understanding flexion-extension cervical injures and diagnosing connective tissue pathology. Determining impairments and the literature-based standard for permanent injuries.

Managing Herniated and Bulging Discs, Serious Injury in Non-Herniated Cases from Trauma, Spinal disc morphology, and innervation. Literature-based documentation requirements for no-dis spinal injuries.

Herniated Discs and Permanent Brain Malfunction & Biomechanical Failure, A case-study of a post-traumatic herniated disc and related brain malfunction supported by contemporary literature, MRI acquisition, and necessity protocols.

Post-Traumatic Herniated Discs, Related Migraines-Headaches & Strain/Sprain Permanencies, Relationship of headaches, and migraines to cervical spine disc herniation, clinical rationale for ordering MRI’s and the relationship of ligamentous pathology to spinal trauma.

Dr. Peyster is a Harvard-trained neuroradiologist published extensively over the last 40 years. Presentation focusing on collaborating with radiologists on case reviews. Dr. Shady neurosurgeon, 30 years of extensive experience in both working with and supporting chiropractic care multidisciplinary approach

extensive research verifying chiropractic as the best first choice, the latest research

Insurance Compliance Documentation. The Research of why Chiropractic over PT, MDs & Drugs for Mechanical Spine Pain. Long-Term Chiropractic Care The Research

Interpretation sequencing of STIR, T1, T2, Axial and Sagittal acquisitions. Landmarks, physics, and literature-based definitions of disc and osseous pathology, Visualizing, diagnosing, and documenting cervical and lumbar anatomy vs. pathology

Visualizing, diagnosing, and documenting lumbar spine sequencing, disc herniations, neural canals, cauda equina, conus medullaris, nerve sleeves, canal stenosis grading, and vertebral width vs. height in determining segmental remodeling. Diagnosing thecal sac abutment, central canal root compression and ligamentum flava involvement

Case study visualizing, diagnosing, and documenting cervical spine sequencing, disc herniations, neural canals, cauda equina, conus medullaris, and vertebral width vs. height in determining segmental remodeling. Identifying the Pons, Occipital junction, and spinal cord to identify Chiari 1 malformations.

Visualizing, diagnosing, and documenting lumbar spine sequencing, disc extrusion type herniations, neural canals, cauda equina, conus medullaris, spondylolisthesis, degenerative spondylolisthesis, disc degeneration, neural canal and central root compressions, central canal stenosis. Varices vs. herniations, and multiple level disc pathology with biomechanical failures

Visualizing, diagnosing, and documenting cervical spine sequencing, disc extrusion type herniations, neural canals, disc degeneration, thecal sac compression, central canal stenosis, cord displacement, reversal of cervical curve, Chiari 1 malformation. Identifying spinal biomechanical failure in MRI sequencing, with visualizing ligamentous pathology as cause for failure. Differentially diagnosing recent vs. older trauma based upon edematous signal in T1, T2, and STIR images

Visualizing, diagnosing, and documenting cervical spine sequencing, multiple disc extrusion type herniations, vertebral remodeling, intradural tumor displacing the spinal cord visualized in T1, T2, and STIR sequences, neural canal stenosis, disc degeneration, thecal sac compression, central canal stenosis, cord displacement, reversal of cervical curve, Chiari 1 malformation, and identifying of inferior brain structures.

Visualizing, diagnosing, and documenting 1) improper sequence acquisitions invalidating interpretation 2) incomplete study invalidating interpretation 3) visualizing, diagnosing, and documenting lumbar spine sequencing, multiple disc extrusion type herniations, vertebral remodeling, multiple thecal sac compressions, neural canal stenosis, disc osteophyte/ridging complex, central canal stenosis, spondylolisthesis. Identifying the spleen, liver, kidneys, inferior vena cava, and psoas musculature on imaging

Visualizing, diagnosing, and documenting cervical spine sequencing, cervical spondylosis, pathological spinal biomechanics, reversal of lordotic curve, and vertebral width vs. height in determining segmental remodeling, central herniation, thecal sac compression of the cord, identifying tongue, epiglottis, hyoid cartilage, pharynx, thyroid. Reviewing fat saturation sequences for osseous metastatic tumors and advanced degeneration

Visualizing, diagnosing, and documenting lumbar spine sequencing, degenerative disc disease, nerve root sleeve abutment, far lateral herniations vs. bulges, normal vs. dissected inferior vena cava aneurism, epidural fat as a space occupying lesion, facet arthropathy and edema, hypertrophy of ligamentum flava, and pseudo disc at the S1-S2 level.

Visualizing, diagnosing, and documenting cervical spine sequencing utilizing T1 weighted images for pathology, inclusive of advanced degeneration and tumor detection. STIR in a fat saturated image for ligamentous pathology inclusive of the posterior longitudinal, ligamentous flava and interspinal ligaments. Normal clivus and odontoid for cerebellar tonsil location. Cerebral spinal fluid (CSF) flow and the utilization of the spinal cord’s central canal for CSF transport.

Connective tissue morphology, embryology and wound repair as sequalae to trauma. Full components of strain-sprain models and permanency implications with wound repair and osseous aberration with aberrant structural integrity.

Disc pathology as sequella to trauma; herniation, extrusion, protrusion, sequestration and how the spinal unit as one system creates homeostasis to balance the pathology.

The peripheral and central innervation of the disc and spinal ligaments of the dorsal root ganglion, spinal thalamic tracts, periaqueductal gray areas innervating the Thalamus and multiple regions of the brain. The efferent neurological distribution to disparate areas of the spine to create homeostatis until tetanus ensues creating osseous changes under the effect of Wolff's Law.

Identifying normal anatomy and variants on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures. Identifying fractures in the adult and pediatric cases and traumatic etiologies. Differentially diagnosing various arthritic etiologies of osseous derangement

Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors.

Identifying normal anatomy and variants on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors

Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors

Identifying normal anatomy and variants on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement and traumas. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors

Identifying normal anatomy and variants on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures. Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement

Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors

Identifying normal anatomy and variants on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures. Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement

Identifying fractures in the adult and pediatric cases. Differentially diagnosing various traumatic and arthritic changes vs. benign and metastatic Tumors.

