Bradley Gorski DC, FSBT(c)
1662 Savannah Hwy, Ste. 115, CHARLESTON, SC, 29407
Phone: 843-225-3263
Cell: 2692774344
Fax: 843-225-3264
drbradgorski@gmail.com
https://elitefamilycharleston.com

 

Brad Gorski DC

1662 Savannah Hwy Ste 115., Charleston, SC, 29407

Phone: 843-225-3263

drbradgorski@gmail.com

https://www.charlestonspineandinjurycenter.com

 

 SELECTED OCCUPATIONAL HISTORY

Clinic Director, Doctor of Chiropractic, Elite Family Chiropractic LLC. dba Charleston Spine & Injury Center, Charleston, South Carolina, 2009 - Present 

 

EDUCATION AND LICENSURE

 

MRI Intrepretation Review Qualified – Cleveland University, Kansas City, 2022-present

Trauma Qualified – Cleveland University, Kansas City, 2021-present

 

Hospital Based Spine Care Qualified - Cleveland University, Kansas City, 2021-present

 

Candidate - Fellowship in Spinal Biomechanics & Trauma – Cleveland University, Kansas City, 2021-2023

Doctor of Chiropractic, Licensed in the State of South Carolina, License #3470, 2009 -Present

Doctor of Chiropractic, Palmer College of Chiropractic, Davenport, Iowa, 2009

National Board of Chiropractic Examiners, Part I-IV, 2008

Bachelor of Biomedical Science, Grand Valley State University, Michigan, 2005

 

SELECTED POST-GRADUATE EDUCATION CERTIFICATIONS AND DIPLOMATES

 

2023 National Spine Management Conference South – Role of a Spine Management Physician - Outline and overview of what a Spine Management Physician is, and the present day need in healthcare. Details relating to the Doctor of Chiropractic filling that role with specific discussion related to WHY physical therapy, nurse practitioners or physician assistants are unable to fill this position. Overview of a spine manager’s role in the evaluation and triage of non-operative spine patients was presented. Introduction to the diagnosis of non-specific spine pain was outlined with focus on the needs of primary care, pain management and spinal surgeons. National Spine Management Group, LLC, Parker University, Alabama State Board of Chiropractic Examiners, Kentucky Board of Chiropractic, Louisiana State Board of Chiropractic Examiners, Texas Board of Chiropractic Examiners, Florida Board of Chiropractic Medicine, Arizona Board of Chiropractic Examiners, Federation of Chiropractic Licensing Boards – PACE, 2023.

 

2023 National Spine Management Conference South – Moving From a Curative Model of Spine Care - A comprehensive look at the history of spinal care, degenerative changes and both regional and global spinal compensation. Outline the spine as a whole organ system that must be monitored in relation to physical activity, lifestyle, and traumatic patient history was discussed and presented. Application of spine management principles mirroring internal medicine disorders was presented and reviewed. Specific peer reviewed medically index research was presented outlining initial criteria for determining medical necessity of supportive spine care. National Spine Management Group, LLC, Parker University, Alabama State Board of Chiropractic Examiners, Kentucky Board of Chiropractic, Louisiana State Board of Chiropractic Examiners, Texas Board of Chiropractic Examiners, Florida Board of Chiropractic Medicine, Arizona Board of Chiropractic Examiners, Federation of Chiropractic Licensing Boards – PACE, 2023.

 

2023 National Spine Management Conference South – Interprofessional Communication with Primary Care Physicians - Research trends and working with primary care physicians was outlined. Focus on the conservative management of spinal conditions, aiding the primary care clinic and working to prevent unnecessary escalation of care. Reduction in opioid utilization and reduced surgery trends will be discussed. Research documenting modulation of pain at the central nervous system level with the chiropractic adjustment was presented. Application to real world scenarios including evaluation and management documentation was reviewed. Details of effective communication were presented including phone call, email, fax, and text messaging within the HIPAA compliance environment was discussed. National Spine Management Group, LLC, Parker University, Alabama State Board of Chiropractic Examiners, Kentucky Board of Chiropractic, Louisiana State Board of Chiropractic Examiners, Texas Board of Chiropractic Examiners, Florida Board of Chiropractic Medicine, Arizona Board of Chiropractic Examiners, Federation of Chiropractic Licensing Boards – PACE, 2023.

 

2023 National Spine Management Conference South – Interprofessional Communication with Pain Management Physicians - Chiropractic diagnosis of spinal ligament pathology will be discussed in the context of co-management with pain management specialists. Specific review of the role of a fellowship trained interventional pain management physician in your community will be presented. Review of epidural steroid injection, medial branch block and spinal ablation will be presented in the context of when and how to refer. National Spine Management Group, LLC, Parker University, Alabama State Board of Chiropractic Examiners, Kentucky Board of Chiropractic, Louisiana State Board of Chiropractic Examiners, Texas Board of Chiropractic Examiners, Florida Board of Chiropractic Medicine, Arizona Board of Chiropractic Examiners, Federation of Chiropractic Licensing Boards – PACE, 2023.

 

2023 National Spine Management Conference South – Interprofessional Communication with the Spine Surgeon - Spinal sagittal balance and spine surgery research trends will be reviewed. Chiropractic’s role in the conservative management of spinal biomechanics pre-surgery and post-surgery will be outlined. Terminology and documentation requirements will be presented. National Spine Management Group, LLC, Parker University, Alabama State Board of Chiropractic Examiners, Kentucky Board of Chiropractic, Louisiana State Board of Chiropractic Examiners, Texas Board of Chiropractic Examiners, Florida Board of Chiropractic Medicine, Arizona Board of Chiropractic Examiners, Federation of Chiropractic Licensing Boards – PACE, 2023.

