Dean Insana DC
2028 Chapel Ave, Cherry Hill, NJ, 08002
Phone: 856-662-4848
Fax: 856-662-9223
drdean4848@comcast.net
http://www.DrDeanInsana.com

SELECTED OCCUPATIONAL HISTORY

Clinic Director, Chiropractor, Dr. Insana’s Wellness Center, L.L.C, Cherry Hill, NJ,

1996-Present

Chiropractor, 6808 Chiropractic Center, Philadelphia, PA, 1996 - 1997

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

EDUCATION AND LICENSURE

Doctor of Chiropractic, licensed in the State of New Jersey, License #MC 04934, 1996 -Present

Doctor of Chiropractic, licensed in the State of Florida, License # CH10440, 2011 -Present

Doctor of Chiropractic, New York Chiropractic College, Seneca Falls, NY, 1996

Internship, New York Chiropractic College Outpatient Facility, Levittown, NY, 1995-1996

National Board of Chiropractic Examiners, Part I, 1994

National Board of Chiropractic Examiners, Part II, 1995

National Board of Chiropractic Examiners, Part III, 1995

National Board of Chiropractic Examiners, Part IV, 1996

Master’s in Business Administration, Long Island University, Brooklyn, NY, 1983

Bachelor of Arts in Accounting, Queens College, Flushing, NY, 1978

CERTIFICATIONS, QUALIFICATIONS, AND DIPLOMATES

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), Cleveland University – Kansas City and the Academy of Chiropractic, Long Island, New York, 2022

Primary Spine Care Qualified, Cleveland University Kansas City, Chiropractic Health Sciences, Academy of Chiropractic – Post-Doctoral Division, 2018

Trauma Qualified, Cleveland University Kansas City, Chiropractic Health Sciences, Academy of Chiropractic – Post-Doctoral Division, 2018

Certification in Spinal Biomechanical Engineering, ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Buffalo, NY 2014

Certification in MRI Interpretation, ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, University of Bridgeport, Division of Health Sciences Postgraduate Education Department, and Federation of Chiropractic Licensing Boards, 2013

Certification in Active Release Techniques (ART), New York Chiropractic College, 2000

SELECTED POST-GRADUATE EDUCATION

Case Management, Documentation, and Diagnosis, Clinically correlating history and clinical findings to biomechanical connective tissue pathology and advanced imaging with herniated, protrude, extruded, and bulging discs. Triaging trauma and chronic patients based upon clinical presentation and testing results. Cleveland University Kansas City, College of Chiropractic, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2022

Traumatic Brain Injury and Concussion Overview: This section is an in-depth overview of traumatic brain injury in concussion. It discusses that all brain injuries are traumatic and dispels the myth of a “mild traumatic brain injury.” Also, this covers triage protocols and the potential sequela of patients with traumatic brain injuries. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022

Head Trauma and Traumatic Brain Injury Part 1: This section discusses gross traumatic brain injuries from trauma and significant bleeding with both epidural and subdural hematomas. There are numerous case studies reviewed inclusive of neurosurgical intervention and postsurgical outcomes. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022

Head Trauma and Traumatic Brain Injury Part 2: This section continues with multiple case studies of gross traumatic brain injuries from trauma requiring neurosurgical intervention and also discusses recovery sequela based upon the significance of brain trauma. This module also concludes with concussion protocols in traumatic brain injury short of demonstrable bleeding on advanced imaging. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022

Concussion And Electroencephalogram Testing: This this section covers concussion etiology and cognitive sequela where gross bleeding has not been identified on advanced imaging. It discusses the significance of electroencephalogram testing in determining brain function and pathology (if present). This module also covers the understanding of waveforms in electroencephalogram testing in both normal and abnormal scenarios. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022