Identifying normal anatomy and variants on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors

Identifying normal anatomy and variants on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement and trauma. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors

MRI & X-Ray Interpretation

Program with comprehensive review of MRI Spinal cases covering the cervical, thoracic, and lumbar spinal regions with in-depth analytics of T1, T2, STIR, proton density, and fat-suppressed T2 weighted sequences. The pathology reviewed covers normal anatomy, herniations, bulges, protrusions, extrusions, sequestrations, cysts, varices, tethered nerves, redundant nerves, hypertrophic ligaments, ligamentous edema, cauda equina involvement, syringomyelia, brain stem anomalies, spinal cord compressive pathology and intra and extra-dural lesions

Clinical case review of MRI's including sagittal, axial, T1, T2, STIR, and proton density sequences. The vertebrae, spinal cord, discs, nerve roots, thecal sac, posterior longitudinal ligament, epidural veins, and fat saturation pulses are identified. Pathology of bulges, herniations, protrusions, extrusions, myelomalacia, cord edema, and Schmorl's nodes

Clinical skills of interpreting X-ray, MRI, and other imaging modalities correlated with a clinician's understanding of joint pathology. Age dating pathology as a central component of patient prognosis and projected recovery, evidence-based rationale

Imaging protocols based upon history and clinical presentation, along with analyzing imaging findings in determining the etiology. Extensive question and answer session following the instructional presentation

A "master class" in Strain-Sprain in fully understanding the research regarding permanency of this connective tissue disorder, along with effect on long-term care

Dr. Baker is an Assistant Professor of Clinical Radiology at the State University of New York at Stony Brook, School of Medicine, teaching the radiology and MSK radiology programs at SUNY

Ligament pathology correlating to the mechanisms of patho-neuro-biomechanical lesions (vertebral subluxation complex). How ligaments play a critical role in a chiropractic spinal adjustment and defining the chiropractic spinal adjustment mechanisms

Evidence disproving “non-specific back pain.

Clinical case review of MRI's including sagittal, axial, T1, T2, STIR, and proton density sequences. Pathology of bulges, herniations, protrusions, extrusions, myelomalacia, cord edema, and Schmorl's nodes. Magdy Shady MD, Neurosurgeon, case collaboration on a patient significant extrusion-type herniation with cord compression and myelomalacia as sequelae. Chiropractic as the primary spine care provider and team based approach.

Ligament pathology correlating to the mechanisms of path-neuro-biomechanical lesions (vertebral subluxation complex). Defining the chiropractic spinal adjustment mechanisms and ligament considerations. Colorizing to reveal pathology visually.

Changing of treatment plans and diagnosis based upon follow-up examinations. Future trends in chiropractic and clinical record keeping, importance of context, med/legal considerations.

Analyzing the requirements in anatomical diagnostic imagery to communicate spinal pathology. Integrating technology, clinical findings, and advanced graphic tools to communicate a diagnostic conclusion.

Clinical case review of MRI including intra and extra-dural findings inclusive of the disc and vascular anatomical lesions. Differentially diagnosing central cord lesions, and spinal cord vascular lesions in both acute trauma and degenerative presentations.

Analyzing neuro-biomechanical pathological lesions defines primary spinal lesions and removes the dogma of non-specific back pain. Creating evidence-based demonstrative documentation in the creation of treatment plans.

Diagnosing and documenting: Ependymoma, Astrocytoma, Hemangioblastoma, Lipoma, Meningioma, Neurofibroma, Schwannoma, Myxopapillary Ependymoma.

Clinical record-keeping, why write clinical notes, the importance of context, what to include in a clinical note, tips for better clinical documentation, basic legal considerations, open clinical notes, how to keep documentation efficient.

Master-Class in ligaments; anatomy, physiology, vascularization, neurological innervation, tissue repair, and how they all relate to clinical practice. Ligament pathology correlating to the mechanisms of patho-neuro-biomechanical lesions (vertebral subluxation complex). Also, how ligaments play a critical role in the chiropractic spinal adjustment and in defining the chiropractic spinal adjustment mechanisms.

Case reviews concluding and accurate diagnosis, prognosis, and treatment plan utilizing evidence-based instrumentation and algorithms. Using demonstrative reporting of case findings to collaborate with co-treating physicians.

A documentation discussion on meeting the requirements of the courts, carriers, and licensure boards in complete and accurate reporting. Ensuring the diagnosis, prognosis, and treatment plan are demonstratively documented.

ochum Radiology & Spinal Decompression, Current & Future research/University of South Florida understanding double blinded studies and placebo, traditional chiropractic care and decompression, incorporating technologies to improve outcomes, psychology behind opioid addiction, PM&R approach to decompression, neurology, decompression and preventative care, Osteopathy approach to decompression, MD/DO/DC approaches to decompression regenerative therapy,

Current & Future research/University of South Florida understanding double blinded studies and placebo, traditional chiropractic care and decompression, incorporating technologies to improve outcomes, psychology behind opioid addiction, PM&R approach to decompression, neurology, decompression and preventative care, Osteopathy approach to decompression, MD/DO/DC approaches to decompression regenerative therapy

Biomechanical Changes and Degenerative Disc Disease – detailed presentation on the biomechanical effects of intervertebral disc degeneration on the human cervical spine. Review of relevant anatomy including vertebral bodies, healthy intervertebral disc, degenerative intervertebral disc, spinal nerves, spinal cord, spinal ligaments, and facet joints was outlined. Structural changes were correlated to biomechanical alterations with a detailed focus on the C5-6 segment of the spine. Aberrant facet joint loading was discussed and correlated to intervertebral disc disease and alternations in normal motion and acceleration of spinal arthritis.

Updated Trends in Spinal Biomechanics. Diagnosis and management of ligament (connective tissue) pathology in chronic and acute patients. Evidence-based physiology of the morphology, mechanisms, and sequella to trauma inclusive of compensatory actions of the human spine.

Connective tissue pathology as sequella to trauma and diagnosing of ligament laxity and strain-sprain in conjunction with biomechanical lesions of the human spine. The demonstrative reporting of spinal biomechanical lesions and the subsequent creation of treatment plans.