 

2023 National Spine Management Conference South – Anatomy and Physiology of the Healthy Intervertebral Disc - Anatomy of the healthy intervertebral disc and its nerve supply will be reviewed. A brief overview of the biochemical structure of the intervertebral disc will be presented. The role of the intervertebral disc as a spinal stabilizer and its influence on facet joint function will be outlined. Specific attention will be given to radiologic vocabulary such as intervertebral disc herniation, extrusion, sequestration, and traumatic annular tears. MRI samples will be provided demonstrating

 

2023 National Spine Management Conference South – Anatomy and Physiology of the Degenerated Intervertebral Disc - Anatomy of the degenerative intervertebral disc and its nerve supply will be reviewed. An overview of the biochemical process of intervertebral disc degeneration will be outlined. Specific attention will be given to the Pfirrmann Scale and radiographic terms such as desiccation, intervertebral disc bulge and degenerative annular tears.

 

2023 National Spine Management Conference South – Basic Spinal Biomechanical Modeling – Basic spinal biomechanical principles will be reviewed including sagittal spinal alignment and coronal positioning in relation to the spinal facet joints. Research trends including symptomatic vs asymptomatic spinal parameters will be presented in the context of the Doctor of Chiropractic as the portal of entry spine care provider.

 

2023 National Spine Management Conference South – Spinal Ligament Histological Structure and Function - Histology of ligament structure and function will be presented. Microanatomy and the wound repair process will be discussed. Structural deficits post ligament injury will be presented and reviewed. Anatomical positioning of ligamentous structures will be outlined with specific attention to the spinal enthesis and the difference between an enthesophyte and osteophyte in spinal degeneration.

 

2023 National Spine Management Conference South – Spinal Ligament Traumatic Pathology - Ligament pathology as a source of persistent spinal pain and dysfunction will be outlined and reviewed. Objectifying ligament injury will be presented, and context will be provided using plain film radiographs and MRI examples. Focus on facet capsules and interspinous ligament will be central to the discussion.

 

2023 National Spine Management Conference South – Compliance and Documentation - Review of federal documentation guidelines with specific focus on CPT coding for initial and re-evaluation visits. Detailed outcomes of documentation audits by insurance carriers, regulator and special investigators will be presented in a case study format. Emphasis will be placed interprofessional communication and compliance.

 

2023 National Spine Management Conference South – Trends in Chiropractic Research - Review and discussion of 2022/2023 research supporting the chiropractic profession and the doctor of chiropractor as a spine care manager. Specific papers will be presented related to the pain management, corrective, and health maintenance phases of chiropractic care. Overview of current and future research trends will be demonstrated.

 

Chiropractic Diagnosis and management of cervical spine disc herniation 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022 

 

Grand Rounds – Chiropractic Management – CT Lumbar Spine Anatomy – detailed review of anatomical structures in the axial, sagittal and coronal planes of CT of the lumbar spine. Musculature presented included gluteus medius, psoas major, multifidus, iliacus, lumbar paraspinals and quadratus lumborum in both the T1 and T2 axial sequences. Emphasis was placed on the structure and morphology of the hard tissues of the spine with particular focus on the facet joints and pars interarticularis. Location and anatomical structure of the sacroiliac joint was presented and discussed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards – PACE, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences – 2022.

 

2023 Demonstrative Documentation Requirements, Analyzing the requirements in anatomical diagnostic imagery to communicate spinal pathology. Integrating technology, clinical findings, and advanced graphic tools to communicate a diagnostic conclusion. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022

 

MRI Spine Advanced Clinical Case Grand Rounds, 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.  Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022

 

Non-Specific Spine Pain, Chiropractic and Outcomes, 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022

 

Spinal Tumor MRI Interpretation, Diagnosing and documenting: Ependymoma, Astrocytoma, Hemangioblastoma, Lipoma, Meningioma, Neurofibroma, Schwannoma, Myxopapillary Ependymoma. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022

 

Demonstrative Narrative and Evaluation and Management Report Writing, 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022

 

Age-Dating Ligament/Connective Tissue Physiology and Pathology, 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022

 

Clinical Grand Rounds in Biomechanics, Digitizing, and Advanced Imaging: Case reviews concluding and accurate diagnosis, prognosis, and treatment plan utilizing evidence-based instrumentation and algorithmsUsing demonstrative reporting of case findings to collaborate with co-treating physicians. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022

 

Medical-Legal Documentation: 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022

 

Grand Rounds – Chiropractic Management and Patient Triage – review and discussion on the beginning of patient triage at phone intake was presented and related to the physical examination, review of diagnostic imaging and diagnosis. Detailed discussion of proper triage protocols including physical examination findings, plain film radiographs, MRI, diagnosis, and response to care was presented. Evidence based utilization of advanced imaging protocols was detailed including presence of neurological deficit non-response to care, increase in radicular symptoms and spinal instability on plain film imaging. Overview of interprofessional communication during triage including last E/M report, imaging reports, specialist referral and demographic sheet was presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards – PACE, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences – 2022.

 

Grand Rounds – Indications and Absolute/Relative Contraindications to Chiropractic Care – review of inclusion criteria accompanying modification of chiropractic treatment plan due to an absolute or relative contraindication to chiropractic care. Examples of clinical rationale, physical examination findings and proper diagnoses were provided. Review of the definitions of both relative and absolute contraindications to chiropractic care, specific details on referral to medical specialty were provided. Analysis of regional contraindications and treatment in adjacent regions were provided and discussed. The keys to understanding indications to care were detailed including the patient interview, review of medical records, diagnosis, and spinal examination findings. Review of most common reasons for chiropractic license violations were presented including application of the chiropractic adjustment to a contraindicated condition, failing to refer in the presence of a contraindication, failure to properly evaluate the patient to determine if a contraindication is present and failing to properly document the patient encounter. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards – PACE, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences –2022.

