SELECTED OCCUPATIONAL HISTORY

Clinic Director, Doctor of Chiropractic, Body Right Chiropractic, Clearwater, Florida, 2008 - Present

Founding Partner, Spine Trauma Network LLC, Palm Harbor, Florida, 2018 - Present

Clinic Director, Doctor of Chiropractic, Great Lakes Chiropractic, Traverse City, Michigan, 1998 - 2008

Clinic Director, Doctor of Chiropractic, Erickson Chiropractic Health Center, Traverse City, Michigan, 1998 - 1999

EDUCATION AND LICENSURE

Fellow in Spinal Biomechanics and Trauma, National Spine Management Group and Cleveland University-Kansas City, 2018

Doctor of Chiropractic, Licensed in the State of Florida, License # CH 8684, 2004 -Present

Doctor of Chiropractic, Licensed in the State of Michigan, License # 2301007661, 1998 - Present

Doctor of Chiropractic, Palmer College of Chiropractic, Davenport, Iowa, 1998

Internship, Nu-Best Diagnostic Labs, Palm Harbor, Florida, 1997 - 1998

Internship, Palmer Sports Injury Club and Mally Clinic, Davenport, Iowa, 1996 - 1997

National Board of Chiropractic Examiners, Part I, 1997

National Board of Chiropractic Examiners, Part II, 1997

National Board of Chiropractic Examiners, Part III, 1997

Bachelor of Arts in Chemistry, Hope College, Michigan, 1994

POST-GRADUATE FELLOWSHIPS, QUALIFICATIONS AND CERTIFICATIONS

Fellow in Spinal Biomechanics and Trauma (FSBT), 2018

Trauma Qualified, 2018

Primary Spine Care Qualified, 2018

Interprofessional Hospital Qualified, 2016

Board Certified Naturopathic Physician (BCNP), 2002

Certified Traditional Naturopath (CTN), 2009 - 2012

POST-GRADUATED FELLOWSHIP- SPINAL BIOMECHANICS AND TRAUMA

Pain Management Fellowship Rotation

Specialty Research in Pain Management – Clinical and Procedural – Growth of Interventional Pain Management Techniques and Current Trends in Pharmacological Management of Neuropathic Pain. ESI comparison to gabapentin in lumbosacral radicular pain – current trends and future progress of pain management interventions. Mode of action, required dosage, advantages and side effects profiles of currently available pharmacological approaches. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Therapeutic Effects of Spinal Injection Therapy - Facet, medial branch blocks, prolotherapy and epidural interventions utilization within the Medicare population, effectiveness on lumbar central canal stenosis with and without steroids and effect on prevention of spinal surgery, herniated disc, fibromyalgia and chronic musculoskeletal pain. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Adverse Events Associated with Injection Therapy – transforaminal and interlaminar epidural steroid injections, anesthesia technical considerations, effects on cervical radiculopathy midline versus paramedian approaches and perineurial injection of autologous conditioned serum. Review of FDA risk assessment. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Correlation of MRI Findings and Injection Outcomes - MODIC Changes on MRI and effectiveness of facet injection, facet joint signal change on MRI with fat suppression comparison with SPECT/CT. Discussion of Modic 1, 2 and 3 with correlation of clinical outcomes and patient selection criteria. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Therapeutic Effects of Botulinum Toxin and Dry-Needling in Myofascial Pain Syndrome – cost effectiveness, patient response and triage of therapeutic interventions.   Physiological review of trigger point etiology and clinical presentation of acute and chronic pain. Functional response of intervention including relief and recurrence. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Systematic Review Technical Considerations in Cervical Epidural Analgesia - Chemical blockage of cervical nerve roots, review of anatomical structures and correlation with MRI imaging. Blockage effects on the respiratory, circulatory and neurological systems. Review of cervical epidural space (CES) borders and variants in patient population. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Trends in opioid analgesic abuse and mortality in the USA, Evaluation of Opioid Pain Management in Injured Children, assessment of opioid reporting in Veteran Affairs – Emergency visitation in pediatric injury, pain management and adoption of best practices. Trends in use of prescription opioid medication using RADARS (Research Abuse, Diversion and Addiction Related Surveillance System), comparison between legitimate pharmacy channels and diversion and abuse. Opioid use prevalence and incidents in Veteran Affairs, new prescriptions or long-term conversion and relationship to persistent growth in opioid use. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Electrodiagnostic Testing, Transforaminal Epidural Steroid Injection, Intra-articular Facet Joint Injection, Spinal Manipulation Post-Epidural Injection– Needle EMG, active versus chronic denervation in lumbar, cervical spinal pathologies and differential diagnosis of spinal stenosis and intervertebral disc herniation. Systematic review of facet joint injections, clinical trials and conservative therapy in lower back pain. Results of spinal manipulation post-epidural injection in the cervical spine. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Radiofrequency Ablation and outcome measures - medication, function and pain in relation to pain of spinal origin. Medial Branch Block as prognostic tool prior to lumbar facet radiofrequency denervation. Clinical comparison disc herniation, disc bulge, cervical and lumbar radiculopathy.   Diagnosis and patient triage correlation to anatomical spine structures. Long, short term risk factors and outcomes in radiofrequency ablation.   Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Role of Cannabinoids in Pain Management – review of pharmacological, botanical or synthetic origins of cannabinoids. Mechanism of action in alleviation of pain including analgesic, anti-inflammatory effects, modular actions on neurotransmitters and interactions with prescribed or endogenous opioids. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

MRI Physics Fellowship Rotation

Specialty Research in MRI Physics – The Hardware – magnet types including permanent, resistive and superconducting magnets. Volume RF, surface, quadrature and phase array coils and other hardware necessary for the generation of MRI imaging. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in MRI Physics – Physics of Image Generation 1 – magnetization, excitation, relaxation, acquisition, computing and display. T1 relaxation and relaxation curves, T2 relaxation, phase and phase coherence, T2 relaxation curves. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in MRI Physics – Physics of Image Generation 2 – gradient coils, signal coding including slice encoding gradient, phase encoding gradient, Frequency encoding gradient. Gradient specifications and slice thickness. Filling k-space, k-space symmetry and k-space filling technique.   Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in MRI Physics – Physics of Image Generation 3 – pulse sequences, spine echo sequences including multi-slicing and multi-echo sequencing. T1, T2, proton density contrast and their applications. Turbo spine echo, fast advanced spine echo (HASTE) sequence and gradient echo sequence. Inversion recovery sequence including STIR and FLAIR sequence. Choosing the right sequence pros and cons, T1, T2 and PD parameters. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in MRI Physics – Physics of Image Generation – technical parameters and artifacts – repetition time, echo time, flip angle, inversion time, number of acquisitions, matrix and field of view. Slice thickness, slice gap, phase encoding direction 1 and direction 2 and relation to bandwidth. Motion artifact, para-magnetic artifact, phase wrap artifact, susceptibility artifact, clipping artifact, spine and zebra artifacts. Effects on image quality and acquisition. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Neuroradiology Fellowship Rotation

Specialty Research in Neuroradiology – radiographic evolution of a Schmorl’s node – acute Schmorl’s node and progression to chronic stage comparison to serial MRI.   Endplate fracture and acute presentation and correlation to clinical findings and pain patterns.   Presentation in plain film radiograph and MRI images were compared and contrasted in both acute and chronic stages. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neuroradiology – syringomyelia, fluid dynamics and spinal cord motion – scoliosis curve patters and syrinx characteristics versus Chiari I malformation. Normal MRI appearance and motion artifacts related to cerebral spinal fluid motion related phenomena and common appearances on MRI imaging. Syrinx wall and fluid motion and correlation to cardiac cycle with comparison between systolic and diastolic presentations. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neuroradiology – Spinal Biomechanics, Thoracolumbar Deformity and Surgical Outcomes – full spine analysis, adjacent spinal biomechanics and its impact on surgical outcomes. Sagittal alignment pelvis to cervical spine and association with kyphosis and lordosis mechanical positioning. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neuroradiology – MRI and EMG comparison in denervated muscle diagnosis – lumbar spine pathology and age in relation to paraspinal muscle size and fatty infiltration. Fatty degeneration of paraspinal muscle in degenerative lumbar kyphosis and CT versus MRI digital analysis. Positive correlations with edema on MRI and fibrillations, positive sharp waves, denervation and the level of reduced recruitment pattern. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neuroradiology – association between annular tear and disc degeneration – high intensity zone (HIZ) in lumbar disc and association to annular fissure on MRI. Identification of duel HIZ and its relationship to acute inflammation and calcified tissue and its association with discogenic pain patterns. Influence of phenotype, population size and inclusion sequence. T1, T2 and STIR imaging comparison and correlation. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neuroradiology – degenerative cervical myelopathy – paraspinal muscle morphology, clinical symptoms and functional status. Review of fatty infiltration, asymmetry findings and correlation with clinical symptoms and functional scores. Review of complex anatomical arrangement of superficial and deep muscle layers in the cervical spine, correlation to MRI findings. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neuroradiology – MRI Neurography, Diffuse Tensor Imaging (DTI) – diagnostic accuracy and fiber tracking in spinal cord compression. Review of spinal cord structural integrity, peripheral neuropathy and correlation to diffuse tensor imaging findings. Comparison in combining DTI with T2 and T2 alone and its value in magnetic resonance neurography. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neuroradiology – Nomenclature and Classification of Lumbar Disc Pathology – modified Pfirrmann grading system and lumbar disc degeneration. Consensus driven description of intervertebral disc nomenclature including intervertebral disc bulge, herniation, protrusion, broad based disc herniation, extrusion and sequestration. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neuroradiology – MRI evaluation of intradural tumor – neuroimaging of spinal tumors and correlation to histological study. Determining method of choice for evaluation, review of numerous types of intradural-extramedullary masses including meningioma and schwannoma. Signal intensities, contrast enhancement patterns, presence of cysts and other key differentiation findings of spinal cord tumors. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neuroradiology – Spinal Cord Compression, Myelomalacia, MRI Imaging and Clinical Correlation – positional cervical spinal cord compression and fibromyalgia. T1 and T2 weighted images, comparison of hypo and hyperintense signals and extent of intramedullary changes on MRI. Review of MRI findings associated with myelomalacia and discussion of correlation with clinical findings. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neuroradiology – MRI Characteristics of Lumbar Facet Synovial Cyst – formation characteristics of synovial cyst, relation to degenerative changes in spinal facet joints as demonstrated on MRI.   Pre and post-surgical procedural MRI were reviewed and compared. Surgical management and subsequent resection were demonstrated. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neuroradiology – Variability in MRI Diagnostic Error Rates – in depth review of quality of MRI imaging and comparison to consistent MRI diagnosis between facilities.   Errors of interpretation in the study examinations were considered and presented.   Impact of radiological diagnosis, location of MRI study and reading radiologist and impact on treatment choice and clinical outcomes. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Orthopedic Surgery – Extremity Fellowship Rotation