Review of the ligament injury thresholds, methods of diagnosis utilization of SITR pulse Sequence MRI as the gold standard for evaluating the age of and pathophysiology was discussed and presented. Biomechanical assessment of hypermobility associated with ligament laxity was presented along with the specific ligament involved in the clinical picture. When and how to triage to medical specialist was reviewed. Review of the four columns of vertebral architecture was detailed.

The methods and tools to determine injury to the Occipital-Atlanto and Atlanto-Axial ligaments were presented. Correlation to mechanism of injury and medical legal reports were reviewed. The AO standards for spinal instability was presented.

Differential diagnosis of acute disc injury vs chronic disc herniation was reviewed. Co-management with medical specialist was also reviewed. A discussion of available pain management procedures as also presented.

Specific reviewed of the anatomical innervation of pain generating structures in the human spine was presented. Scientific chronology of nerve supply discovery was presented and discussed. Increased innervation of the degenerating interverbal disc was presented and supported with contemporary scientific evidence. Spinal ligamentous structures as pain generating entities were also reviewed including anterior longitudinal ligament, posterior longitudinal ligament, supraspinous ligament, interspinous ligament and facet capsule. Clinical correlation to patient history, physical examination and imaging findings was emphasized with specific discussion on interprofessional triage and patient management.

Elements of Evaluation and Management codes 99202-99203-99204-99205, inclusive of complexity of management and time components. Demonstrative documentation of spinal-related pain generators; spinal cord, thecal sac, myelomalacia, spinal nerve root insult, connective tissue, recurrent meningeal nerves.

Northwestern Center for Public Safety. Baker's world-renowned text, is an in-depth study of the skills for systematically investigating a traffic crash. Techniques for recognizing and properly recording roadway and vehicle crash evidence are thoroughly presented along with measurements, photographs of the crash scene, creating sketches and after-crash diagrams. Crash Investigation addresses how the collected data are used to reconstruct crashes.

Analyzing patient records, x-rays and MRI’s in determining etiology of traumatically-induced pathological lesions. Clinically correlating the history, clinical findings, imaging findings and diagnosed bodily injuries to conclude an accurate diagnosis, prognosis, and treatment plan.

Differentially diagnosing disc vs. posterior longitudinal ligaments vs. thecal sac vs. spinal cord vs. ligamentum flava pathology and insult. Identifying the borders of lesions and discerning between anatomic structures pathologically effected demonstrably.

Analyzing spinal healthcare trends in both utilization and necessity and understanding the marketplace and how a clinical excellence level is reflected in a doctors' documentation and credentials. Treatment pathways in triaging spinal pathobiomechanics

An evidence-based understanding of time-related etiology of disc pathology considering the American Society of Neuroradiology's designation of protrusion, extrusion, and sequestration of spinal discs, T1, T2, STIR and Proton-Density weighted evaluation to diagnose spine form MRI accurately

Utilizing spinal mensurating algorithms to conclude a pathobiomechanical vs. normal spine in the absence of anatomical pathology. Clinically correlating a history and physical examination findings to x-ray biomechanical results in creating an accurate diagnosis, prognosis, and treatment plan

Utilizing both MRI and x-ray to diagnose 1) Arthritis - Inflammatory and Degenerative, 2) Advanced cartilage assessment, 3) Rotator Cuff Tears, 4) Labral tears (shoulder and hip), 5) Tendon injuries and degeneration, 6) Meniscal tears, 7) Ligamentous injuries, 8) Common fractures, 9) Sports-related injury patterns, 10) Plantar fasciitis

How to effectively create medical-legal documentation and what the courts look for. Making your "4-Corner" (narrative) report demonstrable and build a reputation as an evidence-based provider. The step-by-step minutiae of building a report

Treatment modalities centered upon "best-outcomes" in an evidence-based model considering chiropractic vs. physical therapy and chiropractic vs. medicine. Considerations of disability, pain reduction, functional improvement, drugs utilized, and side-effects are all considered

Spinal biomechanics and computational biomechanics. Mechanical Structure and Function of Spinal Ligaments. Hiatt MD Histological/Immunological Response of Injured Ligaments. Jackson MD Diagnosing Spinal Ligament Injury on Dynamic Plain Film and MRI.

Supportive evidence, outline of trends in spinal pain management versus a curative model. Credentials, training, and triage methods were demonstrated for the Doctor of Chiropractic to increase proficiency in spine management. Scientific evidence supporting the need for a portal of entry spine physician. Key differences between Spine Management Physician and Primary Spine Care were discussed.

Pain Management Care, outline of neurological mechanisms of central nervous system modulation of pain in the human body was demonstrated. Specific peer-reviewed, medically indexed evidence was presented starting with 2012 Systematic Review outlining spinal manipulation’s effectiveness in pain management. Current evidence as well as future trends were discussed and presented. Neurological downregulation was discussed including afferent and efferent neurological pathways regulated by the dorsal horn of the spinal cord. Interprofessional communication and compliant documentation of the pain management phase of care was emphasized.

specific trends in the biomechanical assessment of the human spine. Emphasis was placed on the transfer of laboratory based biomechanical science and clinical utilization of biomechanical parameters in the diagnosis and correction of spinal biomechanical pathology. Peer reviewed medically indexed publications defining symptomatic vs asymptomatic. Sagittal alignment and its relation to pelvic incidence was reviewed in relation to asymptomatic parameters. Interprofessional communication relating to biomechanical stabilization and spinal rehabilitation. Review of a regional versus whole spine model of spine management was presented emphasizing the needs of the patient, primary care physician, pain management physician and spine surgeon.

Cervical Spine detailed review of cervical spinal physical examination with emphasis on clinical triage between anatomical and biomechanical sources of spine pain. Neurological evaluation of the neck and surrounding structures was reviewed including pathological reflexes, assessment of vascular compromise and myelopathic findings. Detailed patient screening was stressed and its correlation to physical examination, red flags and relative vs absolute contraindications to chiropractic care was presented. Patient positioning and efficient processes were reviewed and demonstrated. Details relating to cervical spine and orthopedic testing was discussed.

Thoracic and Lumbar Spine and Pelvis, outlines of thoracic, lumbar and pelvis physical examination were presented. Neurological evaluation of the lumbar spine and surrounding structures was reviewed including pathological reflexes, assessment of cauda equina syndrome and triage processes for neurologically compromised patients. Detailed screening and its correlation to physical examination, red flags and relative vs absolute contraindications to chiropractic care. Patient positioning and efficient processes, details relating to lumbar spine and pelvic orthopedic testing.