 

Clinical Grand Rounds – x-ray dosage, sagittal balance and surgery success rates – discussion related to millisievert and cumulative effective dose was presented. Outline of the definition and research process of achieving Minimal Clinical Important Difference in spine surgery was discussed. CED levels below 100mSv was reviewed and compared to patients receiving multiple plain film radiographs. Discussion and relation of spinal biomechanics, sagittal balance, utilization of spine radiographs and MRI to working with the neurosurgeon was outlined. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards – PACE, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences – 2022.

 

Clinical Grand Rounds – Trial Testimony and the Spine Management Patient – discussion and presentation of the trial process and requirements of both the treating physician and expert physician was outlined. Emphasis was placed on detailed preparation of case flow and objective demonstrable findings. Review of courtroom proceedings including witness and expert testimony was included. Expert versus treating physician requirements were presented. Emphasis was placed on thorough evaluation and narrative reporting processes to prepare for court room questioning. Specific review of illustration of demonstrative evidence was outlined. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards – PACE, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences – 2022.

 

Clinical Grand Rounds – Intervertebral Disc Nomenclature and Morphology – discussion of intravertebral disc morphology was presented and reviewed. Correlation between morphological and ideological findings was presented. Detailed review of spondylosis deformans, intravertebral osteochondrosis, intravertebral disc herniation and bulge was outlined. Specific detail was placed on changes in disc morphology due to ligament injury in the human spine. Clinical correlation of disc  herniation versus disc bulge was presented. Overview and detailed analysis of types of annular tearing in the desk was presented with an emphasis on the delineation between clinical findings and findings on advanced imaging. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards – PACE, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences – 2022.

 

Documenting Herniated Discs, Age-Dating Disc Pathology, and Connective Tissue Pathology as Sequella to Trauma Case Management, Spinal MRI and Documentation 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 vs. normal and bulging discs and protruded, extruded and fragmented discs. Normal vs. Pathological connective tissues and age-dating herniated discs. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

Case Management of Traumatic Spinal Injuries Case Management, Spinal MRI and Documentation, 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. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

Managing Herniated and Bulging Discs, Serious Injury in Non-Herniated Cases from Trauma Case Management, Spinal MRI and Documentation, Managing Herniated and Bulging Discs, Serious Injury in Non-Herniated Cases from Trauma, Spinal disc morphology, and innervation. Herniated, bulged, protruded, and sequestered disc characteristics and management. Literature-based documentation requirements for no-dis spinal injuries. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

Herniated Discs and Permanent Brain Malfunction & Biomechanical Failure  Case Management, Spinal MRI and Documentation, 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. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

Demonstrative Documentation of Disc Herniationand MRI Physics Case Management, Spinal MRI and Documentation, Demonstrative Documentation of Disc Herniationand MRI PhysicsUnderstanding 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. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

Post-Traumatic Herniated Discs, Related Migraines-Headaches & Strain/Sprain Permanences Case Management, Spinal MRI and Documentation, Post-Traumatic Herniated Discs, Related Migraines-Headaches & Strain/Sprain Permanences, 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. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

Documentation of Low-Speed Crashes in Determining Etiology of Serious Bodily Injuries Case Management, Spinal MRI and Documentation, 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 the forces involved to conclude a differential diagnosis, while concurrent ruling malingerers, if applicable. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

MRI Spinal Anatomy, 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 discs in both trauma and non-trauma patients and the biochemical properties of joints in age dating pathology. Disc bulges from degenerative and sequela to osseous issues, herniation pathology and protrusion, extrusion, migrated and sequestered variations. Clinical scenarios as sequela to disc and pre-existing pathologies. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2022

 

MRI Spine InterpretationHerniated, 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 relationshipCleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2022

 

Diagnosis and Management of Vertebral Osteomyelitisreview of the causes of vertebral osteomyelitis was presented including findings on patient subjective complaint and objective findings on physical examination. Differentiation between plain film radiographs, T1, T2, Flair and STIR weighted imaging was presented and discussed. Associated clinical findings including infections in adjacent areas including intervertebral discitis areas was presented. Causes of osteomyelitis including past surgical procedure, frequent injections, infection in an adjacent tissue, IV drug use and long-term corticosteroid use were presented. Anterior elements of the functional motor unit were outlined as the primary location of osteomyelitis. Correlation clinically to difficulties in identifying this clinical entity in its early stages was reviewed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2022.

 

Extremity MRI & Xray Interpretation of the Hip, Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

Extremity MRI & Xray Interpretation of the KneeIdentifying 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. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

Extremity MRI & Xray Interpretation of the Knee, Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

Extremity MRI & Xray Interpretation of the HandIdentifying 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. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

Extremity MRI & Xray Interpretation of the FootIdentifying 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. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

Extremity MRI & Xray Interpretation of the WristIdentifying 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. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

Extremity MRI & Xray Interpretation of the HandIdentifying 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. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

Extremity MRI & Xray Interpretation of the HipIdentifying 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. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

Extremity MRI & Xray Interpretation of the ShoulderIdentifying 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. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

Extremity MRI & Xray Interpretation of the Shoulder, Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

Extremity MRI & Xray Interpretation of the ElbowIdentifying 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. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022

 

MRI Interpretation Review Qualified, Recognized by Cleveland University-Kansas City, Chiropractic and Health Sciences with courses recognized by the ACCGME in conjunction with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences. Qualification language approved by the American Chiropractic College of Radiology (ACCR) and the American Chiropractic Board of Radiology (ACBR)

 

Diagnosis and Management of Lumbar Disc Herniationcase review of traumatically induced 10mm L5-S1 intervertebral disc extrusion was presented. Correlation of neurological examination including testing of myotomes, dermatomes and deep tendon reflexes was presented. Detailed review of sagittal T1, sagittal T2, axial T1, axial T2 as well as STIR images were presented. Clinical referral for surgical consultation was outlined and clinical rationale was presented. Review of the different between anatomical and functional sources of pain were outlined with a focus on biomechanical parameters such as pelvic incidence. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2022.