Concussion And Electroencephalogram Testing Pathological Results: This module covers amplitude, conduction and conduction delays as sequela to traumatic brain injury to diagnose concussion and traumatic brain injury in the absence of gross bleeding and advanced imaging. This section covers electroencephalograms and event-related potentials which measures the brain response that is a direct result of specific sensory or motor events. It is a stereotype electrophysiological response to a stimulus and provides a noninvasive means of evaluating brain function. In this module multiple case studies are discussed with ensuing triage protocols pending the results. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2022

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 , 2022

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 , 2022

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. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2022

2022 Trends in Spinal Healthcare, Analyzing evidenced-based spinal healthcare trends in both utilization and necessity and understanding the marketplace.  The use of evidenced-based demonstrative documentation in reporting treatment pathways in triaging spinal pathobiomechanics. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021

MRI Spine Clinical Case Grand Rounds, Clinical case review of MRI’s including sagittal, axial, T1, T2, STIR, and proton density sequences. Identified will be the vertebrate, spinal cord, discs, nerve roots, thecal sac, posterior longitudinal ligament, epidural veins, and fat saturation pulses. Pathology will include bulges, herniations, protrusions, extrusions, myelomalacia, cord edema, and Schmorl’s nodes. Learn how to collaborate effectively with radiologists, neuroradiologists, and neurosurgeons on the clinical findings.Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021

Chiropractic vs. Physical Therapy vs. Medical Case Management and Outcomes, Analysing evidence-based outcomes in triaging non-anatomical lesions. The analysis of neuro-biomechanical pathological lesions defines primary spinal lesions and removes the dogma of non-specific back pain. Managing collaborative relationships with medical primary providers and specialists in clinical practice. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021

MSK Extremity Radiological Interpretation, Utilizing both MRI and x-ray in identifying via x-ray and advanced imaging extremity instabilities from ligamentous, osseous or neoplastic derangement.Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021

Demonstrative Narrative and Evaluation and Management Report Writing, Effectively creating demonstrative medical-legal documentation and meeting the needs of the courts, and making your "4-Corner" (narrative) report to build your reputation as an evidence-based provider. The step-by-step minutiae of building a report, accomplishing report writing timely and effectively by understanding the regulatory and administrative rules. Learn how to educate the lawyer on bodily injury through evidence-based demonstrative reporting.Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021

Ligament/Connective Tissue Physiology and Pathology, Master-Class in ligaments; anatomy, physiology, vascularization, neurological innervation, tissue repair and how they all relate to clinical practice.  Ligament pathology correlating to the mechanisms of patho-neuro-biomechanical lesions (vertebral subluxation complex). Also, how ligaments play a critical role in the chiropractic spinal adjustment and in defining the chiropractic spinal adjustment mechanisms. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021

Stroke Evaluation and Risk Factors in the Chiropractic Practice, Diagnosing, triaging, and documenting headaches, migraines, and vascular incidents (stroke) in the primary provider's office. Imaging protocols based upon history and clinical presentation will be presented, along with analyzing imaging findings in determining the etiology. There will be an extensive question and answer session following the instructional presentation.Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021

Age-Dating Herniated Discs and Trauma, Age dating herniated discs and trauma is a critical skill for an expert in spine. It combines the clinical skills of interpreting X-ray, MRI, and other imaging modalities with a clinician's understanding of joint pathology. This level of expertise is critical when collaborated with other physicians or working in the medical-legal environment as an expert. Age dating pathology is also central to creating a prognosis on your patient's recovery and must be evidence-based in rationale. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021

Clinical Grand Rounds in Spinal Biomechanics, Case reviews utilizing E/M, MRI, and x-ray mensuration report to conclude an accurate diagnosis, prognosis, and treatment plan. Common diagnosis requiring interprofessional collaboration with a discussion of diagnostic dilemmas and proper communication methods. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021

Neurosurgical Grand Rounds, A clinical discussion of collaborating with neurosurgeons on spinal cord and spinal nerve root co-morbidities. Triaging cases with herniated, protruded, extruded, fragments discs and differentially diagnosing tethered cord, syringomyelia, traumatic Schmorl’s Nodes, Myelomalcia, spinal cord edema, vacuum disc and other intra, and extra-dural lesions. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2021