Specialty Research in Orthopedic Extremity Surgery – Wrist Anatomy and Osseous Kinematics – normal kinematics using biplanar radiographic model were reviewed. Discussion of extensive database of carpal bone anatomy and kinematics from a large number of healthy subjects. 3-D motion of each bone was calculated for each wrist position and discussed. Database constructed including high-resolution surface models, measures of bone volume and shape, and the 3-D kinematics of each segmented bone. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery – Normal Motion of the Shoulder and Glenohumeral Instability – normal motion of the shoulder joint compared with clinical implications of glenohumeral joint instability including surgical recommendations. Review and overview of the anatomy of the glenohumeral joint, emphasis on instability based on the current literature. Description of detailed anatomy and anatomical variants of the glenohumeral joint associated with anterior and posterior shoulder instability. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery – Orthopedic Testing and Shoulder Pathology Diagnosis - use of orthopedic special tests (OSTs) to diagnose shoulder pathology and clinical examination. Review OST clusters, examination of methodology and illustration of their use in arriving at a pathology-based diagnosis. Discussion of examination of the biceps tendon and clinical relevance. Review of SLAP lesion and shoulder impingement syndrome were reviewed.Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery – Electrodiagnostic Testing and Carpal Tunnel Syndrome – Review of the most common mononeuropathy in the human body.   Relationship between clinical findings, neurological examination and electrodiagnostic testing in the diagnosis of carpal tunnel syndrome. Acute and chronic symptoms including progression of the disorder were reviewed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery – Current Concepts in Elbow Disorders – Detailed anatomy of osseous, ligamentous and muscular structure of the elbow was reviewed. Common disease of elbow disorders and their treatment was discussed. Lateral epicondylitis and medial collateral ligament injury of the elbow were outlined. Rheumatoid arthritis, posttraumatic osteoarthritis, and elderly patients with comminuted distal humeral fractures. Surgical design and technique were outlined. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery – Differentiating Cervical Spine from Shoulder Pathology – anatomical review of cervical spine and glenohumeral joint focus on similarities and differences. Cervical disorders masking shoulder pain, cervical radiculopathy, cervical spondylotic myelopathy, facet and discogenic pain patterns were outlined.   Details of shoulder pathology parsonage-tuner syndrome, subscapular neuropathy and thoracic outlet were presented. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery – MRI of the Shoulder and Shoulder Girdle – review of MRI analysis of scapular fracture.   Detailed review of scapular function rehabilitation and training on chronic pain syndromes. Reliability of magnetic resonance imaging versus arthroscopy for the diagnosis and classification of superior glenoid labrum anterior to posterior lesions.Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery -Cataloging Movements of the Ankle, Hip and Spine - Review Standardization and Terminology Committee (STC) of the International Society of Biomechanics (ISB) and classification of joint kinematics. Standard for the local axis system in each articulating bone is generated and presented.   Rationale for international standards among researchers was presented.Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery -Cataloging Movements of the Shoulder, Elbow, Wrist and Hand - Review Standardization and Terminology Committee (STC) of the International Society of Biomechanics (ISB) and classification of joint kinematics. Standard for the local axis system in each articulating bone is generated and presented. Rationale for international standards among researchers was presented.Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery – MRI and Diagnosis of Shoulder Disorders – normal and abnormal shoulder anatomy as viewed on MRI was presented. Review and presentation of MRI in the diagnosis and treatment of brachial plexus injury. Discussion of preganglionic avulsions and muscular denervation. Comparison of CT myelography to MRI myelography were outlined. Enhanced three dimensional T1 high-resolution isotropic volume excitation MR in the evaluation of shoulder pathology. Comparison with two-dimensional enhanced T1 fat saturation MRI were discussed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery – Clinical Evaluation of Upper and Lower Extremity Pathology – review of relevant anatomy in shoulder, elbow, wrist, hip, knee and ankle was presented. Physical examination including orthopedic, neurological and range of motion testing was presented and compared with findings on MRI results. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Orthopedic Spine Surgery Fellowship Rotation

Specialty Research in Orthopedic Spine Surgery – Fusion Surgery and Lumbar Stenosis – efficacy of fusion and decompression surgery in patients with lumbar spinal stenosis. Review of degenerative spondylolisthesis and patient selection criteria. Discussion of correlation of MRI, CT findings and clinical evaluation. Review of sedimentation sign on MRI and indications of prognostic factors. Surgery versus nonsurgical treatment outlined and outcomes discussed. Compensation for lumbar spinal stenosis and clinical sagittal plane deformity was presented. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Posterior Lumbar Interbody Fusion and Adjacent Segment Degeneration (ASD) – adjacent segment degeneration as major consequence of spinal fusion. Review of occurrence and location with correlation between surgical outcomes were discussed.   Discussion of age, BMI and pre-existing stenosis in cranial adjacent segment as risk factors. ASD prevalence in radiographic evidence between cranial and caudal segments were reviewed. Presentation of risk factors and pre-operative radiological features. Facet sagittalization and tropism were discussed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Morbidity and Mortality Predictions in Spinal Surgery – Review of the Charlson Comorbidity Index (CCI) and the American Society of Anesthesiologist (ASA) Physical Status Classification System. Review of index outcomes and relation to costs of care. Discussion of index rating and likelihood of complications. Review of classification system in cerebral spinal fluid (CSF) leaks. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Spondylolisthesis, clinical and radiographic classifications - classification system that considers disc space height, sagittal alignment and translation, and the absence or presence of unilateral or bilateral leg pain was discussed.   Detailed review of spondylolisthesis etiology, clinical presentation and imaging findings was reviewed. Review of inter and interobserver reliabilities of radiographic and clinical criteria. Review of consensus driven treatment options for degenerative spondylolisthesis presented. Transforaminal Lumbar Interbody Fusion (TLIF) in degenerative disc disease with associated spondylolisthesis grade I was reviewed and correlated.Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Sagittal Alignment and Spinal Surgery, Clinical Outcomes and Follow up – discussion of outcomes and sagittal alignment in single unilateral transforaminal lumbar interbody fusion (TLIF). Detailed review of surgical TLIF procedure and associated mid and long-term clinical outcomes. Discussion and presentation of influence of pelvic incidents and lumbar lordosis mismatch and post-operative residual symptoms. Analysis of adjacent segment disease following fusion. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Complications and Outcomes in Adult Spinal Deformity Surgery – review of surgical approaches and complications in correction of adult spinal deformity. Relevance of age, comorbidities, blood loss, osteoporosis and smoking were discussed. Discussion of Cobb Angle, Sagittal Vertical Axis, Pelvic Tilt, Thoracic Kyphosis were reviewed and examined in relation to transpsoas lateral interbody fusion (LIF), percutaneous pedicle screw (PPS), transforaminal lumbar interbody fusion (TLIF). Comparison between minimally invasive and traditionally open procedures was provided and reviewed.   Discussion of minimally invasive surgery options were emphasized and outcomes reviewed with correlation to diagnosis and procedural coding. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Surgical Interventions in Lumbar Disc Herniation – review of differences in surgical treatment of recurrent lumbar disc herniation. Clinical correlation between plain film radiography, MRI studies and clinical presentation were reviewed. Data on frequency in management of recurrent lumbar intervertebral disc herniations presented. Duration of symptoms and influence of patient outcomes in sciatica patients undergoing micro-discectomy and decompressions. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Length of Stay in Lumbar Spinal Surgery – discussion on epidemiology of lumbar surgery outcomes and hospital stay.   Correlation to clinical presentation and comorbidities were reviewed.   Outline of decompression and instrumental fusion in the lumbar spine. Review of costs of lumbar surgery, trends in hospital stay and costs both on a cumulative and daily basis. Comparison of the nationwide inpatient sample and national surgical quality improvement program databases for lumbar spine fusion procedures was reviewed and presented. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Pre-Surgical Planning and Implant Design – 3-D printing and surgical planning discussion a variety of historical materials in the creation of patient specific implants based on unique individual anatomy.   Historical trends in the creation of prosthetics with 3-D modeling software using neuroimaging data. Review of treatment complex spinal pathologies and surgical planning was discussed. Outline of current and future barriers to global implementation and commercialization was reviewed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Spine Surgery Procedures in Medical Specialty Training – discussion of current spine surgery training including fellowship programming in the United States. Accreditation Council for Graduate Medical Education (ACGME) cases logs were reviewed and discussed. Variability of procedures within programs and between medical specialty programs were outlined. Differential utilization between orthopedic and neurosurgical fellows was reviewed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Cerebral Spinal Fluid Dynamics, Central Nervous System Pathology and Intracranial Hypotension – pathophysiology and various craniospinal disorders. Directional phase contrast MRI (4D Flow) was reviewed along with the anatomical and physiological properties of cerebral spinal fluid. Specific disorders such as Alzheimer’s disease, hydrocephalus, Chiari Malformation and syringomyelia. Clinical correlation of CSF dynamics to understanding disease process was reviewed including normal and abnormal flow patterns. Recent advancements in fluid flow studies were outlined and presented. Signal intensity changes on MRI study in cervical spondylotic myelopathy was discussed and compared to normal parameters. Fluid dynamics patterns within syringomyelia and Chiari malformation was discussed and correlated to MRI findings and clinical presentations.   Spinal microsurgical exploration surgery and resultant CSF leak and spontaneous intractable intracranial hypotension was reviewed and its pathoanatomical presentation outlined.   Review of the natural and surgical history of Chiari malformation Type I in pediatric population and clinical correlation with MRI studies. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Neurosurgery Fellowship Rotation

Specialty Research in Neurosurgery – Anatomy and Physiology of the Blood Brain Barrier – Review of consequences of alterations in homeostatic control of the neuronal environment. Discussion of blood flow alterations and altered vessel permeability as determinants in the pathophysiology of brain injury. Review present day literature on the anatomy, development and physiological mechanisms of the blood–brain barrier. The blood brain barrier’s role in the maintenance of the extracellular environment. Vascular anatomy of the spinal cord was review in relation to the physiology of the neural environment.Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neurosurgery – Spinal Cord Anatomy, Physiology and Vascular Reactivity – detailed review of the blood supply of the spinal cord, anatomy of the vascular system and physiology of blood flow.   Pathophysiology of various conditions including Thoracic Aortic Occlusion and Spinal Cord Injury were discussed with specific relation to risk of neurological deficit. Severity and duration as an effect was reviewed and correlated clinically. Cerebral circulation and aging, discussion of effects on cognitive functioning and cerebrovascular disease in aging. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neurosurgery – Upper Cervical Spine Anatomy and Cerebral Spinal Fluid Flow – MRI flow imaging and computational fluid dynamics in healthy patients with Chiari Malformations.   Review of abnormal cerebral spinal fluid flow oscillations and their effects on healthy patients. Discussion of nonlaminar complex spatial and temporal variations with associated pressure waves and pressure gradients causing syringomyelia, headaches and other clinical manifestations in Chiari I malformation. Microsurgical anatomy and internal architecture of brainstem in 3D images and surgical considerations. CSF hydrodynamic changes, spinal cord injury and development of post traumatic syringomyelia (PTSM). Impact of spinal cord nerve roots and denticulate ligaments on cerebral fluid dynamics in the cervical spine was reviewed and discussed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neurosurgery – Compression and Degeneration in Chronic Nerve Root Entrapment – differentiation between peripheral nerves and spinal nerve roots and effects of electrostimulation. Discussion of various stimulating or recording neurosurgical implants and success vs failure rates. Review of the nerve root compression and its relation to consequences of disc herniation and acute compression during surgery. Maximum pressure level a spinal nerve root can sustain is reviewed. Discussion of microsurgical anatomy of lumbosacral nerve rootlets, Rhizotomy and chronic spinal cord injury. Review of qualitative grading of severity of lumbar spinal stenosis on morphology of dural sac on MRI studies, review of classification systems and the consideration of impingement of neural tissue. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neurosurgery – Anatomy of Circle of Willis, Cerebral Arteries and Stroke Etiology – discussion of stroke by embolism, source and cause in diagnosis and long-term treatment. Review of complex nature of embolus transport and its relation to etiology. Image based hemodynamics with discrete particle dynamics in relation to the distribution of emboli across the various cerebral arteries. Detailed anatomy of Circle of Willis reviewed and discussed with particular focus on size/inertia dependent trends in embolus distribution to the brain, distribution of cardiogenic versus aortogenic emboli among anterior, middle and posterior cerebral arteries, left versus right brain preference in cardio-embolus and aortic emboli transport and source-destination relationship for embolisms affecting the brain. Detailed review of the microsurgical anatomy of the posterior cerebral artery in three dimensional images. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neurosurgery – Stroke Therapy, Implementation and Cost-Effectiveness – review of endovascular therapy in addition to standard care in acute ischemic vessel occlusion stroke. Comparison in National Institutes of Health Stroke Score (NIHSS) score, symptom onset, Alberta Stroke Program Early CT Score (ASPECTS) and occlusion location. Considerations in acute management and revascularization of tandem occlusions in acute ischemic stroke with literature review. Discussion of Transcirculation Pipeline embolization device deployment as a rescue technique. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neurosurgery – Surgical Approaches and Outcomes in Spine Surgery 1 – review of historical interventions, multilevel decompression and instrumented fusion in reduction of neural compression and spinal column stabilization. Discussion of morbidity and mortality in relation to surgical procedures. The use of the modified fragility index to predict 30-day morbidity and mortality from spine surgery. Differences in patient selection for minimally invasive versus open surgical procedures, and review of post-surgical outcomes. Morbidity, mortality and health care costs for patients undergoing spine surgery following ACGME resident duty-reform. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neurosurgery – Surgical Approaches and Outcomes in Spine Surgery 2 – Predisposing factors for dural tears in lumbar spine surgery including degenerative conditions, prior surgery and age related indicators were reviewed. Discussion and review of re-admission rages in spine surgery through metanalysis and systematic review. Bibliometric study of the most important minimally invasive (MIS) spine surgery papers including Level III and IV studies with focus on moving toward Level I and Level II. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Emergency Medicine Fellowship Rotation