 

Diagnosis and Management of Lumbar Arachnoiditisoutline of the causes of arachnoiditis in the human spine was presented. Specific focus was on a case of lumbar arachnoiditis involving the cauda equina evidenced on T1, T2 sagittal and axial MRI. Treatment options and lack of curative interventions was presented. Relevant anatomy of the lumbar spine including cauda equina, conus medullaris, filum terminale, dura mater, pia mater and arachnoid mater were reviewed in detail. Review of arachnoiditis and chiropractic adjustment were discussed as well as interprofessional coordination of care with interventional pain management and surgical consultation. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2022.

 

Hospital Based Spine Care QualifiedCredentialed in hospital protocols, emergency room protocols, acute and chronic patient triage inclusive of MRI spine interpretation, spinal biomechanical engineeringhead trauma, concussion, mild traumatic and traumatic brain injuries. Co-credentialed through the ACCME (Accreditation Council for Continuing Medical Education), Cleveland University – Kansas City and the Academy of Chiropractic, Long Island, New York, 2021

 

Clinical Grand Rounds – Chiropractic Diagnosis and Management of Cervical Ligament Laxitydetailed outline of injury thresholds of the anterior longitudinal, posterior longitudinal and ligamentum flavum was presented. Review of structural and physiological properties relating to stress/strain curve of the above ligaments. Outline of the toe region, linear region and failure region was demonstrated. Transversely isotropic material properties of spinal ligaments was included and correlated to chiropractic care and impairment rating using the AMA Guides to the Evaluation and Management 5th and 6th editions. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

 

Chiropractic Diagnosis and Management of Lumbar Ligament Laxity – detailed outline of injury thresholds of the anterior longitudinal, posterior longitudinal and ligamentum flavum was presented in the lumbar spine. Review of structural and physiological properties relating to stress/strain curve of the above ligaments. Outline of the toe region, linear region and failure region was demonstrated. Transversely isotropic material properties of spinal ligaments was included and correlated to chiropractic care and impairment rating using the AMA Guides to the Evaluation and Management 5th and 6th editions. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

 

Chiropractic Diagnosis and Management of Whiplash Disorder – outline and discussion of Whiplash as a mechanism of injury with particular focus on damage to underlying tissue structures. Review of anatomy, with specific focus on surrounding muscular, supraspinous ligament, interspinous ligament, spinal nerve, spinal cord, facet capsule and dorsal/ventral nerve roots was presented. Clinical correlation to imaging studies and its influence on management of the Whiplash patient was reviewed. Focused attention was paid to Whiplash as a mechanism of injury and not a complete diagnosis. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

 

Diagnosis and Management of Post-Surgical Cervical Facet Syndromea case of persistent and worsening neck and left shoulder pain post-surgical fusion was presented. Pre and post plain film and advanced imaging slides were reviewed and correlated clinically to left sided mid-scapular pain. Physical examination including orthopedic and neurological testing was discussed in correlation to presenting symptoms. Differential diagnosis of radiculopathy, radiculitis, discogenic pain, scapular myofascial syndrome and thoracic intersegmental dysfunction was presented. Cervical facet joint referral patterns were reviewed and outline of referral for diagnostic facet joint block was discussed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

 

Chiropractic Diagnosis and Management of Vertebral Compression Fracture – review of the influence of osteoporosis on development of vertebral compression fracture was reviewed and detailed in comparison to neoplasm. Utilization of MRI as the gold standard for evaluating the age of and pathophysiology was discussed and presented. Absorptiometry was outlined and presented in relation to monitoring bone density. Interprofessional communication of absolute versus relative contraindications to conservative care and spinal manipulation was outlined and reviewed. Review of the three columns of vertebral architecture was detailed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

 

Chiropractic Diagnosis and Management of the Post-Surgical Patient - outline and analysis of spinal biomechanical parameters in a whole spine model of care in the post-surgical analysis of the spine pain patient. Review of the details of measuring Pelvic Incidence and discussion of history of its analysis in relation to sagittal balance and vertebral body rotation was discussed. Outline of movement from a regional model of spine care to a full spine model was presented particularly in the context of pain management strategies post-surgery. Analysis of the components of the post-surgical patient including muscle movement patterns, segmental mobility, spinal curvature and rotation in the coronal, sagittal and axial planes was presented. Interprofessional communication and co-management was emphasized. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences –2021.

 

Clinical Grand Rounds – Chiropractic Management of Cervical Myelopathy – review of all relevant spinalanatomy in the cervical and lumbar spine including vertebral bodies, central canal, neuroforamen, ligamentum flavum, anterior and posterior longitudinal ligaments, facet capsule, interspinous ligament, supraspinous ligament and spinal cord anatomy. Review of spinal cord anatomy included white and gray matter, ventral and dorsal nerve roots, spinal nerve including the dura mater, arachnoid mater and pia mater. Specific review of patient history, mechanism of injury, physical examination including neurological and orthopedic evaluation as well as criteria for ordering and reading advanced imaging such as MRI and CT were presented in relation to cervical myelopathy, spinal cord compression and myelomalacia. Patient centered; consensus driven clinical diagnosis including interprofessional communication was presented, specific presentation relating to diagnostic outcomes and management. Attention was given to MRI and CT myelogram in both the uncomplicated and complicated patient. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

 

Chiropractic Diagnosis and Management of the Pre-Surgical Patient – outline and analysis of spinal

biomechanical parameters in a whole spine model of care. Review of the details of measuring Pelvic

Incidence and discussion of history of its analysis. Outline of movement from a regional model of spine

care to a full spine model was presented. Analysis of the components of the pre-surgical patient

including muscle movement patterns, segmental mobility, spinal curvature and rotation in the coronal,

sagittal and axial planes was presented. National Spine Management Group, LLC, Federation of

Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine

and Biomedical Sciences – 2021.

