Michael Norman, DC

A literature based model for collaborating with hospitals, medical primary care providers and specialists. Reviewing the documentation requirements to communicate the diagnosis, prognosis and treatment plans with medical entities and having the evidence as a basis for those recommendations.

MRI Spine Interpretation of the spine. How to triage a trauma and non-trauma with advanced imaging and document the necessity. We will also cover the basics of MRI Spine Interpretation inclusive of all types of herniations, bulges.

MRI Spine The spine-brain connection in managing chronic pain patients. Understanding how chronic pain negatively effects brain morphology and potential pathology as sequella. The role of chiropractic in preventing the loss of gray matter and the most recent evidence as outlined in indexed peer reviewed literature over the last 10 years verifying chiropractic’s role.

The biological, neurological and mechanical mechanisms and pathways from the thrust to the dorsal horn and brain connection and how the brain processes the chiropractic spinal adjustment based upon the literature. Care paths of chiropractic and physical therapy from an outcome basis.

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.

he 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.

Triage, care and collaboration for herniated, bulged, protruded, extruded and fragmented spinal discs. Compliant documentation of evaluation and management of new and established patients inclusive of chief complaint, history of present illness, review of systems, past-family-social histories with case management protocols and the required elements. Clinically coordinating treatment with subjective complaints, clinical findings and diagnosis for each encounter.

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.

Integration of lumbar 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.

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. 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.

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.

Central neural pathways of pain and higher cortical responses to pain and the effect of high amplitude-low velocity forces on mechanoreceptors and proprioceptors. The effects of neuropeptides on the hypothalamus, pituitary and adrenal axis when treating patients.

The effects of trauma on spinal vertebral segments and the short and long term sequella to morphology. Identifying and diagnosing bone edema, spurring, types of degeneration in assessing biomechanical stability in conjunction with Modic and Pfeiffer changes.

Identifying spinal lesions inclusive of cord and root lesion through examination and advanced imaging in creating an accurate diagnosis, prognosis and treatment plan to effectively triage in collaboration and coordination with medical specialists and emergency department physicians. Differentially diagnosing and triaging disc degenerative bulges, traumatic disc bulges, protrusion herniations, extrusion herniations and fragmented herniations along with managing traumatically induced pain as sequella to degenerative disc trauma.

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.

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, dislocationa and functional loss are also detailed in relation to impairment ratings.

Correlating spinal biomechanics secondary to trauma and MRI findings inclusive of herniation, bulging, protruded and extruded discs. Correlating co-efficient of forces translated form the bullet vehicle to the target vehicle to the occupant in determining causality of bodily injury.

Chiropractic as primary spine care based upon the literature conclusions and the documentation requirements to support those conclusions in an ethical collaborative environment inclusive of hospitals, emergency rooms, primary care medical doctors and medical specialists.

The latest scientific evidence of the effects of the chiropractic spinal adjustment on the central nervous system, both upper and lower motor neurons. A comparative analysis of chiropractic vs. other modalities and therapies.

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.

An extensive understanding of the physics involved in the transference of energy from the bullet car to the target car. 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-Electronystagmosgraphy (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.

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 sequelae 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 sequelae.

The whiplash phenomenon, including all factors affecting outcome. Epidemiology of whiplash injuries, outcome studies, common syndromes and conditions resulting from whiplash, including brain injuries, temporomandibular disorders, muscular pain syndromes, thoracic outlet syndrome, carpal tunnel syndrome and chronic pain disorders.

Accident reconstruction principles used in low speed rear impact collisions. History taking and physical examination. Radiographic and advanced imaging, including CT, MRI, scintigraphy, PET and SPECT. Electrodiagnostic testing and their applications in whiplash. Healing of soft tissue injuries and designing a rational treatment program, including activities of daily living advice.

Comprehensive narrative report construction, including special graphics, charts, and color enhancement to make them more understandable.

Foundations for successful outcome in medicolegal cases. Preparing for depositions, arbitration and court. Use of demonstrative evidence, literature searches and bibliographic services.