James Garabo, DC

Documenting basics of diagnosing bodily injuries vs. pain, and the correct utilization of active vs. sequella coding. Diagnosing the radiation of pain and ensuring etiology is diagnosed and not solely the effect of the pathology. Documenting pathologies with the understanding of relative weights of the ICD

Understanding spinal biomechanical engineering and biomechanical pathologies to correctly diagnose and document according to demonstrative validation of the specific connective tissue injuries. Considering outcomes studies in spinal analytics when concluding an accurate diagnosis, prognosis, and treatment plan. The safe use of X-rays when utilizing digitizing tools to conclude an accurate biomechanical diagnosis

Utilization of Federal Daubert admissibility standards when documenting the utilization of tools, devices, and modalities in treatment. The applicability of research meeting Federal and state requirements for the necessity of treatment in clinical practice. How a doctor's credentials lead to better outcomes, and resolve many issues based on the knowledge attained while earning the credentials

Clinically correlate history, clinical findings, and advanced spinal imaging to conclude and accurate diagnosis, prognosis, and treatment plan in an evidence-base 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.

Protocols and Disc Pathology, Normal anatomy of axial and sagittal views utilizing T1, T2, gradient and STIR sequences of imaging. Degeneration and annular fissures of disc in both trauma and non-trauma patients and the biomechanical properties of joints in age dating pathology and protrusion, extrusion, migrated and sequestered variations. Clinical scenarios as sequela to disc and pre-existing pathologies.

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.

Identifying normal anatomy on both MRI and x-ray, inclusive of osseus, connective, 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.

Herniated, bulged, extruded, protruded, sequestered and degenerative discs. The morphology of a pathological disc vs. normal morphology and the sequences required including T1, T2 and STIR for all spinal regions. Modic 1-2-3 changes detailed and the traumatic relationship.

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: protrusions, extrusions (sequestered and migrated/comminuted extrusions). MRI sequencing for accurate interpretation with contemporary nomenclature and reporting.

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

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

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

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

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

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

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.

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.

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 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 the 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.

This section is an in-depth overview of traumatic brain injury in concussion. It discusses that all brain injuries are traumatic and dispels the myth of a "mild traumatic brain injury". Also, this covers triage protocols and the potential sequela of patients with traumatic brain injuries.

This section discusses gross traumatic brain injuries from trauma and significant bleeding with both epidural and subdural hematomas. There are numerous case studies reviewed inclusive of neurosurgical intervention and postsurgical outcomes.

This section continues with 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. This module also concludes with concussion protocols in traumatic brain injury short of demonstrable bleeding on advanced imaging.

This section covers concussion etiology and cognitive sequela where gross bleeding has not been identified on advanced imaging. It discusses the significance of electroencephalogram testing in determining brain function and pathology (if present). This module also covers the understanding of waveforms in electroencephalogram testing in both normal and abnormal scenarios.

This module covers 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. This section covers electroencephalograms and event-related potentials which measures the 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. In this module multiple case studies are discussed with ensuing triage protocols pending the results.

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

Disc pathology as sequela 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 homeostasis until tetanus ensues creating osseous changes under the effect of Wolff's Law.

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

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. Better visualization of intradural and extradural lesions, neoplasms, and infections

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 99201, 99202, 99203, 99204, and 99205. The application of time as the prime element as per Medicode in coding examinations and re-examination with face to face, review of records and the time necessary to document in an electronic health record

Ependymoma, Astrocytoma, Hemangioblastoma, Lipoma, Meningioma, Neurofibroma, Schwannoma, Myxopapillary Ependymoma.

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.

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.

Utilizing pain patterns, the high signal in the annulus, high signal outside the annulus, Modic changes, disc height, vacuum disc, sclerosis, Phirrman rating, facet edema, and previous MRIs to determine the chronicity of pathology., 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.

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.

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.

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

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.

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.

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.

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.

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

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.

Integrating technology, clinical findings, and advanced graphic tools to communicate a diagnostic conclusion.

Analyzing evidenced-based spinal healthcare trends in both utilization and necessity and understanding the marketplace. The use of evidenced-based demonstrative documentation in reporting treatment pathways in triaging spinal pathobiomechanics

Clinical case review of MRI’s including sagittal, axial, T1, T2, STIR, and proton density sequences. Identified will be the vertebrate, spinal cord, discs, nerve roots, thecal sac, posterior longitudinal ligament, epidural veins, and fat saturation pulses. Pathology will include bulges, herniations, protrusions, extrusions, myelomalacia, cord edema, and Schmorl’s nodes. Learn how to collaborate effectively with radiologists, neuroradiologists, and neurosurgeons on the clinical findings

Analysing evidence-based outcomes in triaging non-anatomical lesions. The analysis of neuro-biomechanical pathological lesions defines primary spinal lesions and removes the dogma of non-specific back pain. Managing collaborative relationships with medical primary providers and specialists in clinical practice

Utilizing both MRI and x-ray in identifying via x-ray and advanced imaging extremity instabilities from ligamentous, osseous or neoplastic derangement.