Specialty Research in Emergency Medicine – Emergency Medicine and Spine Pain – review of lack of guidelines for the management of lower back pain in the ED.   Frequency of lower back pain visitation in the emergency department including environmental/sociocultural dimensions and physical/psychospiritual dimensions were reviewed. Discussion of utilization of significant healthcare resources with complete description of lower back pain characteristics, health services use in non-urgent lower back pain patients presenting to the ED. Managing spine pain in the ED using usual and customary medical intervention.   Extent of appropriate CT and MRI scans in the hospital setting, accessibility reviewed in conjunction with presented national data. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – Medication Usage and Motor Vehicle Accidents – review of ADHD medication utilization and motor vehicle accident data and frequency of motor vehicle accident sin this specific patient population. Review of the prevalent and preventable cause of morbidity and mortality among patients and concepts of restricting based on prognostic factors. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – Emergency Department Imaging Perspectives – review of imaging protocols among a spectrum of clinical indications, perspective on aging populations and clinical complexity. Review of CT, MRI, plain film imaging and ultrasound and their relationships to internal medicine and musculoskeletal disorders examined on an emergency basis through patient generated national survey data. Details of specific contexts in which imaging has become concentrated and targeted efforts for optimization of utilization. considerations of utilization of CT in the emergency department and evaluation to increasing trends.   Review of quality improvements in imaging utilization. Comparison between pediatric and adult imaging protocols and trends. Discussion and analysis of “Choose Wisely” recommendations and creating of guideline/policy/clinical pathways in New England EDs. MRI utilization in pediatric ED reviewed and analyzed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – Cauda Equina Syndrome and Other Emergent Conditions – traumatic injuries to the thoracolumbar spine and overall impact on emergency services. Discussion of exact definitions of Conus Medullaris Syndrome (CMS) and Cauda Equina Syndrome (CES). Diagnosis in acute phase and radiological findings clinically correlating with physical examination findings. Parameters for spinal regions of traumatic injury were presented and reviewed. Case presentations for neck and spine were included and reviewed with particular focus on differential diagnosis and case uniqueness. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – Emergency Medicine Residency Curriculum – review of Ohio State University Emergency Medicine Residency Program Musculoskeletal Emergencies Curriculum. Outline of the significant nature of musculoskeletal emergency presentations to ED. Details in the training required to master clinical experience, self-directed learning and small group didactics. Case study reviews and discussion was presented with particular focus on infection vs non-infections and traumatic vs non-traumatic presentations in ED. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – Opioid vs Non-Opioid Medications in the Emergency Department – discussion of limited evidence of long-term outcomes of opioids with non-opioid medication for chronic pain.   Literature review on effectiveness for opioid interventions. Discussion of alternative recommendations, evidence demonstrating lack of benefit and poor long term outcomes.   Variation in physician opioid prescriptions discussed.   Patterns of opioid initiation at first visits for pain in the ED in the United States including frequency and dosage. Emergency Department data concerning the persistent pain after motor vehicle accidents and comparison between opioid and NSAID prescribed in the ED. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – Concussion and Repeat ED visits – review of patients presenting to ED with concussion with re-visitation within 72 hours. Mechanism of injury including closed head injury, assault, fall and motor vehicle accidents discussed. Epidemiological evidence presented regarding number of visitations, characteristics and care paths reviewed. Discussion of adoption of a more comprehensive discharge plan to further prevent repeat visits was outlined. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – CDC Epidemiology of ED Visits in the United States, Adults Over 65 and Motor Vehicle Accidents – Evaluation of data from the National Hospital Ambulatory Medical Care Survey and frequency of ED visitation. Percentage of visits requiring hospital admission was reviewed along with patterns of need for critical care. Review of imaging ordering statistics and clinical diagnosis was discussed. Details of primary and secondary ED diagnosis presented in relation to sprain/strain, contusion and spinal pathology including herniated intervertebral disc, facture and spinal cord compression. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – National Hospital Ambulatory Medical Care Survey – a review of the current representative data on ambulatory care visits to hospital emergency departments in the United States.   Demographics, residence, insurance class, chief complaint with focus on traumatic injury, diseases of the nervous and musculoskeletal systems were outlined. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – Lower Back Pain and Emergency Room Visits – detailed analysis of impact of lower back pain on ED globally. First systematic review of the trends in the literature including lower back pain as significant complaint and the variables in its definition.   Discussion of the proper diagnosis and triage of lower back pain and its current impact on ED management was reviewed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – Spinal Cord Injury without Radiographic Abnormality (SCIWORA) in Adults – case reports – detailed review of Spinal Cord Injury without Radiographic Abnormality was presented.   Syndrome of post traumatic myelopathy demonstrable on MRI with no evidence of osseous injury on plain film or CT scan. Reporting of incidence was included with detailed discussion of case presentations, accurate diagnoses and triage was reviewed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – CDC Traumatic Brain Injury Data – Related Emergency Department Visits, Hospitalizations, Deaths – United States, 2007 and 2013 – traumatic brain injury, short and long term adverse clinical outcomes, death and disability reviewed and compared based on CDC data over a 7 year period. Mechanism of causation including motor vehicle accidents, falls and assault. Public health recommendations and interpretation of data was presented. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – CDC Data, Trends in Emergency Department Visits for Ischemic Stroke and Transient Ischemic Attack – relationship between stroke and statistical cause of death, type of stroke and prognosis related to recurrence was discussed. Specific definitions of ischemic stroke, transient ischemic attack with etiology and relationship to emergency visits were outlined and presented. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – US Emergency Department Use by Children – pediatric utilization of emergency medicine resources, description of trends on a national basis. Detailed analysis of specific demographics including race and resident status were reported and reviewed. Discussion in allocation of resources including insurance class and coverage were reviewed. Anticipated expansion of Medicaid was considered and reviewed.   Estimates of nonurgent ED visits by children were presented and discussed. Academy of Chiropractic, State University of New York at Buffalo, Jacobs School of Medicine, 2019

Primary Care/Internal Medicine Fellowship Rotation

Specialty Research in Primary Care and Internal Medicine – Supply of Chiropractic Care and Visits to Primary Care Physicians for Neck and Back Pain – discussion of primary care visits and lower back pain. Expenditures and contributions to disability data.     Discussion of supply of chiropractic care in context of visits for lower back pain and primary care physicians.   Estimated national impact of primary care visits and expenditures was outlined with a focus on chiropractic’s assistance in managing lower back pain. Defining an “episode” of lower back pain and relationship to collection of epidemiological data. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Primary Care and Internal Medicine – Safety of Chiropractic Care in Lower Back Pain and Migraine Headaches – review of adverse events associated with chiropractic care in the treatment of migraine. Outline of a prospective 3-armed, single-blinded, placebo RCT. Discussion of transient and mild events following chiropractic intervention. Randomized clinical trials and meta-analysis reviewed and discussed relating to the diagnosis and management of lower back pain including adverse event reporting. Risk of injury to the head, neck or trunk following an office visit for chiropractic spinal manipulation, as compared to office visit for evaluation by primary care physician.Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Primary Care and Internal Medicine – Chiropractic and Pain Management in Primary Care – evaluation of the analgesic effects of spinal manipulation on both healthy and pain inflicted patients.   Discussion of evidence of increased in pressure pain thresholds in musculoskeletal pain at both local and remote sites. Detailed knowledge of patient population regarding demographics and socioeconomic factors as well as disease-specific characteristics. Suggestion that lower back pain should not be seen as benign and self-limiting with focus on management. Describe the communication system surrounding the management of chronic pain from the perspectives of allopathic providers, acupuncture and chiropractor providers, and chronic musculoskeletal pain patients.     Chiropractic manipulative treatment (CMT) association with lower healthcare costs among multiply comorbid Medicare beneficiaries with an episode of chronic low back pain was reviewed.Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Primary Care and Internal Medicine – Perceptions of Chiropractic Care – demographic review of data on the perceptions of chiropractic care. Review of patient interest, trustworthiness, costs and frequency of visits was discussed. Nationally representative survey to compare characteristics and use of survey respondents with positive and negative perceptions of DCs and chiropractic care. Positive perceptions of DCs were more common than those for chiropractic care. US adults generally perceive DCs in a positive manner.   Describe the preferences of older adults for low back pain co-management by MDs and DCs and identify their concerns for receiving care under such a treatment model.Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Primary Care and Internal Medicine – Chiropractic and Post-Surgical Care and Care for Veterans – discussion of persistent post-surgical lower back and radicular pain response to chiropractic care. Relevant anatomy related to lower back pain and intervertebral disc injury was outlined and presented. Discussion and development of an integrated care pathway for doctors of chiropractic, primary care providers, and mental health professionals who manage veterans with low back pain, with or without mental health comorbidity, within Department of Veterans Affairs health care facilities. Support for the inclusion of chiropractic care as a component of multidisciplinary health care for low back pain, as currently recommended in existing guidelines with a focus on US Service Members. Discussion of availability of chiropractic care to military healthcare systems, referral and interprofessional communication models. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Primary Care and Internal Medicine – Effects of Chiropractic Care Combined with Medical Care, First Contact and Provider Type – differences in outcomes, patient satisfaction, and related healthcare costs in spinal, hip, and shoulder pain patients who initiated care with medical doctors (MDs) vs those who initiated care with doctors of chiropractic (DCs). Pain of musculoskeletal origin and epidemiology of reduced productivity. Comparison of data on health outcomes, patient satisfaction, and related healthcare costs in patients consulting differing first-contact care providers for musculoskeletal pain. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Primary Care and Internal Medicine – Integrating Chiropractic Care into Primary Care and Private Sector Healthcare Facilities – suggestion of a diverse role for chiropractors within conventional health care facilities.   Discussion of chiropractic’s effectiveness for managing musculoskeletal disorders, particularly spine-related pain and disability. Descriptions of doctors of chiropractic who work in nongovernmental, private sector health care settings in the United States. Shared electronic health records, face-to-face informal consultations methods for interprofessional communication.Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Primary Care and Internal Medicine – American College of Physicians – Guideline Recommendations – Non-Invasive and Non-Pharmacological - American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on noninvasive treatment of low back pain. Systematically review the current evidence on non-pharmacologic therapies for acute or chronic non-radicular or radicular low back pain. Comparative benefits of non-pharmacological therapies in acute/subacute low back pain including exercise, spinal manipulation, lumbar supports, acupuncture, laser, ultrasound and traction. Discussion of first and second line therapies with reduction in opioid prescription.Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

SELECTED POST-GRADUATE EDUCATION, CERTIFICATIONS, FELLOWSHIPS AND DIPLOMATES

Spine Management Clinical Workflows – in-depth review and discussion of the Doctor of Chiropractic as a Spine Management Physician with specific focus on the diagnosis and management of spine pain of mechanical origin. Details were outlined in relation to triage of anatomical causes of spine pain such as fracture, tumor, infection.  National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT 2021.

 

Pain Management and the Chiropractic Adjustment – Current peer reviewed indexed research demonstrating the chiropractic adjustment’s effect on the central nervous system and pain threshold was outlined and reviewed. Anatomical review and contemporary supportive research were discussed. Details of central nervous system response to the chiropractic adjustment was reviewed and demonstrated. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT 2021.

 

Corrective Spinal Care and Chiropractic Case Management - Current peer reviewed indexed research demonstrating the chiropractic adjustment’s effect on the biomechanical structure of the human spine during the corrective/rehabilitative phase of care.  Basic outline of biomechanical parameters in symptomatic and asymptomatic patients was reviewed with particular focus on pathobiomechanics in chiropractic practice. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT 2021.