Documentation, Demonstrative and Compliance, Elements of Evaluation and Management codes 99202-99203-99204-99205, inclusive of complexity of management and time components. Demonstrative documentation of spinal-related pain generators; spinal cord, thecal sac, myelomalacia, spinal nerve root insult, connective tissue, recurrent meningeal nerves. Academy of Chiropractic Post-Doctoral Division, Cleveland University Kansas City, Chiropractic and Health Sciences, Long Island, NY, 2021

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, 2021

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, 2021

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, 2021

Spinal Biomechanical Engineering Clinical Grand Rounds, Case reviews utilizing E/M, MRI, and x-ray mensuration report to conclude an accurate diagnosis, prognosis, and treatment plan. Common diagnosis requiring interprofessional collaboration with a discussion of diagnostic dilemmas and proper communication methods. Academy of Chiropractic Post-Doctoral Division, Cleveland University  Kansas City, Long Island, NY, 2021

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

Evaluation and Management, An overview of the evaluation and management process inclusive of utilizing electronic medical records to conclude evidenced-based conclusions with the utilization of macros. The importance of adhering to an academic standard and considering co-morbidities. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019

Evaluation and Management, Concluding a chief complaint, history and what needs to be considered in a physical examination. This covers in dept the required elements for chief complain, history of present illness, review of systems, and past, family, and/or social history. This module also covers the following components of a physical examination: observation, palpation, percussion, and auscultation. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019

Evaluation and Management, Coding and Spinal Examination: Detailing 99202-99205 and 99212-99215 inclusive of required elements for compliant billing. It reviews the elements for an extensive review of systems, cervical and lumbar anatomy and basic testing. The course also covers the basics of vertebra-basilar circulation orthopedic assessment. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019

Evaluation and Management, Neurological Evaluation: Reviewing complete motor and sensory evaluation inclusive of reflex arcs with an explanation of Wexler Scales in both the upper and lower extremities. The course breaks down testing for upper and lower motor neuron lesions along with upper and lower extremity motor and sensory testing examinations. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019

Evaluation and Management, Documenting Visit Encounters: Forensically detailing the S.O.A.P. note process for visit encounters and discussing the necessity for clinically correlating symptoms, clinical findings and diagnosis with the area(s) treated. It also details how to modify treatment plans, diagnosis, document collaborative care and introduce test findings between evaluations. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019

Evaluation and Management, Case Management and Treatment Orders: This module discusses how to document a clinically determined treatment plan inclusive of both manual and adjunctive therapies. It discusses how to document both short-term and long-term goals as well as referring out for collaborative care and/or diagnostic testing.  It also includes how to prognose your patient and determine when MMI (Maximum Medical Improvement) has been attained. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019

Electrodiagnostics: Electromyogram/Nerve Conduction Velocity (EMG/NCV), Diagnosis & Interpretation: Anatomy and Physiology of Electrodiagnostics:  An in-depth review of basic neuro-anatomy and physiology dermatomes and myotomes to both the upper and lower extremities and the neurophysiology of axons and dendrites along with the myelin and function of saltatory for conduction. The sodium and potassium pump’s function in action potentials. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island NY, 2019

Electrodiagnostics: Electromyogram/Nerve Conduction Velocity (EMG/NCV), Diagnosis & Interpretation: Nerve Conduction Velocity (NCV) Part 1: Nerve conduction velocity testing, the equipment required and the specifics of motor and sensory testing. This section covers the motor and sensory NCV procedures and interpretation including latency, amplitude (CMAP) physiology and interpretation including the understanding of the various nuances of the wave forms. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island NY, 2019