Review of electronic health record workflows with emphasis on CPT compliant and efficient reporting. Specific needs of the primary care physician, pain management physician and spine surgeon with details of simplified vocabulary and thoroughness. Administrative workflows ensuring regular and continued communication of clinical documentation was provided.

Communication techniques with emphasis on patient comprehension to increase compliance and reduce patient anxiety. Details were presented on simplification of complex medical terminology to ensure understanding at the initial visitation as well as throughout the patient’s care plan. Proper reporting and interprofessional communication in a wholistic approach to supporting the patient’s needs.

Morphological descriptions of intervertebral disc pathology in the cervical, thoracic, and lumbar spine. Attention was given to the five grades of annular fissure associating circumferential, radial, and transverse morphology. High intensity zone (HIZ) was discussed in detail as well as its correlation to acute inflammatory fluid. Specific MRI images were presented and correlated to consensus driven definitions of intervertebral disc pathology. Pre-existing degenerative changes in the human spine such as disc osteophyte complex, spondylosis, increased innervation of the intervertebral disc and endplate changes were discussed and correlated to acute findings on MRI. In depth discussion of the difference between morphology and etiology of intervertebral disc pathology was outlined.

Anatomical review of spinal ligaments including nerve supply and formation of scar tissue post injury was presented. Function and histological composition were detailed and clinically correlated to physiological thresholds. Injury thresholds were also outlined and compared to the AMA Guides to the Evaluation of Permanent Impairment 5 th and 6 th edition. Detailed review of radiographic findings in the cervical and lumbar spine in the presence of ligamentous injury was reviewed and presented. Clinical criteria supporting the diagnosis of ligament injury and ligament laxity including patient history, physical examination, radiographic findings, and advanced imaging was presented.

Detailed outline of acute versus chronic spine injury findings were presented. Reliable grading systems for phases of spinal degeneration was reviewed and discussed. Scientifically validated measuring process for intervertebral disc height and the 5 Grades of spinal degeneration proposed by Kettler were outlined. Specific discussion was presented in the differential diagnosis of ligament laxity due to degenerative process and acute ligamentous injury in the functional spinal unit with specific examples of radiographic and advanced imaging findings. Clinical correlation with Modic I, Modic II and Modic III endplate changes including cadaver specimens was presented.

Review of spinal tissue types and their response to physical stress and injury was presented. Prognostic factors in patient management were presented in relation to injury to spinal musculature, nerve tissue, ligamentous tissue, intervertebral disc, and bone. Tissue based triage, patient and interprofessional communication was emphasized and stressed.

evidence based neurological protocols for assessing and treating chronic pain. Scientific study of fundamental mechanisms that underlie disorders of the brain and central nervous system, identifying brain regions and biomechanical faults that influence pain, with customized treatment plans based on a person’s unique biomechanics and neurology.

The requirements for diagnosing based upon in an initial evaluation and management encounter ranging from a 99202 – 99205 that includes comorbidities, non-musculoskeletal, and sequellae to injury diagnosis.

The requirements for diagnosing imaging inclusive of static x-rays, biomechanical x-rays, and MRI. Documenting the clinical findings of disc bulge, herniation, protrusion, extrusion, and fragmentation. Coding, diagnosing, and documenting individual treatment encounters in the clinical setting.

Analyzing spinal healthcare trends in both utilization and necessity and understanding the marketplace and how a level of clinical excellence is reflected in a doctors' documentation and credentials. Treatment pathways in triaging spinal pathobiomechanics.

An evidence-based understanding of time-related etiology of disc pathology considering the American Society of Neuroradiology's designation of protrusion, extrusion, and sequestration of spinal discs, Considering the signal intensity of discs in age-dating pathology and acquisition protocols for advanced spinal imaging.

A Literature Perspective, An evidenced-based model for spinal biomechanical engineering and pathobiomechanics considering the pathophysiological limits in translations, angular deviation, and rotational planes. Utilizing the Cartesian system in plotting vertebral points to demonstratively conclude an accurate diagnosis, prognosis and biomechanical treatment plan with the consideration of long-term care in the non-specific mechanical spine pain patient when necessary

Clinical Grand Rounds of herniated, protruded, extruded, sequestered, and bulging discs. Differentially diagnosing vascular vs. mechanical spinal lesions and the necessity for urgent vascular, neurological intervention, Collaborating in a team environment utilizing a neuroradiologist, electrophysiologist, and neurosurgeon with the chiropractor as the primary spine care provider.

History of Electrodiagnosis & Development of Small Pain Fiber NCS, NCS Testing Protocols, SPF-NCS Diagnostic Interpretation & Analysis, Diagnostic Pattern Recognition, Pain Management Clinical Applications, Stem Cell Therapies

Neck and low back pain, optimized MRI and motion biomechanical imaging, commonly missed pain generators. Important injury anatomy and grading systems cervical and lumbar spine structure and function

Documentation and Legal Testimony, report writing for legal cases, documenting damages and consistent reporting of bodily injuries, requirements of reporting causality and permanency, collaborative documentation diagnosis and prognosis and treatment plan, understanding the nuances of functional losses of patients, utilizing demonstrative documentation in direct examination, reporting accurate diagnosis for all images, determining and documenting impairments inclusive of loss of enjoyment of life and duties under duress and the evaluation and validation of pain and suffering, reporting documentation factually, time constraints in rendering an accurate report, reviewing facts of the case inclusive of documentation, medical examiners, medical specialists to ensure accurate and consistent reporting, creating demonstrative evidence, visuals including MRI, electrodiagnostic findings, spinal biomechanics and ipsilateral findings/contralateral symptomatology

Understanding the algorithmic interpretation of spinal biomechanical pathology in a 3-D model and creating treatment plans, impairment ratings and teaching models based upon the vertebral motor unit angles. Determining sagittal and axial alignments in creating a normative baseline for treatment goals and outcomes.

Utilizing x-ray, MRI and other modalities of advanced imaging in conjunction with spinal biomechanical failure and clinical evaluation to collaboratively create treatment protocols for patients in both the operative and non-operative cases. Determining the boundaries of scope of care for both the chiropractor and neurosurgeon based upon a definitive diagnosis of the mechanical vs. an anatomical lesion.