 

Health Maintenance Care and Chiropractic Case Management - Current peer reviewed indexed research demonstrating the chiropractic adjustment’s effect on the maintenance of the human spine.  Details of indexed research reviewing Chiropractic’s role in the reduction of narcotic utilization and decreased absenteeism from work due to disability.  Communicating Health Maintenance Care to the medical profession and the public was emphasized. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT 2021.

 

Evidence Based Clinical Reporting – overview of current CPT and ICD-10 coding guidelines pertaining to the evaluation and management of spine pain patients was presented.  Timed codes, relevant diagnosis related to injured tissue was presented. Specific discussion of proper format of the Assessment portion of clinical documentation was presented.  Review of the difference between daily progress notes and Evaluation and Management [E/M] reporting was provided.  National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT 2021.

 

Cervical Spine Clinical Workflows – detailed review of workflows of a thorough patient history and identification of clinical red flags related to relative and absolute contraindications to chiropractic care was presented. Outline of neurological examination including pathological reflexes present during spinal cord compression, cervical stenosis and cervical myelomalacia was discussed.  Normal vs abnormal measurement of range of motion objectifying spinal dysfunction was presented. Specific orthopedic testing related to specific muscle, nerve or intervertebral disc injury was discussed.  Review of interprofessional triage and imaging decision tree was outlined with specific focus on the pain management physician and spinal surgeon.  National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT 2021.

 

Lumbar Spine Clinical Workflows - detailed review of workflows of a thorough patient history and identification of clinical red flags related to relative and absolute contraindications to chiropractic care was presented. Outline of neurological examination including pathological reflexes present during cervical and lumbar stenosis was discussed.  Normal vs abnormal measurement of range of motion objectifying spinal dysfunction was presented. Specific orthopedic testing related to muscle, nerve or intervertebral disc injury was discussed.  Review of interprofessional triage and imaging decision tree was outlined with specific focus on the pain management physician and spinal surgeon. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT 2021.

 

Interprofessional Clinical Documentation for the Primary Care Physician – contemporary techniques to best communicate chiropractic care to the Primary Care Physician was discussed and presented.  Analysis of the depth and scope of communication was emphasized with direct focus on the proper documentation management system including demographic sheet, imaging reports, most recent evaluation and management reports.  Discussion of appropriate timing for phone consultation was presented. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT 2021.

 

Clinical Documentation for the Spine Surgeon - contemporary techniques to best communicate chiropractic care to the spine surgeon was discussed and presented.  Analysis of the depth and scope of communication was emphasized with direct focus on the proper documentation management system including demographic sheet, imaging reports, most recent evaluation and management reports.  Discussion of appropriate timing for phone consultation was presented. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT 2021.

 

Clinical Documentation for the Pain Management Physician - contemporary techniques to best communicate chiropractic care to the pain management physician was discussed and presented.  Analysis of the depth and scope of communication was emphasized with direct focus on the proper documentation management system including demographic sheet, imaging reports, most recent evaluation and management reports.  Discussion of appropriate timing for phone consultation was presented. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT 2021.

 

Clinical Documentation for Attorney - contemporary techniques to best communicate chiropractic care and permanent injury to the personal injury attorney was discussed and presented.  Analysis of the depth and scope of communication was emphasized with direct focus on the proper documentation management system including diagnosis, response to treatment, causality and persistent functional loss was outlined.  Discussion of appropriate timing for phone consultation was presented. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT 2021.

 

Spinal Biomechanical Engineering – detailed presentation of the progression of laboratory-based biomechanics into the clinical realm was outlined.  Evidence based review of Pelvic Incidence and other sagittal balance parameters was presented. Regional sagittal balance and communication with the spine surgeon in the spine management practice was reviewed. Specific discussions were related to spinal sagittal balance and the non-surgical spine pain patient and correlated to the Corrective Care Phase of Chiropractic Care.  Outline of the future of full spine biomechanical modeling was presented in relation to symptomatic and asymptomatic patients. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT 2021.

 

Objectifying the Biomechanical Spine Lesion – review of ligament laxity and alternation of motion segment integrity was presented with specific correlation to the AMA Guides to the Evaluation of Permanent Impairment 5th and 6th Education.  Correlation to bodily injury, causality and persistent functional losses in the personal injury patient and communication with the attorney was outlined.   Attention was paid to the differences between vertebral body translation and angular motion deficits between adjacent motor units was presented. Specific details on measurement tools and analysis of the injured cervical and lumbar spines were discussed.  National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT 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

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, 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

 

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, 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, 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, Long Island, NY, 2020

 

Clinical Grand Rounds – Morphological versus Etiological Description of Intervertebral Disc Pathology in the Human Spine – case analysis outlining morphological descriptions of the human spine including desiccation, herniation, extrusion and bulge.  Outline and presentation of annulus fibrosis, nucleus pulposus and pain fiber innervation of both healthy and degenerative intervertebral discs was presented. Analysis of injury causation and its relation to MRI findings was detailed.  Cleveland University – Kanas City, MDR Consulting, Buffalo, NY, 2019

 

Clinical Grand Rounds – Anatomical vs Mechanical Sources of Spine Pain in the Spine Pain Patient – case study presentation outlining risk factors for increased injury susceptibility including prior surgical fusion.  Comparison between MRI and plain film radiographic objective data was outlined and presented. Importance of interprofessional communication and review of prior medical records.  Analysis of spinal compression fracture and surgical hardware was outlined.  Cleveland University – Kanas City, MDR Consulting, Buffalo, NY, 2019

 

Clinical Grand Rounds – Clinical Diagnosis and Interprofessional Management of Thoracic and Lumbar Post-Traumatic Compression Fractures – a detailed review of physical examination and assessment of traumatic thoracic and lumbar spine fractures using plain film radiograph and CT scans with and without contrast.  Detailed review of mechanism of injury, emergency department records and radiology reports were presented.  Errors in fracture site, description and omission on plain film study by the radiologist were reviews.  Analysis of potential spinal instability in the cervical spine was discussed and a detailed referral for computerized mensuration analysis was demonstrated. Cleveland University – Kanas City, Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY 2019

 

Documentation, MRI Necessity and Trends in Spinal Treatment Protocols, Correlating history and a thorough clinical evaluation in determining the necessity for x-ray and MRI evaluations in the trauma and non-trauma patient. Considering whole spine patho-biomechanics in formulating treatment plans and long-term supportive care. Documentation requirements in transitioning from telemedicine to in-office care.  Academy of Chiropractic Post-Doctoral Division, PACE Approved for the Federation of Chiropractic Licensing boards, Cleveland University Kansas City, Long Island, NY, 2020

 

Clinical Grand Rounds – Spinal Primary and Secondary Biomechanical Pathology – a case review of objectification of spinal biomechanical pathology utilizing a Whole Organ Model of the human spine.  Discussion of adjacent region mechanical dysfunction and clinical diagnosis utilizing sagittal and coronal plan data.  Interprofessional communication both verbally and through proper evidence-based documentation was emphasized and discussed focusing on acute versus chronic spinal injury. Cleveland University – Kanas City, Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY 2019

 

Chiropractic as the First Option for Spine, A Literature-Based Standard, Utilizing clinical findings in conjunction with advanced imaging and electrodiagnostic findings in managing collaborative relationships with medical specialists. Applying a literature standard to care to ensure conservative care as the first option. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2020

Chiropractic as the First Option for Spine, A Literature-Based Standard, Managing spinal related cases based upon MRI findings of herniations, bulges, protrusion, extrusions (comminuted and fragmented) utilizing thin-sliced acquisition protocols. When to consider ordering T1, T2, Short Tau Inversion Radiant, proton density and Dixon sequencing for spinal related pathology. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2020

Chiropractic as the First Option for Spine, A Literature-Based Standard, Creating literature-based documentation inclusive of history and a clinical examination that encompasses causality, diagnosis, prognosis and treatment plans. Ensuring the whole person impairment ratings are consistent with contemporary literature. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2020

Chiropractic as the First Option for Spine, A Literature-Based Standard, Spinal biomechanical engineering models related to pathobiomechanics and literature-based standards in creating an accurate diagnosis, prognosis, and treatment plan. Determining impairment ratings based upon alteration of motion segment integrity utilizing motion-imaging, and creating demonstrable evidence for continued treatment plans. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2020

Clinical Grand Rounds – Innervation Patterns and their Clinical Application of the Spinal Meninges and the Intervertebral Discs, a detailed review of spinal cord anatomy both in sagittal and axial sections with particular attention being paid to the three covering layers. Analysis of the structure, function and sensory innervation of the dura mater [aka the thecal sac], arachnoid mater and pia mater.   Discussion of the sensory innervation of health and degenerative intervertebral discs was presented and outlined. Causality related to mechanism of injury, physical examination presentation and analysis of bodily injury was presented.   Cleveland University – Kanas City, Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY 2019.

Computerized Mensuration of Spinal Biomechanical Pathology, Understanding the algorithmic interpretation of spinal biomechanical pathology in a 3-D model and creating treatment plans, impairment ratings and teaching models based upon the vertebral motor unit angles. Determining sagittal and axial alignments in creating a normative baseline for treatment goals and outcomes.  Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2019

Neurosurgical-Chiropractic Collaboration on Spinal Pathology, Utilizing x-ray, MRI and other modalities of advanced imaging in conjunction with spinal biomechanical failure and clinical evaluation to collaboratively create treatment protocols for patients in both the operative and non-operative cases. Determining the boundaries of scope of care for both the chiropractor and neurosurgeon based upon a definitive diagnosis of the mechanical vs. an anatomical lesion. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2019

Documentation and Ethics in Medical-Legal Relationships, Creating ethical relationships based upon accurate documentation reflective of the casually related condition of the injured. Ensuring accepted credentials of the doctor based upon Voir Dire standards reflected in an admissible curriculum vitae. How to present demonstrative documentation in the courts reflective of the patient’s pathology. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2019

Coding, Documentation and Compliant Coding, Ensuring the correct codes are utilized in an evaluation and management encounter. The correct elements are utilized to support the level of E&M coded along with a self-audit program to ensure ethical billing occurs. Guidelines for history of present illness, primary complaint, review of systems, family, social and past histories are discussed and how to document the same. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2019

Trends in Spinal Treatment, Migration of spinal care for mechanical spine issues from hospitals and medical specialists to trauma qualified chiropractors based upon published outcomes. Utilizing imaging studies in spinal biomechanics, pain models and clinical outcomes to determine a conclusive diagnosis, prognosis and treatment plan for triaging in a collaborative environment.  Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019

Neurology of Spinal Biomechanics, Understanding the normal of spinal biomechanics and the neurotransmitters required for homeostasis. The interconnected role of Pacinian Corpuscles, Ruffini Corpuscles, Golgi Organ Receptors, Nociceptors, Proprioceptors and Mechanoreceptors in maintaining sagittal and axial alignment in the presence of mechanical pathology. Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019

Coding, Documentation and Compliant Coding, Ensuring the correct codes are utilized in an evaluation and management encounter. The correct elements are utilized to support the level of E&M coded along with a self-audit program to ensure ethical billing occurs. Guidelines for history of present illness, primary complaint, review of systems, family, social and past histories are discussed and how to document the same. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2019

MRI Age-Dating of Herniated Discs, The literature, academic and clinical standards to age-date herniated discs. The clinical correlation the pain patters with advanced imaging findings of bone edema, spurs based upon the Piezoelectric effect of remodeling, high signal on T2 weighted images, Vacuum Discs and disc heights in determining the time frames of the etiology of the spinal disc pathology. Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019

Creating Ethical Collaborative and Medical-Legal Relationships, Understanding the timely triage necessities based upon clinical and imaging outcomes and the documentation required for collaborative physicians to continue care. Ensuring that the documentation is complete, reflective of services rendered and clear for third party consideration in an admissible format to considered in a medical-legal environment. Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019