Electrodiagnostics: Electromyogram/Nerve Conduction Velocity (EMG/NCV), Diagnosis & Interpretation: Nerve Conduction Velocity (NCV) Part 2: Compound motor action potentials (CMAP) and sensory nerve action potentials (SNAP) testing and interpretation including the analysis and diagnosis of the wave forms. It also covers compressive neuropathies of the median, ulnar and posterior tibial nerves; known as carpal tunnel, cubital tunnel and tarsal tunnel syndromes. This section offers interpretation algorithms to help understand the neurodiagnostic conclusions. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island NY, 2019

Electrodiagnostics: Electromyogram/Nerve Conduction Velocity (EMG/NCV), Diagnosis & Interpretation: Needle Electromyogram (EMG) Studies: The EMG process, inclusive of how the test is performed and the steps required in planning and electromyographic study. This covers the spontaneous activity of a motor unit action potential, positive sharp waves and fibrillations. The insertional activity (both normal and abnormal), recruitment activity in a broad polyphasic presentation and satellite potentials. This covers the diagnosing of patterns of motor unit abnormalities including neuropathic demyelinated neuropathies along with acute myopathic neuropathies. This section also covers the ruling out of false positive and false negative results. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island NY, 2019

Electrodiagnostics: Electromyogram/Nerve Conduction Velocity (EMG/NCV), Diagnosis & Interpretation: Overview of EMG and NCV Procedures, Results, Diagnoses and Documentation. The clinical incorporation of electrodiagnostic studies as part of a care plan where neuropathology is suspected. It also covers how to use electrodiagnostics in a collaborative environment between the chiropractor as the primary spine care provider and the surgeon, when clinically indicated. This section covers sample cases and health conclude and accurate treatment plans based upon electro-neurodiagnostic findings when clinically indicated. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island NY, 2019

Forensic Documentation-Report Writing, Report writing in a medical-legal case inclusive of causality, bodily injury, persistent functional loss and restrictive sequela from trauma. Demonstratively documenting bodily injury utilizing models, graphs and patient image of x-ray and advanced imaging. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019

Forensic Documentation- Demonstrative Documentation, Demonstratively reporting spinal biomechanical failure and spinal compensation. How in a medical-legal environment to ethically report pre-existing injuries vs causally related current injuries and what is permissible in a legal proceeding. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019

Forensic Documentation- Reporting Direct Opinions , Cauality, bodily injury and persistent functional losses documented and reported in a medical-legal environment as your direct opinion. Avoiding hearsay issues to ensure ethical relationships. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019

Forensic Documentation- Initial, Final and Collaborative Reporting ,Preparing demonstrative documentation in a medical-legal case ensuring that you are familiar with all other treating doctor’s reports. Correlating your initial and evaluation and management (E&M) report and your follow-up E&M reports with the narrative upon maximum medical improvement documenting continuum of care.  Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019

Forensic Documentation- Qualifications and Preparation of Documentation, How to prepare your documentation for courtroom testimony and ensuring your qualifications are documented properly on an admissible, professional curriculum vitae. How to include indexed peer-reviewed literature in medical-legal documentation,  Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019

Forensic Documentation- Reporting Patient History and Credentials ,Preparing patient history in a medical-legal case based upon your initial intake forms and understanding the work, social, academic, household and social activities of your patient. Understanding and explaining your doctoral and post-doctoral credentials in the courtroom.  Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019

Forensic Documentation- Reporting Chiropractic Care and Injured Anatomy , Preparing demonstrative documentation in a medical-legal case to report the bodily injuries of your patients , inclusive of loss of function and permanent tissue pathology.  Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019

Forensic Documentation- Reporting Temporary vs. Permanent Issues, Preparing documentation in a medical-legal case ensuring that you can communicate permanent vs. temporary functional losses and permanent vs. temporary tissue pathology. How to maintain and explain ethical relationships in medical-legal cases, Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019

Forensic Documentation- Reporting Bodily Injury, How to report bodily injury and functional losses as supported by your credentials in a medical-legal case. Clinically correlating causality and permanent tissue pathology as sequela to trauma, Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019