Creating ethical relationships based upon accurate documentation reflective of the casually related condition of the injured. Ensuring accepted credentials of the doctor based upon Voir Dire standards reflected in an admissible curriculum vitae. How to present demonstrative documentation in the courts reflective of the patient’s pathology.

Ensuring the correct codes are utilized in an evaluation and management encounter. The correct elements are utilized to support the level of E&M coded along with a self-audit program to ensure ethical billing occurs. Guidelines for history of present illness, primary complaint, review of systems, family, social and past histories are discussed and how to document the same.

Migration of spinal care for mechanical spine issues from hospitals and medical specialists to trauma qualified chiropractors based upon published outcomes. Utilizing imaging studies in spinal biomechanics, pain models and clinical outcomes to determine a conclusive diagnosis, prognosis and treatment plan for triaging in a collaborative environment

Understanding the normal of spinal biomechanics and the neurotransmitters required for homeostasis. The interconnected role of Pacinian Corpuscles, Ruffini Corpuscles, Golgi Organ Receptors, Nociceptors, Proprioreceptors and Mechancoreceptors in maintaining sagittal and axial alignment in the presence of mechanical pathology.

he literature, academic and clinical standards to age-date herniated discs. The clinical correlation the pain patters with advanced imaging finings of bone edema, spurs based upon the Piezoelectric effect fo remodeling, high signal on T2 weighted images, Vacuum Discs and disc heights in determining the time frames of the etiology of the spinal disc pathology.

Understanding the timely triage necessities based upon clinical and imaging outcomes and the documentation required for collaborative physicians to continue care. Ensuring that the documentation is complete, reflective of services rendered and clear for third party consideration in an admissible format to considered in a medical-legal environment.

Understanding the lateral and ventral horn’s innovations of Pacinian Corpuscles, Ruffini Corpuscles, Golgi Organ Receptors, Nociceptors, Proprioreceptors and Mechancoreceptors and the pathways through the spinal thalamic tracts through the periaqueductal region, the Thalamus into the Occipital, pre-frontal, sensory and motor cortexes and the efferently back through the Thalamus to disparate regions in creating spinal homeostasis, Pacinian Corpuscles, Ruffini Corpuscles, Golgi Organ Receptors, Nociceptors, Proprioreceptors and Mechancoreceptors.

Utilizing T1, T2, STIR and Gradient studies in determining myelomalacia, intra and extra-dural tumors and systemic disease patterns affecting the spinal cord. When to use contrast post-operatively in identifying discal structures vs. adhesions on postoperative advanced imaging. MRI Interpretation of herniated, circumferential bulges, focal bulges, protruded, extruded, comminuted, sequestered and fragmented discs. When to consider a neurosurgical consultation based upon the correlation of imaging and clinical findings.

Fundamental and advanced concepts on spinal biomechanics are introduced by presenting a coherent spinal model describing normal segmental coupling, regional adaptation and global compensation. The clinical model is a structural and mechanical engineering approach based on x-ray physics, mathematics and statistical analysis. The normal movements of gait are integrated in this total biomechanical approach to explain spine distortion, predictable functional scoliosis and lumbar disc failure. Case studies are demonstrated to radiographic analyses and physical findings to determine clinical solutions and soft tissue rehabilitation.

Analyzing a sample accident (case 3) utilizing all the vehicle, road surface combining standardized calculation variables in reconstructing an accident and the resultant energy considered for connective tissue pathology and resultant aberrant spinal biomechanics

Analyzing a sample accident (case 2) utilizing all the vehicle, road surface combining standardized calculation variables in reconstructing an accident and the resultant energy considered for connective tissue pathology and resultant aberrant spinal biomechanics

Mathematical worksheet reviewing kinetic and work energy, momentum, acceleration and G-forces in numerically quantifying a collision, the energy created to deform an automobile and the transference of forces creating connective tissue pathology and altered spinal biomechanics

Analyzing a sample accident (case 1) utilizing all the vehicle, road surface combining standardized calculation variables in reconstructing an accident and the resultant energy considered for connective tissue pathology and resultant aberrant spinal biomechanics

Energy and momentum coefficients and data utilized as determinants and error ranges in calculations. Considering the stiffness of the vehicle, air bag function and formulation of timing in it's release point and injury potential to facial and spinal structures

The osseous and ligamentous structures that are subject to pathology in bodily injury. The pathological reaction of connective tissue when it exceeds its paraphysiological limits and the bio-neuro-mechanical changes the connective tissue undergoes as sequella to trauma

Coefficients of momentum and calculating plastic vs. elastic deformation. Direction of forces as mathematical determinants of collision and resultant bodily injury forces

Coefficients of acceleration, negative acceleration and G-forces in collisions that contribute to vehicular and bodily injuries. Analyzing time, speed and weight of bullet and target automobiles to reconstruct the energy of a collision and injury potential

Reconstructing and calculating speed and velocity as injury and damage factors based upon yaw marks considering coefficients of friction based upon various road surfaces

Reconstructing and calculating minimal speed and velocity as injury and damage factors based upon skid marks considering coefficients of friction based upon various road surfaces

Newton's laws of inertia and the determinant calculations required based upon the action of the vehicle and how spinal biomechanics are effected. Analyzing the vehicle and accident site to reconstruct the actions of the car to create a model

When correlating crash to injury, inspecting the vehicle for evidence of damage to verify causality and extent of malformation of the vehicle beyond that of the outer shell of the vehicle

An analysis of vehicle parts and construction design that contribute to the energy translated to the human body and spine inclusive of seatbelts, airbags, bumpers, event data recorders, tires, axles and auto frames

Calculation worksheets in the mathematical models required to analyze a collision and create coefficients of forces transferred in a collision that effect the automobile and the occupant

Understanding the mathematical models required to analyze a collision and create coefficients of forces transferred in a collision that effect the automobile and the occupant

Analyzing the integration of collision reconstruction and spinal biomechanics utilizing a mathematical model. Understanding the model and transference of energy from the bullet car to the target car to the occupant to aberrant spinal biomechanics

Integration of orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae

Integration of cervical orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae.

Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae.

Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae.