Central Innervation of Spinal Biomechanical Engineering, Understanding the lateral and ventral horn’s innovations of Pacinian Corpuscles, Ruffini Corpuscles, Golgi Organ Receptors, Nociceptors, Proprioceptors and Mechanoreceptors and the pathways through the spinal thalamic tracts through the periaqueductal region, the Thalamus into the Occipital, pre-frontal, sensory and motor cortexes and the efferently back through the Thalamus to disparate regions in creating spinal homeostasis, Pacinian Corpuscles, Ruffini Corpuscles, Golgi Organ Receptors, Nociceptors, Proprioceptors and Mechanoreceptors. Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019

Identifying Spinal Pathology of MRI, Utilizing T1, T2, STIR and Gradient studies in determining myelomalacia, intra and extra-dural tumors and systemic disease patterns affecting the spinal cord. When to use contrast post-operatively in identifying discal structures vs. adhesions on postoperative advanced imaging. MRI Interpretation of herniated, circumferential bulges, focal bulges, protruded, extruded, comminuted, sequestered and fragmented discs. When to consider a neurosurgical consultation based upon the correlation of imaging and clinical findings. Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019

Clinical Grand Rounds – Clinical Diagnosis of Traumatically Induced Intervertebral Disc Injury versus Pre-Existing Disc Bulge in the Cervical Spine – case review of pre-existing cervical spine degenerative disc disease, myelomalacia and spinal cord compression with superimposed central canal stenosis due to overlying traumatically induced cervical disc herniation. Discuss of Modic 1 changes and acute injury with associated foraminal canal stenosis and acute intervertebral disc herniation. Causality related to mechanism of injury, physical examination presentation and analysis of bodily injury was presented.   Cleveland University – Kansas City, Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY, 2019

Clinical Grand Rounds – Differentiating Pre-existing vs Causally Related Spinal Injury using MRI – case review of traumatic injury to the cervical spine with underlying pre-existing traumatic injuries.  Physical examination, neurological and orthopedic testing was clinically correlated to mechanism of injury, plain film radiographs and MRI studies.  Comparison of T1, T2 and STIR views were reviewed in relation to intervertebral disc bulge, intervertebral disc herniation, Modic 1, Modic 2 and Modic 3 changes.  Comparative review of causally related versus pre-existing changes was demonstrated.  Cleveland University – Kansas City, Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY, 2019

Clinical Grand Rounds – Differentiating Pre-existing vs Causally Related Spinal Injury using MRI – case review of traumatic injury to the cervical spine with underlying pre-existing traumatic injuries.  Physical examination, neurological and orthopedic testing was clinically correlated to mechanism of injury, plain film radiographs and MRI studies.  Comparison of T1, T2 and STIR views were reviewed in relation to intervertebral disc bulge, intervertebral disc herniation, Modic 1, Modic 2 and Modic 3 changes.Cleveland University – Kansas City, Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY, 2019

Clinical Grand Rounds – Compensatory Lower Back Pain Due to T2 Biomechanical Pathology – case review of spinal biomechanical engineering study in the care plan of non-responsive lower back pain. Review of medical care plan, epidural steroid injections and past medical history. Patient centered approach to full spine assessment in non-responsive chronic lower back pain with associated primary spinal mechanical lesion identified in upper thoracic spine. Cleveland University – Kansas City, Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY 2019

Documentation, Carrier Mandates and How the Guide and Lawyer Referrals, Documenting electrodiagnostics, concussion and disc pathology as reflective of clinical findings when collaborating with medical specialists in private practice and hospital settings or in the medical-legal arena. Ensuring complete documentation in the evaluation and management process for both the initial and re-evaluation process. Cleveland University – Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island NY, 2019.

Clinical Grand Rounds – Traumatic Cervical Disc Herniation and Associated Sternum Fracture – a case review of traumatically induced multi-level cervical disc herniation with associated Grade 2 Ligament Injury rated as sub-threshold.  Review of case history, physical examination findings, plain film radiographs, cervical spine MRI and bone scan.  Radiographic analysis and objectification of grade 2 sprain was presented and its correlation to the AMA Guides to the Evaluation of Permanent Impairment 5 th  edition was reviewed.  Review of the purpose, function and positive findings on bone scan was reviewed and demonstrated using patient’s fractured sternum.  Interprofessional communication both verbally and through proper evidence-based documentation was emphasized and discussed.   Cleveland University – Kansas City, Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY 2019.

Clinical Grand Rounds – Traumatic Disc Bulge and Associated Grade 2 Ligament Injury – a case review of traumatically induced cervical spine traumatic bulge of the intervertebral disc with concomitant grade 2 ligament injury was presented.  Detailed anatomy and morphological presentation of normal and degenerative intervertebral disc presentation was demonstrated and reviewed.  Review of morphological differences between disc bulge, disc herniation and disc protrusion was presented.  Grade 1, Grade 2 and Grade 3 ligamentous sprains were reviewed and discussed.  Radiographic analysis and objectification of grade 2 sprain was presented and its correlation to the AMA Guides to the Evaluation of Permanent Impairment 5th edition was reviewed. Interprofessional communication both verbally and through proper evidence-based documentation was emphasized and discussed.  Cleveland University – Kansas City, Academy of Chiropractic, Buffalo, NY, 2019

Clinical Grand Rounds – 14 mm Cervical Disc Herniation with Spinal Cord Compression – a case review of traumatically induced 14 mm acute cervical intervertebral disc extrusion with inferior migration resulting in severe right lateral canal stenosis, foraminal stenosis and spinal cord impingement.  A detailed review of physical examination findings, neurological evaluation, MRI images and surgical triage was presented. Interprofessional communication both verbally and through proper evidence-based documentation was emphasized and discussed.  Cleveland University – Kansas City, Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY, 2019.

Clinical Grand Rounds – T11 Spinal Fracture – a case review of traumatically induced T11 vertebral body fracture post motor vehicle collision.  A detailed review of patient history, neurologic examination, plain film radiographs and advanced imaging studies were discussed.  Comparison of Modic 1 and Modic 2 changes on T1 and T2 weighted MRI were reviewed, discussed and compared to plain film images and CT scan images.  Interprofessional communication both verbally and through proper evidence-based documentation was emphasized and discussed.  Cleveland University – Kansas City, Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY, 2019

Clinical Grand Rounds – Interprofessional Management of Cervical Instability and Traumatic Brain Injury,Case review of traumatically induced cervical spine grade 2 ligament tear with associated underlying degenerative disc disease and traumatic brain injury.  MRI review and discussion of axonal shearing findings on advanced imaging, evidenced based triage to neurology concussion clinic and documentation.  Clinical correlation to pre-existing electrodiagnostic evidence.  Surgical co-management of anatomical and biomechanical pathology with post-op follow up, focus on interprofessional communication.  Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY 2019

Documentation in Medical Collaborative Cases, Concluding an E&M report in cases involving medical primary care providers of medical specialists that have complicated case histories, significant risk factors, and inconclusive findings. Triage and management of complicated cases requiring the clinical evaluation, advanced imaging and electrodiagnostics. Academy of Chiropractic, Long Island, New York, 2019

MRI Spine Interpretation and Protocols, Contemporary acquisition protocols including slice thicknesses and sequences inclusive of the ordering process. Interpretation of axial, sagittal and coronal views in T1, T2 and stir views inclusive of the disc, spinal cord, extra-dural and intra-dural pathology. Academy of Chiropractic, Long Island, New York, 2019

Ethics and Medical Collaboration, Having referral relationships with emergency rooms, neurosurgeons, orthopedic surgeons, pain management specialists, neurologists, neuroradiologist and medical primary care providers based upon clinical dilemmas that processed after a thorough history, examination and imaging if clinically indicated to conclude diagnostic dilemmas. Utilizing evidence-based protocols and acquisition of images and treatment pathways, collaborating with medical specialists and primaries to conclude and accurate treatment plan. Academy of Chiropractic, Long Island, New York, 2019

Documentation in a Medical – Legal and Insurances, Constructing and concluding an E&M (99202-99205) report that accurately reflects the history, clinical findings and management of trauma cases that concurrently meets the needs of both the carriers in the courts and ethical relationship that concurrently matches the standards of both contemporary academia requirements and a contemporary literature-based standard. Academy of Chiropractic, Long Island, New York, 2019

Clinical Grand Rounds – Traumatically Induced Biomechanical Pathology with Secondary Underlying Multi-Level Cervical Intervertebral Disc Herniation, Case review of traumatically induced biomechanical pathology in the cervical spine in the absence of pre-existing degenerative change and ligament laxity.  Review of underlying multi-level acute intervertebral disc herniation and clinical correlation to patient presentation.  T1, T2 and STIR MRI review of acute intervertebral disc herniation in both sagittal and axial planes outlining correlation to radiologist report and electrodiagnostic findings.  Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019

Clinical Grand Rounds – Biomechanical Pathology Secondary to Cervical Fusion, Case review of traumatically induced cervical and lumbar spine.  Prior cervical fusion C4-7 with review of plain film radiographs, MRI studies and neurological evaluation.  Biomechanical assessment revealed significant compensation in lumbar spine secondary to cervical disc herniation and grade 2 ligament injury above the prior fusion.  Modic 2 changes on lumbar spine MRI.  Care plan, interprofessional documentation and patient centered education. Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019

Clinical Grand Rounds – Traumatically Induced Cervical Central Canal Stenosis, A case review of severe central canal stenosis and spinal cord impingement.   A detailed review of physical examination findings, neurological evaluation, MRI images and surgical triage.   Interprofessional communication both verbally and through proper evidence-based documentation.   Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY 2019

Connective Tissue Pathology, Spinal Biomechanics as Sequella to Trauma, MRI Spine Interpretation, Ordering Protocols & Triaging the Injure, The latest research on the 6 ways to age-date disc herniations and bulges from trauma inclusive of disc pathology nomenclature. MRI ordering protocols, inclusive of Dixon format and fat-suppressed images. The neurology and pathology of connective tissue and the sequella of trauma at the biomechanical level leading to bio-neuro-mechanical failure. Contemporary “evidenced-based building blocks” for triaging and in a collaborative environment. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2018

Spinal Biomechanical Engineering Digitizing, integrating automated mensuration into creating treatment plans and determining maximum medical improvement. A literature-based study of normal vs. abnormal motor until function. Determining ligamentous laxity, alteration of motion segment integrity and pathological stress units and whole person impairments based upon the literature and academic standards, Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2018

Science of the Chiropractic Spinal Adjustment and Vertebral Subluxation, The literature-based definitions of both the mechanisms the chiropractic adjustment and how it affects the central nervous system in pain pathways and systemic issues that is the arbiter for normal vs. abnormal function. The “physiological mechanisms” of how the chiropractic spinal adjustment affects the peripheral and central nervous systems. Subluxation degeneration/Wolff’s Law will be detailed from a literature perspective combined with the mechanism of subluxation (bio-neuro-mechanical lesion). A literature perspective why “long-term” chiropractic care is clinically indicated as usual and customary to effectuate demonstrable biomechanical changes in the spine. An evidenced-based perspective of why physical therapy is a poor choice for spine as a 1st referral option for any provider inclusive of the literature. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2018

Documentation, Collaboration, and Primary Spine Care, An academic basis for documentation that is usual and customary across professions in collaborative care. Maintaining ethical medical-legal relationships based upon Voir Dire and Daubert standards with ensuring a “4-corners” inclusive report. Ensuring Primary Care Status based upon an academic standard. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2018

Documentation of the Trauma and Non-Trauma Case, Documenting primary and associated complaints, past history, allergies, medications, review of systems, previous treatment, family-social medical histories, previous tests and results, history or previous injuries and illnesses, on the job questionnaire, auto accident questionnaire, vital examination, neurological examination, orthopedic testing, test orders, prognosis and treatment plans. A detailed review of current CPT coding requirements for the proper documentation of E/M visits to properly code for billable patient services.  Focused attention was paid to the performance of comprehensive patient history, physical examination, review of systems as well as determining the level of clinical decision making.  Analysis of a properly organized E/M report was reviewed to demonstrate proper organization and language use. Cleveland University – Kansas City, Long Island, NY, 2018

Interprofessional Reporting and Case Documentation, analysis of case flow, patient chart organization and EMR workflows to optimize the success and satisfaction of the patient encounter, feasibility of accurate and timely documentation as well as strategies to provide timely interprofessional clinical communication.  Focus was provided on patient, primary care and medical specialty communication beginning at the initial visitation all the way through to the release from care. An internal compliance review to ensure complete documentation based upon the E/M level billed. Cleveland University – Kansas City, Long Island, NY, 2018