Forensic Documentation- Record Review and Documentation Reporting, How to report records of collaborative treating doctors and communicating your scope of practice in the management of your case. How to ethically report your role as a doctor in medical-legal cases, Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, 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. Academy of Chiropractic, Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Buffalo, NY, 2019

Clinical Grand Rounds – Thoracic Intervertebral Disc Herniation with Subsequent Four Level Spinal Fusion T6-T10 case review of multilevel intervertebral disc herniations in the thoracic spine with clinical correlation to mechanism of injury, physical examination findings, neurological examination and range of motion analysis. Differential diagnosis of facet syndrome, thoracic radiculopathy and discogenic pain including structural innervation of surrounding tissues and intervertebral discs with referral pattern was reviewed and discussed. Subsequent failure of chiropractic care and rehabilitation leading to multilevel thoracic spinal fusion was demonstrated and reviewed. Plain film radiographs and MRI evaluation of the thoracic spine sagittal and axial images in T1, T2 and STIR was demonstrated and clinically correlated to objective findings and subjective complaints. Interprofessional referral and documentation was outlined and discussed. Academy of Chiropractic, Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Buffalo, 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 5th 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. Academy of Chiropractic, Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, 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. Academy of Chiropractic, Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, 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, Cleveland University Kansas City, Chiropractic and Health Sciences, 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, Cleveland University Kansas City, Chiropractic and Health Sciences, 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, Cleveland University Kansas City, Chiropractic and Health Sciences, 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, Cleveland University Kansas City, Chiropractic and Health Sciences, Long Island, New York, 2019

Clinical Grand Rounds – 14 mm Cervical Disc Herniation with Spinal Cord CompressionA case review of traumatically induced 14 mmm 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. Academy of Chiropractic, Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, 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 comparted to plain film images and CT scan images. Interprofessional communication both verbally and through proper evidence-based documentation was emphasized and discussed. Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, 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.  Recognized by the PACE Program for the Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 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.  Recognized by the PACE Program for the Federation of Chiropractic Licensing Boards, 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. Recognized by the PACE Program for the Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019 

Clinical Grand Rounds – Traumatically Induced Cervical Central Canal Stenosis, Case review of traumatically induced acute cervical intervertebral disc extrusion with superior migration resulting in 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. Recognized by the PACE Program for the Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019

Documentation, Carrier Mandates and How the Guide ER 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 processes. Cleveland University – Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2019

Medical-Legal Ethical Relationships, Documentation and Legal Testimony, Report writing for legal cases, the 4 corners of a narrative and documenting damages with understanding defense medical documentation and consistent reporting of bodily injuries. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018

Medical-Legal Ethical Relationships, Documentation and Legal Testimony, Part 2, Understanding report writing and the types of medical reports required for court inclusive of diagnosis, prognosis and treatment plans with requirements of reporting causality and permanency. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018

Medical-Legal Ethical Relationships, Documentation and Direct Testimony, Organizing your documentation and understanindg all collaborative documentation and how it fits into your diagnosis, prognosis and treatment plan, Understanding the nuances of the functional losses of your patients related to their bodily injuries, Academy of Chiropractic, Post-Doctoral Division. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018

Medical-Legal Ethical Relationships, Documentation and Direct Testimony Part 2, Utilizing demonstrative documentation in direct examination and communicating the results of your care concurrently with the written documentation and reporting an accurate diagnosis for all images. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018

Medical-Legal Ethical Relationships, Documentation and Direct Testimony Part 3, The evaluation, interpretation and reporting of collaborative medical specialists results and concluding an accurate diagnosis inclusive of all findings and reviewing all images to ensure an accurate diagnosis. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018

Medical-Legal Ethical Relationships, Documentation and Direct Testimony Part 4, Determininig and documenting disabilities and impairments inclusive of loss of enjoyment of life and duties under duress and the evaluation and validation of pain and suffering. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018

