| Jas Walia DC |
| 905 NE 45th St. Ste. B, Seattle, WA, 98105 |
| Phone: 206 782 9762 |
| Fax: 206 547 0096 |
| seattlechiropractic@gmail.com |
| https://www.seattlechiropracticspineandinjurycenter.com |
SELECTED OCCUPATIONAL HISTORY
Chiropractic Quality Assurance Commission, appointed member 2020
Chiropractor, Walia Chiropractic DBA Seattle Chiropractic Spine & Injury Center, Seattle, Washington 2004 - Present
Chiropractor, Holistique Medical Center, Bellevue, Washington 2003 - 2004
Chiropractor, Essential Chiropractic, Bellevue, Washington 2002 - 2003
EDUCATION AND LICENSUREFellowship- Spinal Biomechanics and Trauma, 2021
Doctor of Chiropractic, Licensed in the State of Washington, License # CH00034098, 2002-Present
Doctorate of Chiropractic, Western States Chiropractic College, Portland, OR, 2001
Bachelor of Science, Western States, Portland, OR, 2001
National Board of Chiropractic Examiners, Part IV, 2001
National Board of Chiropractic Examiners, Part III, 2001
National Board of Chiropractic Examiners, Physiotherapy, 2000
National Board of Chiropractic Examiners, Part II, 2000
National Board of Chiropractic Examiners, Part I, 1999
SELECTED POST-GRADUATE EDUCATION, CERTIFICATIONS AND DIPLOMATES
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020.
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020.
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, 2020.
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020.
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020.
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. 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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
Specialty Research in MRI Physics – Physics of Image Generation 1 – magnetization, excitation, relaxion, acquisition, computing and display. T1 relaxion and relaxation curves, T2 relaxation, phase and phase coherence, T2 relaxion curves. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
Specialty Research in MRI Physics – Physics of Image Generation – technical parameters and artifacts – repetition time, echo time, flip angle, inversion time, number of acquisitions, matric 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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
Specialty Research in Orthopedic Extremity Surgery – Current Concepts in Elbow Disorders – Detailed anatomy of osseus, 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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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.
ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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 muscuoloskeletal 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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2020
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 Traumatic Brain Injury and Concussion Overview: This section is an in-depth overview of traumatic brain injury in concussion. It discusses that all brain injuries are traumatic and dispels the myth of a “mild traumatic brain injury.” Also, this covers triage protocols and the potential sequela of patients with traumatic brain injuries. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019 Head Trauma and Traumatic Brain Injury Part 1: This section discusses gross traumatic brain injuries from trauma and significant bleeding with both epidural and subdural hematomas. There are numerous case studies reviewed inclusive of neurosurgical intervention and postsurgical outcomes. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019 Head Trauma and Traumatic Brain Injury Part 2: This section continues with multiple case studies of gross traumatic brain injuries from trauma requiring neurosurgical intervention and also discusses recovery sequela based upon the significance of brain trauma. This module also concludes with concussion protocols in traumatic brain injury short of demonstrable bleeding on advanced imaging. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019 Concussion And Electroencephalogram Testing: This this section covers concussion etiology and cognitive sequela where gross bleeding has not been identified on advanced imaging. It discusses the significance of electroencephalogram testing in determining brain function and pathology (if present). This module also covers the understanding of waveforms in electroencephalogram testing in both normal and abnormal scenarios. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019 Concussion And Electroencephalogram Testing Pathological Results: This module covers amplitude, conduction and conduction delays as sequela to traumatic brain injury to diagnose concussion and traumatic brain injury in the absence of gross bleeding and advanced imaging. This section covers electroencephalograms and event-related potentials which measures the brain response that is a direct result of specific sensory or motor events. It is a stereotype electrophysiological response to a stimulus and provides a noninvasive means of evaluating brain function. In this module multiple case studies are discussed with ensuing triage protocols pending the results. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019
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
Spinal Biomechanical Engineering Analysis, Understanding spinal motor units as it relates to the Cartesian system and normal vs. pathological movement. Analyzing normal coupling functions of the spine in relations to gait and pelvic biomechanical function and determining stress units and standards of deviation of segmental dysfunction. Interpreting mensuration lines and block analysis beyond standards of deviation in spinal motor dysfunction about connective tissue failure. Cleveland University Kansas City, Chiropractic and Health Sciences, New York State Department of Education, Academy of Chiropractic Post-Doctoral Division, Long Island , NY, 2018
Spinal Biomechanical Engineering Pathology and Clinical Application, Integrating pathological function based upon the Cartesian system and digital mensuration in developing treatment plans with diagnosed connective tissue failures. Diagnosing corrective vs. clinical management scenarios when considering maximum medical improvement in both the chronic and acute, insidious and traumatically induced patient. Cleveland University Kansas City, Chiropractic and Health Sciences, New York State Department of Education, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2018
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
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 Duabert standards with ensuring a “4-corners” inclusive report. Ensuring Primary Care Status based upon an academic standards. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, 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 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. Academy of Chiropractic Post-Doctoral Division, Cleveland University- Kansas City, Long Island, NY, 2018