Effectively creating demonstrative medical-legal documentation and meeting the needs of the courts, and making your "4-Corner" (narrative) report to build your reputation as an evidence-based provider. The step-by-step minutiae of building a report, accomplishing report writing timely and effectively by understanding the regulatory and administrative rules. Learn how to educate the lawyer on bodily injury through evidence-based demonstrative reporting.

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

Diagnosing, triaging, and documenting headaches, migraines, and vascular incidents (stroke) in the primary provider's office. Imaging protocols based upon history and clinical presentation will be presented, along with analyzing imaging findings in determining the etiology. There will be an extensive question and answer session following the instructional presentation

Age dating herniated discs and trauma is a critical skill for an expert in spine. It combines the clinical skills of interpreting X-ray, MRI, and other imaging modalities with a clinician's understanding of joint pathology. This level of expertise is critical when collaborated with other physicians or working in the medical-legal environment as an expert. Age dating pathology is also central to creating a prognosis on your patient's recovery and must be evidence-based in rationale

Case reviews utilizing E/M, MRI, and x-ray mensuration report to conclude an accurate diagnosis, prognosis, and treatment plan. Common diagnosis requiring interprofessional collaboration with a discussion of diagnostic dilemmas and proper communication methods

A clinical discussion of collaborating with neurosurgeons on spinal cord and spinal nerve root co-morbidities. Triaging cases with herniated, protruded, extruded, fragments discs and differentially diagnosing tethered cord, syringomyelia, traumatic Schmorl’s Nodes, Myelomalcia, spinal cord edema, vacuum disc and other intra, and extra-dural lesions

CPT Coding Guidelines for Initial and Established Patients with particular attention paid to Patient History, Review of Systems, Social and Family History, Physical Examination, and Medical Decision making. Specific differences in coding levels and required elements for a 99202-99203-99204-99205

Pathways to improve coordination of care, and interprofessional communication with collaborating physicians. Maintaining ethical relationships in the medical-legal community through documentation and communication of demonstrable diagnosis, prognosis and treatment plans

History of clinical biomechanics with an emphasis on the diagnosis and management of spine pain of mechanical/functional origin. Evidence-based symptomatic vs. asymptomatic parameters using peer-reviewed medical index literature. Computerized mensuration analysis of spinal biomechanical pathology. Comparison of demonstrable spinal biomechanical failure on imaging to clinical evaluation and physical examination

Case reviews utilizing E/M, MRI, and x-ray mensuration report to conclude an accurate diagnosis, prognosis, and treatment plan. Common diagnosis requiring interprofessional collaboration with a discussion of diagnostic dilemmas and proper communication methods

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

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 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

Report writing for legal cases, the 4 corners of a narrative and documenting damages with understanding defense medical documentation and consistent reporting of bodily injuries

Understanding report writing and the types of medical reports required for court inclusive of diagnosis, prognosis and treatment plans with requirements of reporting causality and permanency

Organizing your documentation and understanding all collaborative documentation and how it fits into your diagnosis, prognosis and treatment plan, Understanding the nuances of the functional losses of your patients related to their bodily injuries

Utilizing demonstrative documentation in direct examination and communicating the results of your care concurrently with the written documentation and reporting an accurate diagnosis for all images

The evaluation, interpretation and reporting of collaborative medical specialists results and concluding an accurate diagnosis inclusive of all findings and reviewing all images to ensure an accurate diagnosis

Determining and documenting disabilities and impairments inclusive of loss of enjoyment of life and duties under duress and the evaluation and validation of pain and suffering

Reporting your documentation factually and staying within the 4 corners of your medical report and scope of practice inclusive of understanding how your credentials allow you to report your documentation

The level of organization required in a medical-legal case that accurately reflects the bodily injuries of your patients and the time constraints in rendering an accurate report

Reviewing the facts of the case inclusive of your documentation, the defense medical examiner, medical specialists and the attorney to ensure accurate and consistent reporting.