Medical-Legal Ethical Relationships, Documentation and Cross Examination Testimony, Reporting your documentation factually and staying within the 4 corners of your medical report and scope of practice inclusive of understanding how your credentials allow you to report your documentation. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018

Medical-Legal Ethical Relationships, A Documentation Relationship Between the Doctor and Lawyer, The level of organization required in a medical-legal case that accurately reflects the bodily injuries of your patients and the time constraints in rendering an accurate report. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018

Medical-Legal Ethical Relationships, Report Writing and Preparing for a Legal Case, Reviewing the facts of the case inclusive of your documentation, the defense medical examiner, medical specialists and the attorney to ensure accurate and consistent reporting. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018

Medical-Legal Ethical Relationships, Report Writing and Preparing for a Legal Case, Creating demonstrative evidence, visuals of your patient's bodily injuries inclusive of x-rays, MRI's, CAT Scans and electrodiagnostic findings, the spinal biomechanics of herniated disc with ipsilateral findings and contralateral symptomatology. 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 of the spine. 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, MRI Spine The spine-brain connection in managing chronic pain patients. Understanding how chronic pain negatively effects brain morphology and potential 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 dorsal 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.  Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2018

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, Cleveland University – Kansas City, 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, Cleveland University – Kansas City, 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, Cleveland University – Kansas City, Long Island, NY, 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, Cleveland University – Kansas City, Long Island, NY, 2017

Spinal Trauma Pathology, Triage and Connective Tissue Injuries and Wound Repair, Triaging the injured and differentially diagnosing both the primary and secondary complaints. Connective tissue injuries and wound repair morphology focusing on the aberrant tissue replacement and permanency prognosis potential. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2017

Spinal Trauma Pathology, Ligament Anatomy and Injury Research and Spinal Kinematics, Spinal ligamentous anatomy and research focusing on wound repair, future negative sequelae of abnormal tissue replacement and the resultant aberrant kinematics and spinal biomechanics of the spine. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2017

Spinal Trauma Pathology, Spinal Biomechanics, Central Nervous System and Spinal Disc Nomenclature, The application of spinal biomechanical engineering models in trauma and the negative sequelae it has on the central nervous system inclusive of the lateral horn, periaqueductal grey matter, thalamus and cortices involvement. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2017

Spinal Trauma Pathology, Biomechanics of Traumatic Disc Bulge and Age Dating Herniated Disc Pathology, The biomechanics of traumatic disc bulges as sequelae from trauma and the comorbidity of ligamentous pathology. Age-dating spinal disc pathology in accordance with Wolff’s Law. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2017

Spinal Trauma Pathology, Clinical Grand Rounds, The review of case histories of mechanical spine pathology and biomechanical failures inclusive of case histories, clinical findings and x-ray and advanced imaging studies. Assessing comorbidities in the triage and prognosis of the injured. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2017

Spinal Trauma Pathology, Research Perspectives, The review of current literature standards in spinal trauma pathology and documentation review of biomechanical failure, ligamentous failure and age-dating disc pathology. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 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. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 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 instroke inclusive of diabetes, coagulopathy, acquired and hereditary deficiencies. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 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. Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 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.Cleveland University – Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2017

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. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2016

Primary Spine Care - Spinal Biomechanical Engineering and MRI Spine Interpretation, IntegratingSpinal 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.Cleveland University - Kansas City, 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 specialis's care paths for mechanical spine pathology and integrating the doctor of chiropractic in the hospital and allopathic treatment protocols.Cleveland University - Kansas City, 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.Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 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. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016

Orthopedic Testing: Clinical Grand Rounds, how to integrate orthopedic testing in the clinical setting utilizing both simple and complex patient scenarios. It includes potential stroke, or vertebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process. How to integrate orthopedic testing in the clinical setting utilizing both simple and complex patient scenarios. It includes potential stroke, or vertebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process. Cleveland University Kansas City, ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 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 reimburser’s requirements for complete documentation. Cleveland University – Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2015