Neuroradiology Mini-Fellowship, MRI Spine Interpretation, Robert Peyster MD, Neuroradiologist, Professor of Radiology and Neurology, Chief Division of Neuroradiology, State University of New York at Stony Brook, School of Medicine, PACE Recognized by The Federation of Chiropractic Licensing Boards, Stony Brook NY, 2017
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 Recognized by The Federation of Chiropractic Licensure Boards and the Academy of Chiropractic, Long Island, New York, 2017
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 or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2017
National Certified Impairment Rating Specialist, Confirms competency, credibility, and expertise in the field of performing and calculating Impairment Ratings for the AMA Guides to the Evaluation of Permanent Impairment 5th Edition, American Academy of Expert Medical Evaluators, NV, 2017
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 [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2017
Accident Reconstruction: Skid Marks, Time, Distance, Velocity, Speed Formulas and Road Surfaces, The mathematical calculations necessary utilizing time, distance, speed, coefficients of friction and acceleration in reconstructing an accident. The application of the critical documentation acquired from an accident site. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2017
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 or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2017
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 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
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 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
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 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
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 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
Mild Traumatic Brain Injury/Traumatic Brain Injury/Concussion, Differentially diagnosing mild traumatic brain injury vs. traumatic brain injury and the clinical and imaging protocols required to conclude an accurate diagnosis for head trauma. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2017
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, PACE Recognized by The Federation of Chiropractic Licensing Boards, Long Island, NY, 2017
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 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
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. [Texas Chiropractic College, 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, 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. [Texas Chiropractic College, 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, 2017
Spinal Trauma Pathology: Biomechanics of Traumatic Disc Bulge and Age Dating Herniated Disc Pathology, The biomechanics of traumatic disc bulges as sequalae from trauma and the comorbidity of ligamentous pathology. Age-dating spinal disc pathology in accordance with Wolff’s Law. [Texas Chiropractic College, 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, 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 gray matter, thalamus and cortices involvement. [Texas Chiropractic College, PACE Recognized The by 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, 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. [Texas Chiropractic College, 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, 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. [Texas Chiropractic College, 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, 2017
Triaging the Trauma and Non-Trauma Patients, Utilizing detailed history and examination findings to determine the best care path for the patient. Clinical factors in determining the timelines for advanced imaging in 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, 2017
Primary Spine Care Symposium – Interprofessional Spine Care, Clinical analysis of anatomic versus biomechanical spine pain and clinical triage protocols. Relating current research trends in the Whole Spine Model of patient including normal versus abnormal sagittal curvature in the adolescent and adult spine, pelvic incidence as a parameter for sagittal balance in the human spine and current methods of assessment. Patient centered approach to Evidenced Based Spine care with a focus on diagnosis, prognosis and triage of the spine pain patient, Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville NY 2017
Primary Spine Care Symposium – Epidemiology of Spine Pain, Review of the current Centers for Disease Control [CDC} data on the frequency of musculoskeletal pain in the United States population with emphasis on pain of spinal origin. CDC guidelines on opioid medication were discussed and correlated to persistent pain syndromes. Research was reviewed showing the importance of managing the spine pain patient properly from the entry point of care with a concentration on maintenance of spinal biomechanics, Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville NY 2017
Primary Spine Care Symposium- Connective Tissue and Spinal Disc Pathology, The morphology and pathology of connective tissue, inclusive of spinal disc disorders and prognosticating wound repair with permanency implications. Disc bulge, herniation, protrusion and extrusion classifications based upon contemporary literature and how to age-date disc pathology, Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville NY 2017
Primary Spine Care Symposium – Physiology and Anatomy of Spinal Manual Adjusting, Understanding the role of mechanoreceptors, proprioceptors and nociceptors with facets, ligaments, tendons and muscles in aberrant spinal biomechanics. MRI and imaging studies of decompressing via a chiropractic spinal adjustment of the bio-neuro-mechanical lesion and its effects on the central nervous system both reflexively and supratentorally, Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville NY 2017
Primary Spine Care Symposium – Medical-Legal Documentation, The contemporary documentation required in a medical-legal environment that is evidenced based and meets the standards of the courts and academia. Utilizing the scientific data to support a diagnosis, prognosis and treatment plan while meeting the admissibility standards based upon a professional’s credentials. Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville NY 2017
MRI Interpretation of Degenerative Spine and Disc Disease with Overlapping Traumatic Insult to Both Spine and Disc, MRI slices, views, T1, T2, STIR Axial, FFE, FSE and sagittal images in the interpretation of degenerative spondylolesthesis, spinal canal stenosis, Modic type 3 changes, central herniations, extrusions, compressions, nerve root compressions, advanced spurring and thecal sac involvement from an orthopedic, emergency room, chiropractic, neurological, neurosurgical, physical medicine perspective. [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, 2017