It includes potential stroke, or vertebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process. How to integrate orthopedic testing in the clinical setting utilizing both simple and complex patient scenarios. It includes potential stroke, or vertebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process.

The latest research on the 6 ways to age-date disc herniations and bulges from trauma inclusive of disc pathology nomenclature. MRI ordering protocols, inclusive of Dixon format and fat-suppressed images. The neurology and pathology of connective tissue and the sequella of trauma at the biomechanical level leading to bio-neuro-mechanical failure. Contemporary evidenced-based building blocks for triaging and in a collaborative environment

A literature-based study of normal vs. abnormal motor until function. Determining ligamentous laxity, alteration of motion segment integrity and pathological stress units and whole person impairments based upon the literature and academic standards

The literature-based definitions of both the mechanisms the chiropractic adjustment and how it affects the central nervous system in pain pathways and systemic issues that is the arbiter for normal vs. abnormal function. The physiological mechanisms of how the chiropractic spinal adjustment affects the peripheral and central nervous systems. Subluxation degeneration/Wolffs Law will be detailed from a literature perspective combined with the mechanism of subluxation (bio-neuro-mechanical lesion). A literature perspective why long-term chiropractic care is clinically indicated as usual and customary to effectuate demonstrable biomechanical changes in the spine. An evidenced-based perspective of why physical therapy is a poor choice for spine as a 1st referral option for any provider inclusive of the literature.

An academic basis for documentation that is usual and customary across professions in collaborative care. Maintaining ethical medical-legal relationships based upon Voir Dire and Daubert standards with ensuring an inclusive report. Ensuring Primary Care Status based upon an academic standards.

Understanding spinal motor units as it relates to the Cartesian system and normal vs. pathological movement. Analyzing normal coupling functions of the spine in relations to gait and pelvic biomechanical function and determining stress units and standards of deviation of segmental dysfunction. Interpreting mensuration lines and block analysis beyond standards of deviation in spinal motor dysfunction about connective tissue failure.

Integrating pathological function based upon the Cartesian system and digital mensuration in developing treatment plans with diagnosed connective tissue failures. Diagnosing corrective vs. clinical management scenarios when considering maximum medical improvement in both the chronic and acute, insidious and traumatically induced patient.

Dr. Arthur C. Croft & Dr. Yoganandan Chairman Biomedical Engineering Dept. Neurosurgery, 2018 Scientific Conference

This qualification includes graduate chiropractic education in healthy and traumatically altered spinal morphology inclusive of osseous, connective tissue and neurological structure, function and pathology. This certifies you are qualified in assessing predictive models in spinal biomechanics and devising engineering paradigms for treatment plans to maximize spinal homeostasis in an evidenced based conclusion. In addition, this qualification acknowledges your expertise in triaging the injured and coordinating collaborative care from the trauma through conclusion of rehabilitation

Clinical analysis of anatomic versus biomechanical spine pain and clinical triage protocols. Relating current research trends in the Whole Spine Model of patient including normal versus abnormal sagittal curvature in the adolescent and adult spine, pelvic incidence as a parameter for sagittal balance in the human spine and current methods of assessment. Patient centered approach to Evidenced Based Spine care with a focus on diagnosis, prognosis and triage of the spine pain patient.

Review of the current Centers for Disease Control [CDC} data on the frequency of musculoskeletal pain in the United States population with emphasis on pain of spinal origin. CDC guidelines on opioid medication were discussed and correlated to persistent pain syndromes. Research was reviewed showing the importance of managing the spine pain patient properly from the entry point of care with a concentration on maintenance of spinal biomechanics

The morphology and pathology of connective tissue, inclusive of spinal disc disorders and prognosticating wound repair with permanency implications. Disc bulge, herniation, protrusion and extrusion classifications based upon contemporary literature and how to age-date disc pathology

Understanding the role of mechanoreceptors, proprioceptors and nociceptors with facets, ligaments, tendons and muscles in aberrant spinal biomechanics. MRI and imaging studies of decompressing via a chiropractic spinal adjustment of the bio-neuro-mechanical lesion and its effects on the central nervous system both reflexively and supratentorally

The contemporary documentation required in a medical-legal environment that is evidenced based and meets the standards of the courts and academia. Utilizing the scientific data to support a diagnosis, prognosis and treatment plan while meeting the admissibility standards based upon a professional’s credentials.

Functional neuroanatomy and neurochemistry of pain perception, including descending modulation of pain in the central nervous system. Review of specific research outlining spinal manipulations influence on the central nervous system in the spine pain patient. Clinical assessment and interprofessional communications relating to the diagnosis and management of the mechanical spine pain patient.

The influence of spinal sagittal curvature, pelvic incidence, sacral slope and pelvic tilt on conservative and surgical care outcomes. Clinical correlation with radiographic and advanced imaging findings specific to the spine pain patient.

Focus on the safety of chiropractic management of the spine pain patient and review of research related to specific phases of care, acute intervention, corrective care and health maintenance care were reviewed. Documentation and workflows related to an interprofessional team approach focusing on compliance and delivery in the modern practice environment.

Correlating clinical findings and the patient history in determining the correct course of care in triaging the patient utilizing orthopedic and neurological evaluations in the clinical setting. Understanding the parameters for immediate referrals vs. following the continuum of care to determine the necessity for referrals.

Normal vs. abnormal couplig motions in a mechanical model utilizing engineering principles in a predictive model. Applying the cartesian nomenclature to normal and pathological sequella of the human spine

Creating treatment plans based upon predictive models in determining what is corrective vs. management of pathological spinal biomechanical behavior

Bulging, herniated, protruded and extruded disc contemporary nomenclature, analysis and differential diagnosis. Connective tissue physiology and pathology with aberrant biomechanical permanent sequalae

Normal vs. pathological biomechanical spinal motion both in a single motor unit and coupling actions. Interdisciplinary approach to mechanical spine issues and evidenced based care paths

Interdisciplinary approaches in documentation of spinal related injuries inclusive of connective tissue disorders and biomechanical failure. Clinically correlating history, imaging, advanced imaging and clinical findings to conclude an accurate diagnosis, prognosis and treatment plan

The bio-neuro-mechanical scientific foundation of spinal lesion and the neurological pathways, both in the lower and upper motor neuron pathways. The autonomic sequella of the vertebral subluxation and the effects of the correction and maintenance of those lesions

Brain Vascular Anatomy, The anatomy and physiology of the brain and how blood perfusion effects brain function. A detailed analysis of the blood supply to the brain and the physiology of ischemia.