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, 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, 2014

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, 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, 2014

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, 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, 2014

Spinal Biomechanics in Trauma, To utilize whiplash associated disorders in various vectors of impact and whiplash mechanisms in determining pathobiomechanics. To clinically correlate annular tears, disc herniations, fractures, ligament pathology and spinal segmental instability as sequellae to pathobiomechanics from trauma. The utilization of digital motion x-ray in diagnoising normal versus abnormal facet motion along with case studies to understand the clinical application. Texas Chiropractic College, 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, 2014

Spinal Biomechanical Engineering & Organizational Analysis, Integrating spinal biomechanics and pathobiomechanics through digitized analysis.The comparison of organized versus disorganized compensation with regional and global compensation. Correlation of the vestibular, occular and proprioceptive neurological integration in the righting reflex as evidenced in imaging. Digital and numerical algorithm in analyzing a spine. Texas Chiropractic College, 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, 2014

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, 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, 2014

Spinal Biomechanical Engineering: Lumbar Digital Analysis, Digitalizing and analyzing the lumbar spine images to diagnose pathobiomechanics. This includes anterior and posterior vertebral body elements in rotatioal analysis with neutral, left and right lateral bending in conjunction with gate analysis. Ligament instability/failure/pathology is identified all using numerical values and models.  Review of case studies for analysis of pathobiomechanics using a computerized/numerical algorithm along with corrective guidelines. Texas Chiropractic College, 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, 2014

Spinal Biomechanical Engineering: Full Spine Digital Analysis, Digitalizing and analyzing the full spine images to diagnose pathobiomechanics as sequellae to trauma in relation to ligamentous failure and disc and vertebral pathology as sequellae. This includes anterior and posterior vertebral body elements in rotatioal analysis with neutral, left and right lateral bending in conjunction with gate analysis. Ligament instability/failure/pathology is identified all using numerical values and models. Review of case studies for analysis of pathobiomechanics using a computerized/numerical algorithm along with corrective guidelines. Texas Chiropractic College, 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, 2014

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. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, NY, 2013

Neurodiagnostics, Imaging Protocols and Pathology of the Trauma Patient, An in-depthunderstanding of the protocols in triaging and reporting the clinical findings of the traumapatient. Maintaining ethical relationships with the medical-legal community. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, NY, 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 neurodiagnostics. An understanding on how to utilize emergency room records in creating an accurate diagnosis and the significance of “risk factors” in spinal injury. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, NY, 2013

Crash Dynamics and Its Relationship to Causality, An extensive understanding of the physicsinvolved in the transference of energy from the bullet car to the target car. This includes G's offorce, 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. Determiningthe clinical correlation of forces and bodily injury. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, NY, 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, physiologyand clinical indications, x-ray clinical indications for the trauma patient.Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, NY, 2013

Neurodiagnostic Testing Protocols, Physiology and Indications for the Trauma Patient, Electromyography (EMG), Nerve Conduction Velocity (NCV), Somato Sensory Evoked Potential (SSEP), Visual Evoked Potential (VEP), Brain Stem Auditory Evoked Potential (BAER) and Visual-Electronystagmosgraphy (V-ENG) interpretation, protocols and clinical indications for the trauma patient. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, NY, 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. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, NY, 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. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, NY, 2013

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.Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, NY, 2013

Accident Reconstruction: Causality, Bodily Injury, Negative Acceleration Forces, Crumple Zones and Critical Documentation, Factors that cause negative acceleration to zero and the subsequent forces created for the vehicle that get translated to the occupant. Understanding critical documentation of hospitals, ambulance reports, doctors and the legal profession in reconstructing an accident.Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, NY, 2013

Accident Reconstruction: Skid Marks, Time, Distance, Velocity, Speed Formulas and Road Surfaces, The mathematical calculations necessary utilizing time, distance, speed, coefficientsof friction and acceleration in reconstructing an accident. The application of the critical documentation acquired from an accident site. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, NY, 2013