 

Clinical Grand Rounds – Chiropractic Management of Cervical Disc Herniation – clinical differences  between etiology and morphology were reviewed and presented. Outline of patient history, physical  examination including neurological and orthopedic evaluation as well as criteria for ordering and reading  advanced imaging such as MRI and CT were presented. Plain film static and dynamic radiographic  studies were reviewed. Patient centered; consensus driven clinical diagnosis including interprofessional  communication was presented. Specific anatomical location of cervical intervertebral disc herniation  was presented and correlated to neurological findings on physical examination. National Spine  Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at  Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

Clinical Grand Rounds – Chiropractic Management of Cervical Facet Syndromereview of the pathogenesis and morphological presentation of cervical facet syndrome. Outline of patient history,  physical examination including neurological and orthopedic evaluation as well as criteria for ordering  and reading advanced imaging such as MRI and CT were presented. Discussion involving ligamentous  structures such as interspinous ligament, supraspinous ligament and facet capsules was presented. Plain  film static and dynamic radiographic studies were reviewed as well as specific sclerotogenous referrals  patterns of facet mediated pain. Patient centered; consensus driven clinical diagnosis including  interprofessional communication was presented, specific presentation relating to diagnostic medial  branch blocks and pain management referral was emphasized. . National Spine Management Group,  LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs  School of Medicine and Biomedical Sciences – 2021.

2021 Spine Management Conference – West – The Spine Management Physiciandiscussion of  the Spine Management Physician concept utilizing supportive evidence was presented. Outline  of trends in spinal pain management versus a curative model was discussed. 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  physician dedicated to spine management oversight was outlined. Key differences between  Spine Management Physician and Primary Spine Care were discussed. National Spine  Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University of  Health Sciences, College of Chiropractic, Kansas City 2021

2021 Spine Management Conference – West – Chiropractic Evidence – Pain Management Careoutline 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. National  Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland  University of Health Sciences, College of Chiropractic, Kansas City 2021 

2021 Spine Management Conference – West – Chiropractic Evidence – Corrective Carespecific trends in the biomechanical assessment of the human spine were provided and  discussed. 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 were presented and discussed. Sagittal alignment and its relation to pelvic  incidence was reviewed in relation to asymptomatic parameters. Interprofessional  communication relating to biomechanical stabilization and spinal rehabilitation was outlined  and reviewed. 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. National Spine Management Group, LLC, Federation of  Chiropractic Licensing Boards, Cleveland University of Health Sciences, College of Chiropractic,  Kansas City 2021

2021 Spine Management Conference – West – Physical Examination WorkflowsCervical 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. National  Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland  University of Health Sciences, College of Chiropractic, Kansas City 2021 

2021 Spine Management Conference – West – Physical Examination Workflows – 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 was stressed and its  correlation to physical examination, red flags and relative vs absolute contraindications to  chiropractic care was reviewed. Patient positioning and efficient processes was reviewed and  demonstrated. Details relating to lumbar spine and pelvic orthopedic testing was discussed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland  University of Health Sciences, College of Chiropractic, Kansas City 2021 

2021 Spine Management Conference – West – Interprofessional Communication and Reporting  – review of electronic health record workflows were presented and discussed with emphasis on  CPT compliant and efficient reporting. The importance of communication with the patient’s  other healthcare providers was outlined and discussed. Specific needs of the primary care  physician, pain management physician and spine surgeon were outlined and reviewed. Details  of simplified vocabulary and necessity of thoroughness were emphasized. Administrative workflows ensuring regular and continued communication of clinical documentation was  provided. National Spine Management Group, LLC, Federation of Chiropractic Licensing  Boards, Cleveland University of Health Sciences, College of Chiropractic, Kansas City 2021 

2021 Spine Management Conference – West – Patient Communicationcommunication  techniques were discussed 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. Conversational interaction and dissemination of health information at the  appropriate comprehension level was provided. Proper reporting and interprofessional  communication were emphasized in a wholistic approach to supporting the patient’s needs.  National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland  University of Health Sciences, College of Chiropractic, Kansas City 2021

2021 Spine Management Conference – West – Ligamentous Response to Traumatic Injuryanatomical 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 5th and 6th 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. National Spine Management Group, LLC, Federation of  Chiropractic Licensing Boards, Cleveland University of Health Sciences, College of Chiropractic,  Kansas City 2021 

2021 Spine Management Conference – West – Causality and Spinal Ligamentous Injury - 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. National Spine Management Group, LLC, Federation of Chiropractic  Licensing Boards, Cleveland University of Health Sciences, College of Chiropractic, Kansas City  2021 

2021 Spine Management Conference – West – Intervertebral Disc Morphologydetailed  discussion of the morphological descriptions of intervertebral disc pathology in the cervical,  thoracic, and lumbar spine was presented. Differential diagnosis of disc bulge, herniation,  protrusion, extrusion, and sequestration were presented. 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. National Spine  Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University of  Health Sciences, College of Chiropractic, Kansas City 2021 

2021 Spine Management Conference – West – Differential Spinal Tissue and Spinal Injury Triage  – 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. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland  University of Health Sciences, College of Chiropractic, Kansas City 2021 

2021 Spine Management Conference – West – Innervation of Spinal Structuresspecific  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. National Spine Management Group, LLC,  Federation of Chiropractic Licensing Boards, Cleveland University of Health Sciences, College of  Chiropractic, Kansas City 2021

Clinical Grand Rounds – Importance of Interprofessional Healthcare Communication and  TeamworkDiscussion of the history of interprofessional healthcare and the acknowledgement  by the World Health Organization was presented. Specific detail on chiropractic academia and  student perception of its importance was outlined. The growth and importance of both  interprofessional education and communication was stressed and reviewed. Need for a clear  professional identity to facilitate interprofessional education and communication was  presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing  Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical  Sciences – 2021.