Various types of stroke identifying ischemia, hypoperfusion, infarct and penumbra zones and emboli. Cardiac etiologies and clinical features as precursor to stroke with associated paradoxical emboli and thrombotic etiologies. Historical and co-morbidities that have etiology instroke inclusive of diabetes, coagulopathy, acquired and hereditary deficiencies.

Stroke type and treatments performed by vascular specialists. The goals of treatment with the physiology of the infarct and penumbra zones and the role of immediate triage in the primary care setting. Detailing the complications of stroke and future care in the chiropractic, primary care or manual medicine clinical setting.

The neurological history and examination for identifying stroke risks with a focus on supra and infratentorial regions, upper and lower motor lesions, cranial nerve signs, spinal cord pathology, motor and sensory pathology and gait abnormalities. Examining genetic and family histories along with dissection risk factors. Stroke orthopedic testing and clinical guidelines pertaining to triage for the primary care provider.

The review of case histories of mechanical spine pathology and bio mechanical failures inclusive of case histories, clinical findings and x-ray and advanced imaging studies. Assessing comorbidities in the triage and prognosis of the injured.

The review of current literature standards in spinal trauma pathology and documentation review of bio mechanical failure, ligamentous failure and age-dating disc pathology.

The bio mechanics of traumatic disc bulges as sequella from trauma and the comorbidity of ligamentous pathology. Age-dating spinal disc pathology in accordance with Wolff’s Law.

The application of spinal bio mechanical engineering models in trauma and the negative sequelae it has on the central nervous system inclusive of the lateral horn, periaqueductal gray matter, thalamus and cortices involvement.

Spinal ligamentous anatomy and research focusing on wound repair, future negative sequelae of abnormal tissue replacement and the resultant aberrant kinematics and spinal bio mechanics of the spine.

Triaging the injured and differentially diagnosing both the primary and secondary complaints. Connective tissue injuries and wound repair morphology focusing on the aberrant tissue replacement and permanency prognosis potential.

The utilization of opioids, bed rest and other pharmaceutical agents for the treatment of chronic low back pain in outcome studies

The utilization of GFAP and UCH-l-1 in determining, traumatic brain injury, mild traumatic brain injury and mild-moderate traumatic brain injury as a triage tool to manage head trauma patients

Creating patient centered approaches to healthcare to improve outcomes in treatment models while concurrently reducing risk

Trends in hospital and emergent care in the healthcare delivery system inclusive of policies, hospital staffing and current care paths for mechanical spine issues.

MRI Spine Interpretation

Hospital Based Spine Care Qualified, Credentialed in hospital protocols, emergency room protocols, acute and chronic patient triage inclusive of MRI spine interpretation, spinal biomechanical engineering, head trauma, concussion, mild traumatic and traumatic brain injuries

Detailed biomechanical presentation on the structure, function and physiology of the spine and pelvis as it relates to the primary mechanical goals of static equilibrium, gait and functional efficiency. Structural and functional analyses are presented from a mechanical engineering perspective to describe normal joint position, loading and function. Abnormal loading factors common to disc failure are identified. Scoliosis assessment includes structural and functional analyses which identify potential corrections and limitations.

Neurophysiological central and peripheral nervous systems mechanisms of pain with integrated higher cortical functions of the thalamus, cingulate, amygdala, pre-frontal, motor and sensory cortexes. Trauma and chronic pain care affecting mechanoreceptors, nociceptors and proprioceptors through adjustive therapy based upon evidenced based care and current literature verification

Triage of patients based upon MRI findings of disc herniation, disc bulge, protrusion, extrusion or sequestrations and spinal cord or nerve root negative sequella, clinical findings of neuro-compressive pathologies and neurodiagnostic findings of EMG-NCV, SSEP, VEP, BAER, VEP and V-ENG findings.

Spine Research Institute of San Diego, Los Angeles, 2015. Patient Risk Analysis I/II and outcome, epidemiology, outcome studies, brain injuries, pain syndromes, thoracic outlet syndrome, carpal tunnel syndrome. Auto Crash Reconstruction, advanced imaging, electrodiagnostic testing and application to whiplash and mild traumatic brain injury, Spine Research Institute of San Diego, 2015. Impairment Rating Certification, The understanding and utilization of the protocols and parameters of the AMA Guide to the Evaluation of Permanent Impairment 6th Edition. Spine, neurological sequelae, migraine, sexual dysfunction, sleep and arousal disorders, station and gait disorders and consciousness are detailed for impairment rating. Herniated discs, radiculopathy, fracture, dislocation and functional loss are also detailed in relation to impairment ratings.

Low impact crash, medical research 2015

Utilizing peer reviewed scientific literature in creating a diagnosis, prognosis and treatment plan for the chronic and acute patient. How to implement and stay current on techniques and technology in health care.

Magnetic fields, T1 and T2 relaxations, nuclear spins, phase encoding, spin echo, T1 and T2 contrast, magnetic properties of metals and the historical perspective of the creation of NMR and MRI.

Normal anatomy of axial and sagittal views utilizing T1, T2, 3D gradient and STIR sequences of imaging. Standardized and desired protocols in views and sequencing of MRI examination to create an accurate diagnosis in MRI

MRI interpretation of bulged, herniated, protruded, extruded, sequestered and fragmented disc pathologies in etiology and neurological sequellae in relationship to the spinal cord and spinal nerve roots

MRI interpretation of bone, intradural, extradural, cord and neural sleeve lesions. Tuberculosis, drop lesions, metastasis, ependymoma, schwanoma and numerous other spinal related tumors and lesions

MRI interpretation sequencing of the cervical, thoracic and lumbar spine inclusive of T1, T2, STIR and 3D gradient studies to ensure the accurate diagnosis of the region visualized

The clinical application of the results of space occupying lesions. Disc and tumor pathologies and the clinical indications of manual and adjustive therapies in the patient with spinal nerve root and spinal cord insult as sequellae

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images. Clinical indication for the utilization of MRI and pathologies of disc in both trauma and non-trauma sequellae, including bulge, herniation, protrusion, extrusion and sequestration

MRI slices, views, T1, T2, STIR Axial, FFE, FSE and sagittal images in the interpretation of lumbar herniations. With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. morphology of lumbar disc pathologies of central and lateral herniations, protrusions, extrusions, sequestration, focal and broad based herniations are defined and illustrated. Spinal cord and canal compromise interpretation with management.

