Scott Stiffey, DC DAAMLP FASA

Management principles in personal injury. Critical history taking and physical examination skills. Radiographic and advanced imaging, including CT, MRI, scintigraphy, PET, SPECT, and others. Electrodiagnostic testing and their applications in whiplash. Therapeutic approaches to successful management of whiplash and mild traumatic brain injuries.

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.

Understanding AMA guidelines, documentation, rules of documentation, CPT, ICD-9, and HCPCS codes defined. Personal injury consultation, red flags of serious disease, treatment of a minor, and informed consent. The components of evaluation and management including muscle testing and grading, provocative tests, outcomes assessment tests, the re-examination, and SOAP assessment.

Understanding the diagnosis, treatment, and clinical correlation to the injury from whiplash injuries. Understanding the primary cervical misalignments that result from a whiplash injury.

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

Treatment of all musculoskeletal conditions with a chiropractic approach. Spine and extremity adjustments, patient education, patient management, staff training, and nutrition.

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 IME's, preparing for and giving depositions, testifying as an expert witness, courtroom appearance, curriculum vitae, and documentation for trial and personal injury cases.

Understanding the Biomechanics, Anatomy, and Phsyiology of Motor Vehicle Accidents. The TMJ anatomy and how it is injured in MVA's was also discussed. The significance of complicating factors that prolong recovery, normal healing times, and documentation of medical necessity was also included.

Embryology, biological organization and enzymes, physical exam: ROM tests and exercises, Identifying visceral stress points, recognizing pelvic leg patterns and dural tension, physiology of stress, one minute stress point examination and protocols.

The significance documentation and credentials in the personal injury field with a focus on clinically correlating causality, bodily injury and persistent functional loss as sequellae.

Advanced Topics: The Fundamental Science: In depth review of our current state of knowledge of the whiplash phenomenon, including all factors affecting injury risk and outcome. IN-depth biomechanics, traumatology, epidemiology, review of outcome studies, and common sequelae of whiplash, including brain injuries, pain syndromes, thoracic outlet syndrome, carpal tunnel syndrome, and chronic pain disorders. Understanding risk factors and risk analysis part one.

Understanding dietary protein, carbohydrate, lipid, and their metabolism, and normal digestion. The consequences of poor diet and digestion that lead to inflammation. Absorption, liver metabolism, and the lymphatic system. Specific protocols associated with diet, digestion, and bowel elimination.

Understanding liver metabolism and absorption, the lymphatic system, the autonomic nervous system's sympathetic/ parasympathetic effects, the endocrine system, craniosacral repsiration, and food enzymes and their activity.

Understanding to effectively recommend stress management and lifestyle medicine interventions for their patients, Assess key issues in the patient's presentation, Identify current positive and negative lifestyle factors influencing an individual's response to a significant stressor.

Understanding and implementing a complete active care rehabilitation program specializing in upper and lower crossed syndrome, low tech rehab, neuromuscular re-education protocols, evaluation and documentation.

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. There is an emphasis on triaging both the trauma and non-trauma patent.

Advanced Topics: The Fundamental Science: In depth review of our current state of knowledge of the whiplash phenomenon, including all factors affecting injury risk and outcome. IN-depth biomechanics, traumatology, epidemiology, review of outcome studies, and common sequelae of whiplash, including brain injuries, pain syndromes, thoracic outlet syndrome, carpal tunnel syndrome, and chronic pain disorders. Understanding risk factors and risk analysis part one.

Advanced Diagnostics, Treatment, and Auto Crash Reconstruction: Management Principles in Personal Injury. Critical history taking and physical examination skills. Radiographic and advanced imaging, including CT, MRI, scintigraphy, PET, SPECT, and others. Electrodiagnostic testing and their applications in whiplash. Therapeutic approaches to successful management of whiplash and mild traumatic brain injuries. Risk Analysis II.

Bulge, herniated, protruded, extruded, sequestered discs, differential diagnoses and clinical triage implications. MRI physics and slice protocols.

Differential diagnosis of patho-biomechanics in the cervical, thoracic, and lumbar spine as sequellae to micro and macro trauma and chronic biomechanical instabilities. Understanding the clinical implications of long term biomechanical failure in resultant disc pathology, ligament pathology and osseous pathology.

Spinal modeling: the optimum geometry of the sagittal plane curves. Understanding cervical modeling, impact and whiplash injuries, adverse loading and digital x-ray analysis. Cervical and Lumbar motion study analysis: Understanding normal segmental motion, assessing ligament instability, and determining adjustment and instrument adjusting. Spinal rehabilitation using resistance exercises while utilizing specific unilateral spinal exercises as determined from the spinal configuration. Case studies were presented using biomechanical interpretation, physical findings, and adjusting. Applying the spinal model in scoliosis treatment was also presented.

Understanding gait analysis: normal biomechanical motions of the pelvis and lumbar spine during walking. The relationship of gait analysis to predictable pelvic compensation. Correlating and understanding the differences of normal pelvic compensation, x-ray analysis to determine normal or abnormal compensation, abnormal pelvic misalignments, and the physical findings. Clinical examples and integrated adjusting techniques were then presented.

The optimum spine, alignment and organizational characteristics. Understanding lumbar spine biomechanics with motion segment coupling, compensation and misalignment, digital x-ray analysis, clinical interpretation and integrated adjusting techniques.