Clinical Grand Rounds – Cervical Spinal Alignment and Knee Replacement Revision RatesReview of the most common cervical spinal sagittal alignment parameters and their relationship  to interprofessional communication was presented. Discussion of rationale for knee  replacement revision surgery including aseptic loosening, fracture and prosthetic joint infection  was reviewed. Specific statistical review on revision surgery and effective treatment of end stage knee osteoarthritis was presented. Details of evidence-based research outlining patients  with cervical degenerative disorders having a higher rate of total knee replacement revisions  than those without degenerative changes. Analysis of the benefit of radiographic studies  looking at the mechanical relationship between the cervical spine and knee composition was  outlined and reviewed. National Spine Management Group, LLC, Federation of Chiropractic  Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and  Biomedical Sciences – 2021.

 

Accident Reconstruction: Terms, Concepts and Definitions, 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. Cleveland University – Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2021

 

Accident Reconstruction: Causality, Bodily Injury, Negative Acceleration Forces, Crumple Zones and Critical Documentation, 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. Cleveland University – Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2021

 

Accident Reconstruction: Skid Marks, Time, Distance, Velocity, Speed Formulas and Road Surfaces, 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. Cleveland University – Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2021

 

Accident Reconstruction: Research, Causality and Bodily Injury, 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.Cleveland University – Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2021

 

Traumatic Brain Injury and Concussion Overview:  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. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021

 

Head Trauma and Traumatic Brain Injury Part 1: 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. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021

 

Head Trauma and Traumatic Brain Injury Part 2: 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. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021

 

Concussion And Electroencephalogram Testing: This 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. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021

 

Concussion And Electroencephalogram Testing Pathological Results: 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. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2021

 

Stroke Anatomy and Physiology: 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. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

 

Stroke Anatomy and Physiology: Stroke Types and Blood Flow, 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. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

 

Stroke Principles of Treatment an Overview for the Primary Care Provider, 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. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

 

Clinical Evaluation and Protocols for Identifying Stroke Risk, 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. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

 

Clinical Grand Rounds – Chiropractic Management of Chronic Spine PainDiscussion of chronic spine pain as a Public Health issue and Chiropractic’s role in its diagnosis and management. Epidemiological statistics of chronic pain sufferers consulting Doctors of Chiropractic in the United States was presented.  Outline of a spinal function and preventative model as opposed to a curative process was presented and reviewed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

Clinical Grand Rounds – Diagnosis of Ossification of Anterior Longitudinal Ligamentdiscussion of the different types of Ossification of Anterior Longitudinal Ligament (OALL) including Segmental, Continuous and Mixed in the sagittal plane.  Review of axial classification including Flat, Nodular and Globular was presented.  Anatomy of spinal ligaments including the anterior and posterior longitudinal ligament and their attachments was outlined. Context of dysphagia, its progression, symptoms and need for referral was reviewed and outlined.  National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

Clinical Grand Rounds – Aberrant Spinal Motion and Degenerative Disc Diseaseresearch analysis of mechanic factors as etiology of intervertebral disc degeneration.  Review of spinal tissue mechanics and their relation to mechanical stress was discussed and corelated to abnormal changes in the structure and composition of the intervertebral disc.  Detailed discussion of ingrowth of pain transmitting nerve fibers into degenerative intervertebral discs and their relationship to acute and chronic pain was presented.  Clinical correlation between congenital malformations of the spine, including scoliosis, kyphosis, spina bifida, spondylolysis and Klippel Feil syndrome), accidental back injury or ligament injury, occupational exposure and causing aberrant mechanical loading of lumbar spine, and intervertebral disc degeneration visible on T1, T2 and STIR MRI, sagittal and axial sequences was presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

Clinical Grand Rounds – Differentiating Degenerative vs Traumatic Cervical Spondylolisthesis. Outline of  spondylolisthesis clinical work up in the presence of spine pain including plain film dynamic radiographs,  regional MRI study and assessment of alteration of motion segment integrity of specific spinal  segments. Review of the correlation of present segmental degenerative changes such as loss of disc  height, osteophyte formation, ligament ossification and facet joint hypertrophy and its association to  pre-existing spondylosis was presented. Detailed discussion of past and present medical history including  past traumatic events was emphasized. National Spine Management Group, LLC, Federation of  Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and  Biomedical Sciences – 2021.

Spinal Trauma Pathology, Clinical Grand Rounds,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. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2021

Spinal Trauma Pathology, Research PerspectivesThe review of current literature standards in spinal trauma pathology and documentation review of biomechanical failure, ligamentous failure and age-dating disc pathology. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2021

Clinical Grand Rounds – Pelvic Incidence, Chiropractic and the Spine Surgeon – detailed analysis of the historical publication of Pelvic Incidence as a integral part of sagittal spinal balance.  Inter-professional communication with the surgeon using peer reviewed medically indexed biomechanical parameters was outlined and presented.  Functional interaction between the spine and pelvis was demonstrated and discussed.  Components of Pelvic Incidence, sacral slope, pelvic tilt and femoral heads were reviewed and demonstrated on plain film radiographs.  Specific updated research regarding spinal pelvic balance and pelvic incidence measurements was provided. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

Clinical Grand Rounds – Classification of Degenerative Cervical Degenerative Disc Disease- Review of a radiographic rating system for objective assessment of intervertebral disc degeneration in the cervical spine. The degree of degeneration was organized based on loss of disc height, formation of osteophytes and the presence of diffuse sclerosis of adjacent vertebral bodies. Specific details of assessment wereoutlined and presented. Comparison of plain film radiographs to cadaver specimens was demonstrated and discussed. Review of interobserver validity of the grading system between observers was presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

