Tony Sirucek, DC, ND, BCCT, DAAMLP

Chiropractic and exercise. Cutting edge research to improve patients’ outcomes

Anatomic structure and physiologic function of the peripheral nervous system, processes characteristic of and associated with neural compromise, and common sites of peripheral nerve entrapments

The forces in physics that prevail in accidents to cause bodily injury. Quantifying the force coefficients of vehicle mass and force vectors that can be translated to the occupant and subsequently cause serious injury

Factors that cause negative acceleration to zero and the subsequent forces created for the vehicle that get translated to the occupant. Understanding critical documentation of hospitals, ambulance reports, doctors and the legal profession in reconstructing an accident

The mathematical calculations necessary utilizing time, distance, speed, coefficients of friction and acceleration in reconstructing an accident. The application of the critical documentation acquired from an accident site

Delta V issues correlated to injury and mortality, side impact crashes and severity of injuries, Event data recorder reports correlated to injury, frontal impact kinematics, crash injury metrics with many variables and inquiries related to head restraints

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

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

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

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

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

Brain and head physiology, brain mapping and pathology as a sequellae to trauma. Traumatic brain injury, mild traumatic brain injury, axonal shearing, diffuse axonal injury and concussion are detailed in etiology and clinically. Clinical presentation, advanced diagnostic imaging and electrodiagnostic are detailed in analysis to create a differential diagnosis. Balance disorders that are often as a result of trauma are also explored from clinical presentation to advanced imaging and differential diagnosis

Function and properties of discs, ligaments, muscles, bone and motion of cervical spine. Soft tissue injuries, prognosis, history and physical examination of cervical acceleration/deceleration syndrome (CAD)

Muscular pain, post concussion, electrodiagnostics, soft tissue healing and designing a treatment plan

All aspects of the preparation of a masterpiece narrative report

Collection of published research of whiplash syndrome

Theory and practical experience in the development of cardiovascular assessment procedures, adult individualized aerobic exercise programs, and postural corrective exercise techniques

Special exam procedures, including diagnosis making and treatment strategies

Practical clinical applications with emphasis on the management of pain and related syndromes

Spinal impairment rating to spinal industrial disability evaluation

Determining the etiology of the patient's complaints in a traumatic or non-traumatic scenario. Analyzing the patient's past history and review of systems along with the performance of a complete orthopedic, neurological and clinical examination to correlate both past, current and causality issues to formulate an accurate diagnosis, prognosis and treatment plan.

Multiple Cervical unit advanced technology helps perform objective evaluations and standardized treatment, has computerized interface that records real-time cervical spine movement and isometric strength in all three planes of motion.

Eval Tech, It's the state of the science system, offers broad physical evaluation and rehab services to employers and payors performing standard or custom physical test. Advanced therapeutic program.

ICD-9 and CPT requirements in coding for the traumatically injured including intergrating electronic health records including informed consent, evaluation and management, testing orders. The utilization of research in medical reports for both the trauma and non-trauma patients. Clinical coordination of care and reporting to healthcare and legal providers

Review of current research published in peer reviewed medically indexed journals focusing on traumatic injuries and how current literature affects the diagnostic conclusion and how to formulate treatment plans.

Spinal MRI findings related to degenerative changes vs. traumatic changes of the inervertebral disc by using definitions provided by th American Society of Neuroradiology. Anatomy of the inervertebral disc, spinal cord, nerve roots and spinal ligaments correlated to T1,T2, STIR sagittal, stacking and axial images. Anatomical MRI differentiation of normal, degenerative and traumatic changes.

Somato-sensory evoked potentials, brain stem auditory evoked potention and visual evoked potential utilization, physiology and interpretation, electrodiagnostic testing as a clinical component in part of the neurological work-up of the traumatically injured patient in both the peripheral and central nervous system. Inductions and contraindications to electrodiagnostic procedures. The utilization on electrodiagnostics in concluding radiculopathy, myelopathy and plexopathy and determining recent trauma or chronic pathology.

Documentation requirements of the courts in a medical-legal case including causality, bodily injury and persistent functional losses, ethically reporting of funcional loss as it pertains to e=the integrity of the joint and activities of daily living and implications of chronicity, reporting of normal findings, maximum medical improvement and the release of the patient in the medical-legal arena.