Documenting Trauma and Non-Trauma Cases & Triaging Disc Pathology, Triage care and collaboration for herniated, bulged, protruded, extruded and fragmented spinal discs. Compliant documentation of evaluation and management of new and established patients inclusive of chief complaint, history of present illness, review of systems, past-family-social histories with case management protocols and the required elements. Clinically coordinating treatment with subjective complaints, clinical findings and diagnosis for each encounter.  Cleveland University-Kansas City Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2018

Triage and Management of the Trauma and Non-Trauma Patient, Differentially diagnosing spinal issues in the trauma and non-trauma patient inclusive of spinal disc pathology utilizing x-ray, MRI, CAT Scan and clinical evaluations. Collaborative triaging protocols with neurologists, neurosurgeons, orthopedic surgeons, pain management and primary medical care providers with both mechanical and anatomical spinal pathologies. Academy of Chiropractic, Cleveland University - Kansas City Chiropractic and Health Sciences, Long Island, NY, 2018

Primary Evidenced Spine Care Qualified, This qualification includes graduate chiropractic education in healthy and traumatically altered spinal morphology inclusive of osseous, connective tissue and neurological structure, function and pathology. This certifies you are qualified in assessing predictive models in spinal biomechanics and devising engineering paradigms for treatment plans to maximize spinal homeostasis in an evidenced based conclusion. In addition, this qualification acknowledges your expertise in triaging the injured and coordinating collaborative care from the trauma through conclusion of rehabilitation, Academy of Chiropractic Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island NY, 2018

Evidenced Based Care in a Collaborative Setting; Primary Spine Care 5, A literature based model for collaborating with hospitals, medical primary care providers and specialists. Reviewing the documentation requirements to communicate the diagnosis, prognosis and treatment plans with medical entities and having the evidence as a basis for those recommendations. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2018

Current Literature Standards of MRI Spine Interpretation; Primary Spine Care 5, MRI Spine Interpretation.  How to triage a trauma and non-trauma with advanced imaging and document the necessity. We will also cover the basics of MRI Spine Interpretation inclusive of all types of herniations, bulges, Academy of Chiropractic Post-Doctoral Division. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2018 

Spine Brain Connection in Pain Pathways; Primary Spine Care 5, The spine-brain connection in managing chronic pain patients.  Understanding how chronic pain negatively effects brain morphology and pathology as sequella. The role of chiropractic in preventing the loss of gray matter and the most recent evidence as outlined in indexed peer reviewed literature over the last 10 years verifying chiropractic's role. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2018  

Bio-Neuro-Mechanical Mechanism of the Chiropractic Spinal Adjustment; Primary Spine Care 5, The biological, neurological and mechanical mechanisms and pathways from the thrust to the lateral horn and brain connection and how the brain processes the chiropractic spinal adjustment based upon the literature. Care paths of chiropractic and physical therapy from an outcome basis. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2018

Spinal Bio-Engineering Seminar, A course describing the structural and functional organization of the spinal-pelvic system.  Fundamental and advanced concepts on spinal biomechanics are introduced by presenting a coherent spinal model describing normal segmental coupling, regional adaptation and global compensation. The clinical model is a structural and mechanical engineering approach based on x-ray physics, mathematics and statistical analysis. The normal movements of gait are integrated in this total biomechanical approach to explain spine distortion, predictable functional scoliosis and lumbar disc failure. Case studies are demonstrated to radiographic analyses and physical findings to determine clinical solutions and soft tissue rehabilitation. PACE Recognized by The Federation of Chiropractic Licensing Boards, Arlington Heights, IL, 2017

Ethics, Documentation and Research, Primary Spine Care, Maintaining ethical Interprofessional relationships based upon an evidenced based practice inclusive of triage, diagnostics and reporting. Creating thorough documentation that reflects your complete findings encompassing descriptive ICD-10 codes and concludes the presence or absence of pathology. Academy of Chiropractic Post-Doctoral Division, PACE Recognized by The Federation of Chiropractic Licensing Boards, Long Island, NY, 2017

Bio-Neuro-Mechanical Lesions and Spine Care, Primary Spine Care, Mechanoreceptor, proprioceptor, nociceptor innervation and control of the spinal system with central nervous system action and interaction. The integration of the pain processing network and the HPA Axis (hypothalamus, adrenal and pituitary) with the chiropractic spinal adjustment. Academy of Chiropractic Post-Doctoral Division, PACE Recognized by The Federation of Chiropractic Licensing Boards, Long Island, NY, 2017

Connective Tissue Pathology and Research, Primary Spine Care, Utilization in spinal models considering the opioid abuse and various spinal models in contemporary health care. Care paths for mechanical spine pain and the evidence for conservative chiropractic care. Academy of Chiropractic Post-Doctoral Division, PACE Recognized by The Federation of Chiropractic Licensing Boards, Long Island, NY, 2017

Connective Tissue Spinal Disc Permanent Pathology, Primary Spine Care, Herniated, bulged, protruded and extruded discs, etiology and morphology. Age-dating disc pathology inclusive of Modic changes, piezoelectric effect, Wolff’s Law and radicular clinical presentation. Academy of Chiropractic Post-Doctoral Division, PACE Recognized by The Federation of Chiropractic Licensing Boards, Long Island, NY, 2017

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. PACE Recognized by The Federation of Chiropractic Licensing Boards, 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, Academy of Chiropractic, Buffalo, NY, 2017

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 in stroke inclusive of diabetes, coagulopathy, acquired and hereditary deficiencies. PACE Recognized by The Federation of Chiropractic Licensing Boards, 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, 2017

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. PACE Recognized by The Federation of Chiropractic Licensing Boards, 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, 2017

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. PACE Recognized by The Federation of Chiropractic Licensing Boards, 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, 2017

Primary Spine Care 2: Spinal Trauma Pathology, Morphology of healthy and traumatized connective tissue and the permanency implication of adhesions, spinal disc morphology in the healthy and pathological patient as sequella to trauma in relationship to bulges, herniations, protrusions, extrusions and sequestrations. Aberrant spinal biomechanics and negative sequella to trauma. Texas Chiropractic College, Academy of Chiropractic, Setauket, NY, 2017

Primary Spine Care 2: Utilizing Research in Trauma, The ability of your electronic health records to convey tissue pathology while documenting case studies, field experiments, randomized trials and systematic literature reviews, Introducing evidence based macros in documentation to support the literature and necessity of care. Texas Chiropractic College, Academy of Chiropractic, Setauket, NY, 2017

Primary Spine Care 2: Chiropractic Evidence, Analyzing segmental pathology, adjusting vs. mobilization with cervicogenic headaches, Opioid alternatives and case management of mechanical spine pain based upon outcome studies. Texas Chiropractic College, Academy of Chiropractic, Setauket, NY, 2017

Primary Spine Care 2: Chiropractic Spinal, Adjustment Central Nervous System Processing, Literature reviews of mechanoreceptor, proprioceptor and nociceptor stimulation of later horn gray matter with periaqueductal stimulation affecting the thalamus and cortical regions with efferent distribution in disparate regions of the body in both pain and systemic stimulation. Texas Chiropractic College, Academy of Chiropractic, Setauket, NY, 2017

McKenzie Method of Mechanical Diagnosis and Therapy, How the McKenzie Method is an assessment tool that incorporates repetitive test movements in various planes to help determine a directional preference to treat a patient’s condition and how it determines the appropriate progression of forces to which the patient will likely respond. Learn the three primary subgroups (syndromes); Derangement Syndrome involves mechanical obstruction to movement within the joint. Dysfunction Syndrome involves pain caused by the mechanical loading of structurally impaired soft tissues and in Postural Syndrome pain develops from prolonged overloading of tissue.  Palmer College of Chiropractic Florida, Port Orange, FL, 2016

Understanding Functional Assessment of the Cervical Spine: Simple Steps to Fix People Faster, An introduction to the examination of the cervical spine anatomy, range of motion and function assessment. A review of the impact of common cervical conditions in the cervical assessment. Learn to efficiently identify the cause of cervical pain and develop effective home-care plans Palmer College of Chiropractic Florida, Port Orange, FL, 2016

Primary Spine Care - Credentials and Knowledge Base, The credentials and knowledge based from an academia perspective when cooperatively treating in a collaborative environment inclusive of understanding pathology and mechanical spine issues. Texas Chiropractic College Graduate Doctoral Program, PACE approved for the Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2016

Cervical Spine Sports Injuries and Concussion Assessment, The pathophysiology of sports related cervical-spine injuries and concussions, including demographics and risk factors, and the most common clinical presentations of cervical-spine injury and concussion sufferers. Acute assessment and management of patients with cervical-spine injuries and concussions with emphasis on pre-participation examinations and post-concussion evaluations for athletes Palmer College of Chiropractic Florida, Port Orange, FL, 2016

Condition, Exam and Adjustment for Pediatric Patient, A look at common conditions presented in a chiropractic office, exploring different exams and techniques for differing age patients presenting with the same conditions. Why modification in exam and technique are important in different age groups. Palmer College of Chiropractic Florida, Port Orange, FL, 2016

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. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016

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. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016

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-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. Central canal and cauda equina compromise interpretation with management. Texas Chiropractic College, Academy of Chiropractic, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Buffalo, NY, 2016

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. Texas Chiropractic College, Academy of Chiropractic, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Buffalo, NY, 2016

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. Texas Chiropractic College, Academy of Chiropractic, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Buffalo, NY, 2016

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 spondylolisthesis, 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. Texas Chiropractic College, Academy of Chiropractic, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Buffalo, NY, 2016

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. [Texas Chiropractic College or PACE Approved for the Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2016

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. [Texas Chiropractic College or PACE Approved for the Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2016

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. [Texas Chiropractic College or PACE Approved for the Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2016

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.[Texas Chiropractic College or PACE Approved for the Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2016

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 diagnosing normal versus abnormal facet motion along with case studies to understand the clinical application. [Texas Chiropractic College or PACE Approved for the Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2016

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, ocular and proprioceptive neurological integration in the righting reflex as evidenced in imaging. Digital and numerical algorithm in analyzing a spine. [Texas Chiropractic College or PACE Approved for the Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division,, Buffalo, NY, 2016

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. [Texas Chiropractic College or PACE Approved for the Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2016

Spinal Biomechanical Engineering: Lumbar Digital Analysis, Digitizing and analyzing the lumbar spine images to diagnose pathobiomechanics. This includes anterior and posterior vertebral body elements in rotational analysis with neutral, left and right lateral bending in conjunction with gate analysis. Ligament instability/failure/pathology is identified all using numerical values and models. Review of case studies for analysis of pathobiomechanics using a computerized/numerical algorithm along with corrective guidelines.[Texas Chiropractic College or PACE Approved for the Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2016

Spinal Biomechanical Engineering: Full Spine Digital Analysis, Digitizing 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 rotational analysis with neutral, left and right lateral bending in conjunction with gate analysis. Ligament instability/failure/pathology is identified all using numerical values and models. Review of case studies for analysis of pathobiomechanics using a computerized/numerical algorithm along with corrective guidelines.[Texas Chiropractic College or PACE Approved for the Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2016

Introduction to Interprofessional Collaboration to Improve Health Care, Interprofessional Communication, Values and Ethics, Teamwork, Interprofessional Education, Roles and Responsibilities. Gain insight on the value of interprofessional collaboration and teamwork as a means of improving healthcare delivery. Accreditation Council on Continuing Medical Education (ACCME) in cooperation with Medscape, Clearwater, FL, 2016

Primary Spine Care – Central Nervous System Processing of Pain and Physiology, Central neural pathways of pain and higher cortical responses to pain and the effect of high amplitude-low velocity forces on mechanoreceptors and proprioceptors. The effects of neuropeptides on the hypothalamus, pituitary and adrenal axis when treating patients. Texas Chiropractic College, Academy of Chiropractic, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Melville, NY, 2016