Clinical Grand Rounds – Mechanical Response of Damaged Human Cervical Spine LigamentsDiscussion of the biomechanical properties of cervical spinal ligaments under sub-failure loads. Ligaments discussed were the Anterior Longitudinal Ligament, Posterior Longitudinal ligament and the Ligamentum Flavum. Deformations exceeding physiological limitations were presented and reviewed. Grade I and Grade II injuries were outlined and discussed. Presentation included observed ligamentous injury significantly compromising ligament ability to give tensile support within physiological spinal motion. Findings were clinically correlated to long term sequalae in Alteration of Motion Segment Integrity and the AMA Guides to the Evaluation of Permanent Impairment 5th and 6th Editions. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

Clinical Grand Rounds – Facet Joint Thresholds and Alteration of Motion Segment IntegrityDiscussion of the predominant mode of joint loading of the cervical facet joints during whiplash injury related to retraction tension on the facet joint capsule. Review of shear forces, translation of the inferior and superior facet joint as well as injury risk due to excessive stretching of spinal ligaments was presented. Overview and discussion of mechanical trauma to ligament tissue and subsequent microstructural damage not visibly detected was outlined. Threshold for microstructural changes during retraction, reduced ligament stiffness and unrecovered strain was discussed in detail. Individual response to facet joint capsule response supported in the medical literature was presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

Documentation and Coding - 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, and a 99212-99213-99214-99215. Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City Long Island, NY, 2021

Demonstrative Documentation and Ethical Relationships - 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. Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City Long Island, NY, 2021

MRI Spine Interpretation - 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. Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City Long Island, NY, 2021

Clinical Grand Rounds – Advanced Imaging Upper Cervical Spine and DocumentationDiscussion and review of ligament injury in the upper cervical spine - Focus was on missed diagnosis due to a lack of imaging and interprofessional communication. Discussion of upper cervical anatomy including occipital condyles, C1/C2 articulation in both MRI, plain film and CT scanning was presented using imaging slides. Clinical documentation was reviewed with particular attention paid to clinical documentation errors form other providers. Discussion on case management and interprofessional communication to correct documentation errors was emphasized. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

Spinal Biomechanical Engineering Clinical Grand Rounds - 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. Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City Long Island, NY, 2021

Clinical Grand Rounds – Biomechanical Analysis in Patient Crash InjuriesDetailed review of the difference between biomechanical and biomedical analysis of injuries was presented. Outline of necessity of the use of properly credentialed biomechanical and crash investigation professionals in the diagnosis, management and reporting of crash injuries. Review of specific research related to forces during Activities of Daily Living and those sustained in a crash were presented. Details of a proper biomechanical analysis were discussed and specific review of a biomedical report omitting the mathematical calculations needed to determine force and injury potential was presented. Additional review of methods needed to determine expertise of the biomechanist or accident investigation was discussed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

Clinical Grand Rounds – Chiropractic Professional Liability LitigationDiscussion of thirty years of jury verdict data was reviewed and presented. Focus was on the rationale for claims against Doctor of Chiropractic and overall decisions rendered by jury pools. Outlining the risk factors associated with overly aggressive treatment, failure to diagnose and lack of interprofessional referral when medical necessary was presented with statistics. Comparison between chiropractic management and surgical management were outlined and detailed. Detailed analysis of causality versus correlation was presented and discussed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021

Clinical Grand Rounds–Inter-professional Communication with the Personal Injury AttorneyReview of the outlined of the initial and re-evaluation E/M reporting in an injured patient. Discussion targeted compliant reporting and interprofessional communication with the attorney. Specific methods of ensuring compliant reporting were discussed and outlined. Statutory language, permanency determination and impairment were presented and reviewed in contact of the final narrative report. Emphasis was placed on the objectification of persistent functional loss and causal relationship in the personal injury patient. Supporting medical evidence of intervertebral disc pathology including disc herniation, disc bulge and annular tear was provided. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

Clinical Grand Rounds – Prevalence of Spinal DegenerationDiscussion of the clinical occurrence of spinal degenerative conditions such as Diffuse Skeletal Hyperostosis (DISH), central stenosis, foraminal stenosis, degenerative disc disease and osteoporosis was presented. Advanced imaging and plain film radiological utilization in the diagnosis of spinal degermation was outlined and reviewed. Acute versus degenerative conditions in the spine were reviewed and detailed in relation to traumatic and non-traumatic events. Consensus driven parameters in the identification and rating of degenerative change severity was discussed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

Clinical Grand Rounds – Diagnosis of Lumbar Facet SyndromeOverview of the most common pain syndrome in the lumbar spine including societal burdens was presented. Discussion of facet joint arthrosis being the most frequent facet joint pathology in the human spine. Outline of level of correlation between clinical symptoms, physical examination findings and degenerative spinal conditions was discussed. Presentation of diagnostic facet block and the medical necessity of such a referral when indicated was outlined. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021.

Clinical Grand Rounds – Types of Annular Fissures on Advanced and Plain Film ImagingDetailed review of the structure and function of the human intervertebral disc was presented including annulus fibrosis, nucleus pulposus, cartilaginous endplate and sharpey’s fibers. Diagrams as well as MRI images were outlined and reviewed in both the cervical and the lumbar spines with particular focus on the difference between degenerative and traumatically induced changes. High intensity zone (HIZ) as a characteristic of injury to the posterior aspect of the annulus fibrosis best visualized on T1 sagittal MRI images. Detailed comparison of axial and sagittal T1, T2 and STIR images was outlined, discussed, and reviewed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences – 2021

Orthopedic Testing: Principles, Clinical Application and Triage, 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

Orthopedic Testing: Cervical Spine, 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

Orthopedic Testing: Lumbar Spine, 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

Orthopedic Testing: Clinical Grand Rounds, 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

MRI Spinal Anatomy and Protocols, 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. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

MRI Disc Pathology and Spinal Stenosis, 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. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

MRI Spinal Pathology, 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. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

MRI Methodology of Analysis, 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. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

MRI Clinical Application, 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. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

MRI Protocols Clinical Necessity, 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. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

MRI History and Physics, 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. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