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of lumbar herniations. With the co-morbities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. Morphology of lumbar disc pathologies of central and lateral herniations, protrusions, extrusions, sequestration, focal and broad based herniations are defined and illustrated. Central canal and cauda equina compromise interpretation with management

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of lumbar degeneration. With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. Spinal cord and canal compromise interpretation with management

MRI slices, views, T1, T2, STIR Axial, FFE, FSE and sagittal images in the interpretation of degenerative spondylolesthesis, spinal canal stenosis, Modic type 3 changes, central herniations, extrusions, compressions, nerve root compressions, advanced spurring and thecal sac involvement from an orthopedic, emergency room, chiropractic, neurological, neurosurgical, physical medicine perspective.

An in-depth understanding of the protocols in triaging and reporting the clinical findings of the trauma patient. Maintaining ethical relationships with the medical-legal community.

An extensive understanding of the injured with clinically coordinating the history, physical findings and when to integrate neurodiagnostics. An understanding on how to utilize emergency room records in creating an accurate diagnosis and the significance of “risk factors” in spinal injury

This includes G's of force, newtons, gravity, energy, skid marks, crumple zones, spring factors, event data recorder and the graphing of the movement of the vehicle before, during and after the crash. Determining the clinical correlation of forces and bodily injury

MRI interpretation, physiology, history and clinical indications, bone scan interpretation, physiology and clinical indications, x-ray clinical indications for the trauma patient.

Electromyography (EMG), Nerve Conduction Velocity (NCV), Somato Sensory Evoked Potential (SSEP), Visual Evoked Potential (VEP), Brain Stem Auditory Evoked Potential (BAER) and Visual-Electronystagmography(V-ENG) interpretation, protocols and clinical indications for the trauma patient

Understanding the necessity for accurate documentation and diagnosis utilizing the ICD-9 and the CPT to accurately describe the injury through diagnosis. Understanding and utilizing state regulations on reimbursement issues pertaining to healthcare

Understanding the necessity for accurate documentation, diagnosis and clinical correlation to the injury when reporting injuries in the medical-legal community. Documenting the kinesiopathology, myopathology, neuropathology, and pathophysiology in both a functional and structural paradigm

Correlating clinical findings and the patient history in determining the correct course of care in triaging the patient utilizing orthopedic and neurological evaluations in the clinical setting. Understanding the parameters for immediate referrals vs. following the continuum of care to determine the necessity for referrals.

The Cartesian Coordinate System from the history to the application in the human body. Explanation of the x, y and z axes in both translation and rotations (thetas) and how they are applicable to human biomechanics.

Spinal biomechanical engineering of the cervical and upper thoracic spine. This includes the normal and pathobiomechanical movement of both the anterior and posterior motor units and normal function and relationship of the intrinsic musculature to those motor units. Nomenclature in reporting normal and pathobiomechanical findings of the spine.

Spinal biomechanical engineering of the lumbar spine. This includes the normal and pathobiomechanical movement of both the anterior and posterior motor units and normal function and relationship of the intrinsic musculature to those motor units. Nomenclature in reporting normal and pathobiomechanical findings of the spine.

To utilize whiplash associated disorders in various vectors of impact and whiplash mechanisms in determining pathobiomechanics. To clinically correlate annular tears, disc herniations, fractures, ligament pathology and spinal segmental instability as sequellae to pathobiomechanics from trauma. The utilization of digital motion x-ray in diagnoising normal versus abnormal facet motion along with case studies to understand the clinical application.

Integrating spinal biomechanics and pathobiomechanics through digitized analysis.The comparison of organized versus disorganized compensation with regional and global compensation. Correlation of the vestibular, occular and proprioceptive neurological integration in the righting reflex as evidenced in imaging. Digital and numerical algorithm in analyzing a spine.

Digitizing and analyzing the cervical spine in neutral, flexion and extension views to diagnose pathobiomechanics. This includes alteration of motion segment integrity (AMOSI) in both angular and translational movement. Ligament instability/failure/pathology are identified all using numerical values and models. Review of case studies to analyze pathobiomechanics using a computerized/numerical algorithm.

Digitalizing and analyzing the lumbar spine images to diagnose pathobiomechanics. This includes anterior and posterior vertebral body elements in rotatioal analysis with neutral, left and right lateral bending in conjunction with gate analysis. Ligament instability/failure/pathology is identified all using numerical values and models. Review of case studies for analysis of pathobiomechanics using a computerized/numerical algorithm along with corrective guidelines.

Digitalizing and analyzing the full spine images to diagnose pathobiomechanics as sequellae to trauma in relation to ligamentous failure and disc and vertebral pathology as sequellae. This includes anterior and posterior vertebral body elements in rotatioal analysis with neutral, left and right lateral bending in conjunction with gate analysis. Ligament instability/failure/pathology is identified all using numerical values and models. Review of case studies for analysis of pathobiomechanics using a computerized/numerical algorithm along with corrective guidelines.

Understanding and applying scientific literature in trauma patients to create diagnostic, prognostic and treatment protocols.

Interpreting MRI pathology as sequella to trauma to determine herniation, bulge, protrusion and extrusion in order to create diagnostic, prognostic and treatment protocols.

Utilizing principles and algorithms of spinal biomechanical engineering to analyze chronic and trauma patients in creating diagnostic, prognostic and treatment protocols.

Accurate and compliant documentation of history and clinical findings inclusive of functional losses, loss of activities of daily living, duties under duress and permanent loss of enjoyment of life. Prognosing static vs. stable care, gaps in care both in the onset and in the middle of passive care with a focus on detailed diagnosing. The integration of chiropractic academia, the court system and the insurance reimburser’s requirements for complete documentation.

Trends in hospital and emergent care in the healthcare delivery system inclusive of policies, hospital staffing and current care paths for mechanical spine issues.