Primary Spine Care – MRI, Bone Edema and Degeneration, The effects of trauma on spinal vertebral segments and the short and long term sequella to morphology. Identifying and diagnosing bone edema, spurring, types of degeneration in assessing biomechanical stability in conjunction with Modic and Pfirrmann changes. Texas Chiropractic College, Academy of Chiropractic, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Melville, NY, 2016

Primary Spine Care – Hospital and Emergency Room Care, Identifying spinal lesions inclusive of cord and root lesion through examination and advanced imaging in creating an accurate diagnosis, prognosis and treatment plan to effectively triage in collaboration and coordination with medical specialists and emergency department physicians. Differentially diagnosing and triaging disc degenerative bulges, traumatic disc bulges, protrusion herniations, extrusion herniations and fragmented herniations along with managing traumatically induced pain as sequella to degenerative disc trauma. Texas Chiropractic College, Academy of Chiropractic, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Melville, NY, 2016

Interprofessional Hospital Based Spine Care, Trends in hospital and emergent care in the healthcare delivery system inclusive of policies, hospital staffing and current care paths for mechanical spine issues. Texas Chiropractic College Graduate Doctoral Program, Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, NY, 2016

Head Trauma, Brain Injury and Concussion, Brain and head physiology, brain mapping and pathology as a sequella to trauma, Traumatic brain injury, mild traumatic brain injury, axonal shearing, diffuse axonal injury and concussion are detailed in etiology and clinically, Clinical presentation, advanced diagnostic imaging and electrodiagnostics are detailed in analysis to create a differential diagnosis. Balance disorders that often occur as a result of trauma are also explained from clinical presentation to advanced imaging and differential diagnosis. Texas Chiropractic College, Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2016

Primary Spine Care - Spinal Biomechanical Engineering and MRI Spine Interpretation, Integrating Spinal Biomechanical Engineering and MRI Spine Interpretation into a primary spine care model, inclusive of necessity and acquisition protocols. A comprehensive review the latest evidence in documenting mechanical issues, Texas Chiropractic College Graduate Doctoral Program, PACE approved for the Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2016

Primary Spine Care - Hospital Administration, Triage, Clinical Requirements and Collaborative Relationships with Medical Specialists, Understanding hospital and medical specialist's care paths for mechanical spine pathology and integrating the doctor of chiropractic in the hospital and allopathic treatment protocols Texas Chiropractic College Graduate Doctoral Program, PACE approved for the Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island , NY, 2016

Primary Spine Care - Contemporary Spine Research and Documentation, Central nervous system connection and the thalamus, hypothalamus connection in both ascending and descending central pathways with neuro-endocrine implications that have the mechanisms to be a component of Schizophrenia, Dementia and Alzheimer’s with a linear relationship to the chiropractic spinal adjustment and chronic pain Texas Chiropractic College Graduate Doctoral Program, PACE approved for the Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island , NY, 2016

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. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016

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. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016

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 gray matter, thalamus and cortices involvement. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post -Doctoral Division, Buffalo, Buffalo, NY, 2016

Spinal Trauma Pathology: Biomechanics of Traumatic Disc Bulge and Age Dating Herniated Disc Pathology, The biomechanics of traumatic disc bulges as sequella from trauma and the comorbidity of ligamentous pathology. Age-dating spinal disc pathology in accordance with Wolff’s Law. Texas Chiropractic College, ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016

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. Texas Chiropractic College, Academy of Chiropractic Post Doctor Division, Long Island, NY, 2016

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 profession in reconstructing an accident. Texas Chiropractic College, Academy of Chiropractic Post Doctor Division, Long Island, Long Island, NY, 2016

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 and accident. The application of the critical documentation acquired from an accident site. Texas Chiropractic College, Academy of Chiropractic Post Doctor Division, Long Island, NY, 2016

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. Texas Chiropractic College, Academy of Chiropractic Post Doctor Division, Long Island, NY, 2016

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. [Texas Chiropractic College or PACE Approved for the Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2016

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. [Texas Chiropractic College or PACE Approved for the Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2016

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. [Texas Chiropractic College or PACE Approved for the Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2016

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. [Texas Chiropractic College or PACE Approved for the Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2016

Orthopedic Testing: Clinical Grand Rounds, Integration of orthopedic testing in the clinical setting utilizing both simple and complex patient scenarios. It includes potential stroke, or vertebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process. How to integrate orthopedic testing in the clinical setting utilizing both simple and complex patient scenarios. It includes potential stroke, or vertebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process. [Texas Chiropractic College or PACE Approved for the Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2016

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards'], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016

Patient Intake, History and Physical Examination, Determining the etiology of the patient's complaints in a traumatic or non-traumatic scenario. Analyzing the patient's past history and review of systems along with the performance of a complete orthopedic, neurological and clinical examination to correlate both past, current and causality issues to formulate an accurate diagnosis, prognosis and treatment plan. There is an emphasis on triaging both the trauma and non-trauma patients. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island , NY, 2016

Utilization of Research in the Clinical setting, Utilizing peer reviewed scientific literature in creating a diagnosis, prognosis and treatment plan for the chronic and acute patient. How to implement and stay current on techniques and technology in healthcare. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2016

Triaging the Trauma and Non-Trauma Patients, Correlating clinical findings and the patient history in determining the correct course of care in triaging the patient utilizing orthopedic and neurological evaluations in the clinical setting. Understanding the parameters for immediate referrals vs. following the continuum of care to determine the necessity for referrals. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island , NY, 2016

Medical-Legal-Insurance Documentation, Accurate and compliant documentation of history and clinical findings inclusive of functional losses, loss of activities of daily living, duties under duress and permanent loss of enjoyment of life. Prognosing static vs. stable care, gaps in care both in the onset and in the middle of passive care with a focus on detailed diagnosing. The integration of chiropractic academia, the court system and the insurance reimbursor’s requirement’s for complete documentation. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, New York, 2016

Hospital Based Spine Care Qualified, Credentialed in hospital protocols, emergency room protocols, acute and chronic patient triage inclusive of MRI spine interpretation, spinal biomechanical engineering, head trauma, concussion, mild traumatic and traumatic brain injuries, co-credentialed through the ACCME (Accreditation Council for Continuing Medical Education) Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Texas Chiropractic College and PACE approved by the Federation of Chiropractic Licensure Boards and the Academy of Chiropractic, Long Island, NY, 2016

Do Opioids Effectively Treat Low Back Pain?, The utilization of opioids, bed rest and other pharmaceutical agents for the treatment of chronic low back pain in outcome studies. Accreditation Council on Continuing Medical Education (ACCME) in cooperation with Medscape, Clearwater, FL, 2016

ICD-10 Fundamentals and Navigation, The basics of ICD-10, such as how the code set is set up and how to get around within the tabular list. Florida Chiropractic Association, Orlando, FL, 2015

ICD-10 Boot Camp for Chiropractors, An eight step strategy for documentation improvement to ensure that ICD-10 codes are properly supported. Florida Chiropractic Association, Orlando , FL, 2015

An Introduction to the Conversion from ICD-9 to ICD-10, A New Reality, The basics of ICD-10 as to how the code set is set up and how to get around within the tabular list. Florida Chiropractic Association, Orlando, FL, 2015

An Introduction to the Conversion from ICD-9 to ICD-10, A New Reality, Get to know the guidelines used by coders and claims reviewers so you can properly select the right codes. Become familiar with three strategies which will help you down the path to find the code you need. Florida Chiropractic Association, Orlando, FL, 2015

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 Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences and Academy of Chiropractic Post Doctoral Division, Buffalo, New York, 2013

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 Federation of Chiropractic Licensing Boards, New York Chiropractic Council, ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences and Academy of Chiropractic Post Doctoral Division, Buffalo, New York, 2013

MRI Spinal Pathology, MRI interpretation of bone, intradural, extradural, cord and neural sleeve lesions. Tuberculosis, drop lesions, metastasis, ependymoma, schwannoma and numerous other spinal related tumors and lesions Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences and Academy of Chiropractic Post Doctoral Division, Buffalo, New York, 2013

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. Federation of Chiropractic Licensing Board Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences and Academy of Chiropractic Post Doctoral Division, Buffalo, New York, 2013

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 Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences and Academy of Chiropractic Post Doctoral Division, Buffalo, New York, 2013

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 Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Buffalo, New York, 2013

Spinal Biomechanical Engineering, Differential diagnosis of pathobiomechanics in the cervical, thoracic and lumbar spine as sequellae to micro and macro trauma and chronic biomechanical instabilities. Understanding the clinical implications of long term biomechanical failure in resultant disc pathology, ligament pathology and osseous pathology Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post Doctoral Division, Boca Raton, Florida, 2013

Multidisciplinary Practice, Integrated practices and what you need to know when you're ready to hire an M.D.. Florida Chiropractic Association, Boca Raton, Florida, 2013

More Commonly Misdiagnosed Disorders in Clinical Practice, One of the most common causes of medical errors is the misdiagnosis of common disorders seen in daily practice, resulting in improper chiropractic and clinical nutrition interventions, lack of appropriated referrals to the correct primary care specialists for co-management and team care Florida Chiropractic Association, Boca Raton, Florida, 2013

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 Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post Doctoral Division, Long Island, New York, 2013

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 neurodiagnostic. An understanding on how to utilize emergency room records in creating an accurate diagnosis and the significance of “risk factors” in spinal injury Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post Doctoral Division, Long Island, New York, 2013

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 Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post Doctoral Division, Long Island, New York, 2013

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 Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post Doctoral Division, Long Island, New York, 2013

Neurodiagnostic Testing Protocols , Physiology and Indications for the Trauma Patient, 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-Electronystagmography (V-ENG) interpretation, protocols and clinical indications for the trauma patient Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post Doctoral Division, Long Island, Florida, 2013

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 Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post Doctoral Division, Long Island, New York, 2013

Documenting Clinically Correlated Bodily Injury to Causality, Understanding the necessity for accurate documentation, diagnosis and clinical correlation to the injury when reporting injuries in the medical-legal community. Documenting the kinesiopathology, myopathology, neuropathology, and pathophysiology in both a functional and structural paradigm Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post Doctoral Division, Long Island, Florida, 2013

MRI Spine Interpretation, Bulge, herniated, protruded, extruded, sequestered discs, differential diagnoses and clinical triage implications. MRI physics and slice protocols Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post Doctoral Division, Boca Raton, Florida, 2013

Documentation and Triage in Trauma, ICD-9 and CPT requirements in coding for the traumatically injured including integrating electronic health records including informed consent, evaluation and management, testing orders. The utilization of research in medical reports for both the trauma and non-trauma patients. Clinical coordination of care and reporting to healthcare and legal providers Florida Board for Chiropractic Medicine, American Academy of Medical-Legal Professionals, Hollywood, Florida, 2012

Medical-Legal Research and the Documentation of Causal Relationship, Prognosis and Treatment of the Traumatically Injured, Review of current research published in peer reviewed medically indexed journals focusing on traumatic injuries and how current literature affects the diagnostic conclusion and how to formulate treatment plans Florida Board for Chiropractic Medicine, American Academy of Medical-Legal Professionals, Hollywood, Florida, 2012

Biomechanics of Spinal Trauma and its Relationship to Pre-Existing Injuries and Degenerative Changes, Whiplash associated disorders and the biomechanics of side impact vs. rear impact with emphasis on traumatic forces and body position, the mechanism of whiplash injury phases with their relationships to physiologic tolerance to trauma, specific diagnosis of disc pathology and annular tear, disc herniation, fracture, ligamentous injury and instability. Details of spinal nerve root stretching injury and dimensions of the spinal canal during whiplash was outlined particular to significant spinal injury resulting from low level accelerations including pediatric spinal trauma and physiological normals. Spinal surgical intervention techniques including ordering diagnostic studies using MRI, CT and digital motion x-ray Florida Board for Chiropractic Medicine, American Academy of Medical-Legal Professionals, Hollywood, Florida, 2012

MRI Spine Interpretation of Disc Bulge and Herniation, Spinal MRI findings related to degenerative changes vs. traumatic changes of the intervertebral disc by using definitions provided by the American Society of Neuroradiology. Anatomy of the intervertebral disc, spinal cord, nerve roots and spinal ligaments correlated to T1, T2, STIR sagittal, stacking and axial images. Anatomical MRI differentiation of normal, degenerative and traumatic changes Florida Board for Chiropractic Medicine, American Academy of Medical-Legal Professionals, Hollywood, Florida, 2012