MRI Interpretation of Lumbar Degeneration/Bulges, 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. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

MRI Interpretation of Lumbar Herniations, 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. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

MRI Interpretation of Cervical Degeneration/Bulges, 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. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

MRI Interpretation of Cervical Herniations, 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. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

MRI Interpretation of Degenerative Spine and Disc Disease with Overlapping Traumatic Insult to Both Spine and Disc, 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. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021  

Neurology of Ligament Pathology- Normal Morphology and Tissue Damage, 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. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2021

Neurology of Ligament Pathology- Spinal Biomechanics and Disc Pathology, Disc pathology as sequella to trauma; herniation, extrusion, protrusion, sequestration and how the spinal unit as one system creates homeostasis to balance the pathology. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2021

Neurology of Ligament Pathology- Neurological Innervation, 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. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2021

Impairment Rating, 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. Cleveland University - Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

Neurodiagnostics, Imaging Protocols and Pathology of the Trauma Patient, 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. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2021

Diagnostics, Risk Factors, Clinical Presentation and Triaging the Trauma Patient, 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. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2021

Crash Dynamics and Its Relationship to Causality, 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. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2021

MRI, Bone Scan and X-Ray Protocols, Physiology and 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. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2021

Documentation and Reporting for the Trauma Victim, 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. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2021

Neurodiagnostic Testing Protocols, Physiology and 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. Cleveland University - Kansas City,Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2021

Documenting Clinically Correlated Bodily Injury to CausalityUnderstanding 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. Cleveland University - Kansas City,Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2021

Spinal Biomechanical Engineering: Cartesian System, 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

Spinal Biomechanical Engineering: Cervical Pathobiomechanics, 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

Spinal Biomechanical Engineering: Lumbar Pathobiomechanics, 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

Spinal Biomechanics in Trauma, 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

Spinal Biomechanical Engineering & Organizational Analysis, 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

Spinal Biomechanical Engineering: Cervical Digital Analysis, 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

Spinal Biomechanical Engineering: Lumbar Digital Analysis, 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

Spinal Biomechanical Engineering: 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2021

Spinal Trauma Pathology, Triage and Connective Tissue Injuries and Wound Repair, 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. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2021

Spinal Trauma Pathology, Ligament Anatomy and Injury Research and Spinal Kinematics, 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. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2021

Spinal Trauma Pathology, Spinal Biomechanics, Central Nervous System and Spinal Disc Nomenclature, 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 grey matter, thalamus and cortices involvement. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2021

Spinal Trauma Pathology, Biomechanics of Traumatic Disc Bulge and Age Dating Herniated Disc Pathology, The biomechanics of traumatic disc bulges as sequelae from trauma and the comorbidity of ligamentous pathology. Age-dating spinal disc pathology in accordance with Wolff’s Law. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2021

Electrodiagnostics: Electromyogram/Nerve Conduction Velocity (EMG/NCV), Diagnosis & Interpretation: Anatomy and Physiology of Electrodiagnostics: 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. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island NY, 2021

Electrodiagnostics: Electromyogram/Nerve Conduction Velocity (EMG/NCV), Diagnosis & Interpretation: Nerve Conduction Velocity (NCV) Part 1: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. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island NY, 2021

Electrodiagnostics: Electromyogram/Nerve Conduction Velocity (EMG/NCV), Diagnosis & Interpretation: Nerve Conduction Velocity (NCV) Part 2: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. This section offers interpretation algorithms to help understand the neurodiagnostic conclusions. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island NY, 2021

Electrodiagnostics: Electromyogram/Nerve Conduction Velocity (EMG/NCV), Diagnosis & Interpretation: Needle Electromyogram (EMG) Studies:The EMG process, inclusive of how the test is performed and the steps required in planning and electromyographic study. This covers the spontaneous activity of a motor unit action potential, positive sharp waves and fibrillations. The insertional activity (both normal and abnormal), recruitment activity in a broad polyphasic presentation and satellite potentials. This covers the diagnosing of 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. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island NY, 2021

Electrodiagnostics: Electromyogram/Nerve Conduction Velocity (EMG/NCV), Diagnosis & Interpretation: 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. This section covers sample cases and health conclude and accurate treatment plans based upon electro-neurodiagnostic findings when clinically indicated. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island NY, 2021

Trends in Spinal Healthcare - 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. Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City, Long Island, NY, 2020

 MRI Spine Interpretation - 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. Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City, Long Island, NY, 2020

 Spinal Biomechanics - 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. Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City, Long Island, NY, 2020

Case Management of Mechanical Spine Pathology - 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. Academy of Chiropractic Post-Doctoral Division, Cleveland University – Kansas City, Long Island, NY, 2020

Diagnosing and Case Management - 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. Academy of Chiropractic Post-Doctoral Division, Cleveland University - Kansas City, Long Island, NY , 2020

Diagnosing and Case Management - 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. Academy of Chiropractic Post-Doctoral Division, Cleveland University - Kansas City, Long Island, NY , 2020

Pathobiomechanics and Documentation - 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. Academy of Chiropractic Post-Doctoral Division, Cleveland University  Kansas City, Long Island, NY, 2020

Using Documentation and Ethical Relationships - 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. Academy of Chiropractic Post-Doctoral Division, Cleveland University  Kansas City, Long Island, NY,

Spinal Biomechanical Engineering Clinical Grand Rounds - Case reviews utilizing E/M, MRI, and x-ray mensuration reports to conclude an accurate diagnosis, prognosis, and treatment plan. Common diagnosis requiring interprofessional collaboration with a discussion of diagnostic dilemmas and proper communication methods. Academy of Chiropractic Post-Doctoral Division, Cleveland University  Kansas City, Long Island, NY, 2020

Spinal Biomechanical Engineering Clinical Application - 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. Academy of Chiropractic Post-Doctoral Division, Cleveland University  Kansas City, Long Island, NY, 2020