Creating demonstrative evidence, visuals of your patient's bodily injuries inclusive of x-rays, MRI's, CAT Scans and electrodiagnostic findings, the spinal biomechanics of herniated disc with ipsilateral findings and contralateral symptomatology

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

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

Understanding report writing and the types of medical reports required for court inclusive of diagnosis, prognosis and treatment plans with requirements of reporting causality and permanency

Organizing your documentation and understanindg all collaborative documentation and how it fits into your diagnosis, prognosis and treatment plan, Understanding the nuances of the functional losses of your patients related to their bodily injuries

Utilizing demonstrative documentation in direct examination and communicating the results of your care concurrently with the written documentation and reporting an accurate diagnosis for all images

The evaluation, interpretation and reporting of collaborative medical specialists results and concluding an accurate diagnosis inclusive of all findings and reviewing all images to ensure an accurate diagnosis

Determininig and documenting disabilities and impairments inclusive of loss of enjoyment of life and duties under duress and the evaluation and validation of pain and suffering

Reporting your documentation factually and staying within the 4 corners of your medical report and scope of practice inclusive of understanding how your credentials allow you to report your documentation,

The level of organization required in a medical-legal case that accurately reflects the bodily injuries of your patients and the time constraints in rendering an accurate report,

Reviewing the facts of the case inclusive of your documentation, the defense medical examiner, medical specialists and the attorney to ensure accurate and consistent reporting

Creating demonstrative evidence, visuals of your patient's bodily injuries inclusive of x-rays, MRI's, CAT Scans and electrodiagnostic findings, the spinal biomechanics of herniated disc with ipsilateral findings and contralateral symptomatology

Report writing for legal cases, the 4 corners of a narrative and documenting damages with understanding defense medical documentation and consistent reporting of bodily injuries,

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

An introduction to active care and the basic principles of rehabilitation as they relate in importance to the chiropractic profession. The participant will be exposed to concepts relevant to understanding and incorporating active care into their practice. The information provided will help to reinforce why active care should be an integral part of the chiropractic practice and how to explain these concepts to our patients.

The literature, academic and clinical standards to age-date herniated discs. The clinical correlation the pain patterns with advanced imaging finings of bone edema, spurs based upon the Piezoelectric effect of 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

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

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

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

Brain and head physiology, brain mapping and pathology as a sequella 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 electrodiagnostics are detailed in analysis to create a differential diagnosis. Balance disorders that often occur as a result of trauma are also explored from clinical presentation to advanced imaging and differential diagnosis

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 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

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.

Integration of 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

integrating automated mensuration into creating treatment plans and determining maximum medical improvement. 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/Wolff's 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 Duabert standards.Ensuring Primary Care Status based upon an academic standards

Documenting primary and associated complaints, past history, allergies, medications, review of systems, previous treatment, family-social medical histories, previous tests and results, history or previous injuries and illnesses, on the job questionnaire, auto accident questionnaire, vital examination, neurological examination, orthopedic testing, test orders, prognosis and treatment plans. A detailed review of current CPT coding requirements for the proper documentation of E/M visits to properly code for billable patient services. Focused attention was paid to the performance of comprehensive patient history, physical examination, review of systems as well as determining the level of clinical decision making. Analysis of a properly organized E/M report was reviewed to demonstrate proper organization and language use,

Analysis of case flow, patient chart organization and EMR workflows to optimize the success and satisfaction of the patient encounter, feasibility of accurate and timely documentation as well as strategies to provide timely interprofessional clinical communication. Focus was provided on patient, primary care and medical specialty communication beginning at the initial visitation all the way through to the release from care. An internal compliance review to ensure complete documentation based upon the E/M level billed

The review of case histories of mechanical spine pathology and biomechanical 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 biomechanics 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 biomechanical 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 biomechanics of the spine.

Full Spine Digital Analysis, Digitalizing and analyzing the full spine images to diagnose pathobiomechanics as sequelae to trauma in relation to ligamentous failure and disc and vertebral pathology as sequelae. This includes anterior and posterior vertebral body elements in rotational 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 lumbar spine images to diagnose pathobiomechanics. This includes anterior and posterior vertebral body elements in rotational 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.

Relating current research trends in the whole spine model of patient including normal versus abnormal sagittal curvature in the adolescent adult 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.

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

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

Utilizing the scientific data to support a diagnosis, prognosis and treatment plan while meeting the admissibility standards based upon a professional’s credentials

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

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, 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. 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 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 cervical 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 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, 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

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

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

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

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

Full Spine Digital Analysis, 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

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

The application of spinal biomechanical 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

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

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.

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.

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

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.

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 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 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