Electrodiagnostics Interpretation, EMG/NCV, Somato-sensory evoked potentials, brain stem auditory evoked potential and visual evoked potential utilization, physiology and interpretation, electrodiagnostic testing as a clinical component in part of the neurological work-up of the traumatically injured patient in both the peripheral and central nervous system. Inductions and contraindications to electrodiagnostic procedures. The utilization of electrodiagnostics in concluding radiculopathy, myelopathy and plexopathy and determining recent trauma or chronic pathology. Federation of Chiropractic Licensure Boards, Academy of Chiropractic, American Academy of Medical-Legal Professionals, Hollywood, Florida, 2012

Admissibility Standards of the Medical Expert in Trauma, Documentation requirements of the courts in a medical-legal case including causality, bodily injury and persistent functional losses, ethically reporting of functional loss as it pertains to the integrity of the joint and activities of daily living and implications of chronicity, reporting of normal findings, maximum medical improvement and the release of the patient in the medical-legal arena Federation of Chiropractic Licensure Boards, Academy of Chiropractic, American Academy of Medical-Legal Professionals, Hollywood, Florida, 2012

Credentials and Clinically Correlating Causality, The significance documentation and credentials in the personal injury field with a focus on clinically correlating causality, bodily injury and persistent functional loss as sequellae Academy of Chiropractic Post Doctoral Division, New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, Long Island, New York, 2011

Taking the Pain out of Assessing Pain, Assessing and documenting pain that meets Medicare requirements while improving patient care. The basis for determining the characteristics of pain and their relation to determining the cause. Florida Chiropractic Association, Orlando, 2011

Using Functional Outcome Assessments Successfully, Establishing and documenting a patient's functional status using standardized tools. The use of some typical standardized outcome assessment tools in determining a plan of active care and documenting efficacy of care through improved function. Florida Chiropractic Association, Orlando, Florida, 2011

The Nutritional Adjustment for Effective Pain, How various botanicals, magnesium, vitamin D, probiotics, omega-3 fatty acids and reduced caloric intake act as a nutritional adjustment and help move patients away from pain towards wellness. Florida Chiropractic Association, Orlando, Florida, 2011

Worker's Compensation Certification Course, How to become a Certified State of Florida Workers’ Compensation Provider. Florida Chiropractic Association, Orlando, Florida, 2010

Certification in Workers Compensation as a Health Care Provider, State of Florida Worker’s Compensation, Tallahassee, FL, 2010

Certification as Traditional Naturopath (CTN), American Naturopathic Certification Board, Missoula, Montana, 2009

Nutrition Response Testing Basic Certification Course, The basic understanding and application of nutrition response testing. Michigan Chiropractic Society, Grand Rapids, Michigan, 2007

Certification in Nutrition Response Testing- Basic Level (NRT), Michigan Chiropractic Society, Grand Rapids, Michigan, 2007

Neurobiology, Understanding the neurology of the subluxation complex. Michigan Chiropractic Society Michigan Chiropractic Society, Kalamazoo, Michigan, 2007

Medicare & Insurance Coding Seminar, How to properly code and document for Medicare. Michigan Chiropractic Society, Mackinaw City, Michigan, 2004

Board Certified Naturopathic Physician (BCNP), American Naturopathic Medical Certification & Accreditation Board, Inc., Washington, District of Columbia, 2002

Essentials of Nutritional Therapy, Clinical application of nutrition for your chiropractic practice. Michigan Chiropractic Society, Mackinaw Island, Michigan, 2002

HIPAA Compliance, How to implement HIPAA into your practice. Michigan Chiropractic Society Michigan Chiropractic Society, Mount Pleasant, Michigan, 2002

Pain Neutralization Technique, A manual technique that uses simple neurological reflexes to treat trigger points that are associated with any muscle or joint pain condition. Michigan Chiropractic Society, Mount Pleasant, Michigan, 2000

Radiology Related to Pain Management, The relationship of radiology in the management of your patients. Michigan Chiropractic Society, Mount Pleasant, Michigan, 2000

SELECTED TEACHING/INSTRUCTING/LECTURING/CONSULTING

 

Instructor, 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, Long Island NY, 2020

 

Instructor, 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, Long Island NY, 2020

EMS Course Instructor, Fractures, Munson Medical Center, Traverse City, Michigan, 2004

EMS Course Instructor, Cardiac Anatomy, Munson Medical Center, Traverse City, Michigan, 2004

Biochemistry Teaching Assistant, Biochemistry Laboratory, Palmer College of Chiropractic, Davenport, Iowa, 1995-1996

SELECTED PUBLICATIONS

Erickson M., Studin M., (2020), Chiropractic Adjustment vs. Manual Therapy DC vs. DO vs. PT, Part 2 of 2, American Chiropractor 42 (2), pgs. 34, 36, 38-40.   The publication can be viewed on the following website:   

The American Chiropractor:  Published January of 2020  

https://theamericanchiropractor.com/article/2020/3/1/chiropractic-spinal-adjustment-manipulation-adjustment-vs-manual-therapy-dc-vs-do-vs-pt

Erickson M., Studin M. (2020) Chiropractic Spinal Adjustment/Manipulation, Part 1 of 2, American Chiropractor 42(1), 22, 24, 26, 28,30-33.  The publication can be viewed on the following websites:

The American Chiropractor:  Published September of 2019  

https://theamericanchiropractor.com/article/2020/1/1/chiropractic-spinal-adjustmentmanipulation

The US Chiropractic Directory:  Published February 19th, 2020

https://www.uschirodirectory.com/index.php?option=com_k2&view=item&id=850:chiropractic-co-management-of-pre-post-spine-surgical-cases&Itemid=320

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Erickson M., Studin M., Ragab A. (2019) Chiropractic Co-Management of Pre and Post-Spine surgical Cases, American Chiropractor 41(9), 34, 36, 38-40.  The publication can be viewed on the following websites:

The American Chiropractor:  Published September of 2019  

https://theamericanchiropractor.com/article/2019/9/1/chiropractic-co-management-of-pre-and-post-surgical-spine-cases

The US Chiropractic Directory:  Published February 19th, 2020

https://www.uschirodirectory.com/index.php?option=com_k2&view=item&id=850:chiropractic-co-management-of-pre-post-spine-surgical-cases&Itemid=320

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Erickson M., Studin M. (2019). Chiropractors Reduce Costs by 40% if the 1st Option for Spine, American Chiropractor 41(8), 38,40-43. The publication can be viewed on the following websites:

The American Chiropractor:  Published August of 2019  

https://theamericanchiropractor.com/article/2019/8/1/chiropractors-reduce-costs-by-40-if-the-1st-option-for-spine

The US Chiropractic Directory:  Published August 16th, 2019

https://www.uschirodirectory.com/index.php?option=com_k2&view=item&id=844:chiropractors-reduce-costs-by-40-if-the-1st-option-for-spine-dc-s-would-save-the-healthcare-system-1-86-trillion-dollars-over-10-years&Itemid=320

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Studin M., Owens W., Erickson M. (2019). The Chiropractic Adjustment Changes Brain Function - The Evidence of Increased Muscle Strength is Added to Pain Sensitivity and Autonomic Changes.  The publication can be viewed on the following website:  

The US Chiropractic Directory:  Published July 16th, 2019

https://www.uschirodirectory.com/index.php?option=com_k2&view=item&id=843:the-chiropractic-adjustment-changes-brain-function-the-evidence-of-increased-muscle-strength-is -added-to-pain-sensitivity-and-autonomic-changes&Itemid=320

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Erickson M, Studin M, Edwards J, Wickiser C. (2019). Traumatic Myelomalacia, Diagnosis & Collaborative Management Between the Chiropractor as the Primary Spine Care Provider and the Neurosurgeon. American Chiropractor 41(6) 18, 20, 22, 23, 24, 26, 28.  The publication can be viewed on the following websites:

The American Chiropractor:  Published August of 2019  

https://theamericanchiropractor.com/article/2019/6/1/traumatic-myelomalacia

The US Chiropractic Directory:  Published May 17th, 2019

https://www.uschirodirectory.com/index.php?option=com_k2&view=item&id=842:traumatic-myelomalacia-diagnosis-collaborative-management-between-the-chiropractor-as-the-primary-spine-care-provider-and-the-neurosurgeon&Itemid=320

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Groteke, E., Erickson, M., Scinico, M. (2007). Chronic Degenerative Syndrome (CDAS) and The Quantification and Use of Its Results. “The Chiropractic-Corporate Connection.”  Michigan Association of Chiropractors Journal, Nov/Dec, 40-41.  The publication can be viewed on the following website:  

Body Right Chiropractic:  Published February 20th, 2020

http://bodyrightchiropractic.com/blog/1376/

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SELECTED MEMBERSHIPS

Academy of Regenerative Orthopedic Medicine, Member, 2018 - Present

Academy of Chiropractic, Active Trauma Team Member, 2017 - Present

Academy of Chiropractic, Member, 2011 - Present

Business Network International, Referral Exchange Chapter, Member, 2009 - 2014

Certified Traditional Naturopath (CTN), American Naturopathic Certification Board, 2009 - 2012  

Michigan Association of Chiropractors, District 8, Regional Representative, 2007

Michigan Association of Chiropractors, District 8, Board Member, 2007

Michigan Association of Chiropractors, Member, 2007

Florida Chiropractic Association, Member, 2004 - Present 

Michigan Chiropractic Society, District 6 President, 2004, 2006

Michigan Chiropractic Society, District 6, Board Member, 2004, 2006

Business Network International, Business Before Sunrise Chapter, Member, 2003 - 2004

Michigan Chiropractic Society, Member, 2000 - 2007

Traverse City Chamber of Commerce, Member, 1999 - 2008

Palmer College of Chiropractic Alumni, Member, 1998 - Present 

Palmer College of Chiropractic Interdisciplinary Club, Member, 1997 - 1998

Palmer Student Alumni Foundation, Member, 1994 - Present 

Hope College Alumni Association, Member, 1994

SELECTED HONORS AND AWARDS

Voted one of Tampa’s Best Chiropractors of the Year, Tampa Style Magazine, 2020

Best Clearwater Chiropractor Award, Best Chiropractors Awards, 2020

America’s Best Chiropractor, National Consumer Advisory Board, 2020

Best Clearwater Chiropractor Award, Best Chiropractors Awards, 2019

Gold Clinical Excellence Award, Academy of Chiropractic, 2019

Silver Clinical Excellence Award, Academy of Chiropractic, 2019

Readers’ Choice Awards, Best Of The Best, TBN Weekly, 2019

Spectrum Award for Excellence in Customer Service, City Beat News, 2019

Bronze Clinical Excellence Award, Academy of Chiropractic, 2018

Copper Clinical Excellence Award, Academy of Chiropractic, 2018

Top Chiropractor in Clearwater, International Association of Chiropractors, 2018

Spectrum Award for Excellence in Customer Service, City Beat News, 2017

Patients' Choice Winner for Chiropractic in Clearwater, OpenCare, 2016

Best of Clearwater in Chiropractic, Best Businesses, 2016

Best of Clearwater in Chiropractic, Best Businesses, 2015

Who’s Who In Executives and Businesses, Who’s Who, 2002

President’s List Award, Palmer College of Chiropractic, 1998

President’s List, Palmer College of Chiropractic, 1997

SELECTED COMMUNITY SERVICE

Clearwater Academy Football Team, Team Chiropractor, Clearwater, Florida, 2011

National Cherry Festival, Ambassador, Traverse City, Michigan, 2001 - 2007

Toys for Tots, Drop Off Site, Traverse City, Michigan, 2001 - 2007

Faith Reformed Church, Usher, Traverse City, Michigan, 2004 - 2007

National Cherry Festival, Assistant Director-Milk Carton Boat Regatta, Traverse City, Michigan, 2005 - 2006

Traverse City Central High School, Team Chiropractor, Traverse City, Michigan, 2000 - 2003

Glen Lake High School Football, Team Chiropractor, Traverse City, Michigan, 1998 - 2001