Accident Reconstruction: Research, Causality and Bodily Injury, Delta V issues correlated toinjury 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 andinquiries related to head restraints.Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, NY, 2013

Impairment Rating Certification, 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. Academy of Chiropractic Post-Doctoral Division, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Long Island, NY, 2013

MRI Protocols Clinical Necessity, MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSEand 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 andsequestration. 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, Long Island, NY, 2013

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. 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, Long Island, NY, 2013

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. 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, Long Island, NY, 2013

MRI Interpretation of Cervical 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. Spinal cord and canal compromise interpretation with management. 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, Long Island, NY, 2013

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. 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, Long Island, NY, 2013

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. 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, Long Island, NY, 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. 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, NY, 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. 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, NY, 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. 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, NY, 2013

MRI Spinal Pathology, MRI interpretation of bone, intradural, extradural, cord and neural sleeve lesions. Tuberculosis, drop lesions, metastasis, ependymoma, schwanoma and numerous other spinal related tumors and lesions. 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, NY, 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. 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, NY, 2013

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. 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, NY, 2013

Implementation of HIPAA Guidelines in NJ, Overview of HIPAA Guidelines. New Jersey Chiropractic Society, Cherry Hill, NJ, 2002

Extremity Adjusting, Extremity adjusting protocols and hands-on technique for adjusting extremities. Northwestern Health Sciences University, New Brunswick, NJ, 2002        

Active Release Techniques Upper Extremity, Upper extremity protocols and hands-on technique to restore optimal texture, motion, and function of the soft tissue and release of entrapped nerves and blood vessels. New York Chiropractic College, Atlantic City, NJ, 2000                                                                                         

Active Release Techniques Upper Extremity, Upper extremity protocols and hands-on technique to restore optimal texture, motion, and function of the soft tissue and release of entrapped nerves and blood vessels. New York Chiropractic College, Atlantic City, NJ, 1999                                                                 

Active Release Techniques Spine, Spine protocols and hands-on technique to restore optimal texture, motion, and function of the soft tissue and release of entrapped nerves and blood vessels. New York Chiropractic College, Atlantic City, NJ, 1999       

Active Release Techniques Spine, Spine protocols and hands-on technique to restore optimal texture, motion, and function of the soft tissue and release of entrapped nerves and blood vessels. New York Chiropractic College, Atlantic City, NJ, 1998

Impairment Rating, Overview of AMA Guidelines to the evaluation of permanent impairment for the chiropractic patient. Parker College of Chiropractic, Philadelphia, PA, 1998

Active Release Techniques Upper Extremity, Upper extremity protocols and hands-on technique to restore optimal texture, motion, and function of the soft tissue and release of entrapped nerves and blood vessels. New York Chiropractic College, Manasquan, NJ, 1997                                                                   

The Neurological Exam, Overview of neuroanatomy and the neurological exam as an essential component of a comprehensive physical examination. Parker College of Chiropractic, Mt. Laurel, NJ, 1997                                                                  

Chiropractic Independent Medical Examination, Performing independent chiropractic examinations. New York Chiropractic College, Mahwah, NJ, 1997

SELECTED TEACHING/LECTURING

Assistant Adjunct Professor, Introduction to Biology for Non-Majors, Temple University, Philadelphia, PA, 2003                            

SELECTED HONORS AND AWARDS

Phi Chi Omega Honor Society, New York Chiropractic College, 1996

SELECTED PUBLICATIONS

Insana, D (2013) HIFU Can Be Effective Option For Prostate Cancer, The Golden Times, (5), 4

SELECTED MEMBERSHIPS

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

Association of New Jersey Chiropractors (ANJC), Member, 2003 - Present

SELECTED COMMUNITY SERVICE

New Jersey State Law Enforcement Officers Association, Physician, 1999 - Present