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 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
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 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
MRI Interpretation of Lumbar Herniations, MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of lumbar herniations. With the co-morbities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. Morphology of lumbar disc pathologies of central and lateral herniations, protrusions, extrusions, sequestration, focal and broad based herniations are defined and illustrated. Central canal and cauda equina compromise interpretation with management. [Texas Chiropractic College or PACE Reconized 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
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 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
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 sequalae, including bulge, herniation, protrusion, extrusion and sequestration. [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
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. [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
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. New York Chiropractic Council, ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, [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
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. [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
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. [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
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. [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
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. [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
Rating Spine Impairment Parts 4a and 4b Cervical. Understanding and utilization of Category Ratings for the Cervical Spine Whole Body Impairments. Washington State Labor and Industries, State of WA, 2016
Rating Spine Impairment Parts 3a and 3b Lumbar. Understanding and utilization of Category Ratings for the Lumbar Spine Whole Body Impairments. Washington State Labor and Industries, State of WA, 2016
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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, 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, dislocationa 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
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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2016
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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2016 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, Long Island, NY, 2016 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, Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2016 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. Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2016 Neurodiagnostics, Imaging Protocols and Pathology of the Trauma Patient, A 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. Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2016
New Blood Biomarkers Useful for Concussion Diagnosis, The utilization of GFAP and UCH-l-1 in determining, traumatic brain injury, mild traumatic brain injury and mild-moderate traumatic brain injury as a triage tool to manage head trauma patients, Accreditation Council on Continuing Medical Education in cooperation with Medscape, 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 sequalae to morphology. Identifying and diagnosing bone edema, spurring, types of degeneration in assessing biomechanical stability in conjunction with Modic and Pfeiffer 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 sequalae 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
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2015
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2015
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2015
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 sequalae 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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2015
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2015
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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2015
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 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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2015
Spinal Biomechanical Engineering: Full Spine Digital Analysis, Digitalizing and analyzing the full spine images to diagnose pathobiomechanics as sequalae to trauma in relation to ligamentous failure and disc and vertebral pathology as sequalae. 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. ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2015
MRI Spine Interpretation and Spinal Biomechanical Engineering-Primary Spine Care, Correlating spinal biomechanics secondary to trauma and MRI findings inclusive of herniation, bulging, protruded and extruded discs. Correlating co-efficient of forces translated from the bullet vehicle to the target vehicle to the occupant in determining causality of bodily injury, Academy of Chiropractic, PACE approved for the Federation of Chiropractic Licensing boards, Texas Chiropractic College, Las Vegas NV, 2015
Evidence Based Inter professional Collaboration- Primary Spine Care, Chiropractic as Primary spine care based upon the literature conclusions and the documentation requirements to support those conclusions in an ethical collaborative environment inclusive of hospitals, emergency rooms, primary care medical doctors and medical specialists. Academy of Chiropractic, PACE approved for the Federation of Chiropractic Licensing boards, Texas Chiropractic College, Las Vegas NV, 2015.
Contemporary Literature Review of the Chiropractic Adjusting Mechanisms- Primary Spine Care, The latest scientific evidence of the effects of the chiropractic spinal adjustment on the central nervous system, both upper and lower motor neurons. A comparative analysis of chiropractic vs. other modalities and therapies, Academy of Chiropractic, PACE approved for the Federation of Chiropractic Licensing boards, Texas Chiropractic College, Las Vegas NV, 2015
DynaROM Motion Surface EMG Certification- Hands on DynaROM training to objectively document muscle guarding and pain when end point range of motion is normal, review of court records and preparation for deposition, maximizing patient benefit for PI/worker comp cases, relevant up to date research studies. Myovision, Seattle WA 2014
Whiplash Injury Biomechanics and Traumatology: Medico legal Fundamentals for Practitioners and Experts. Essentials of documentation and record keeping, medical photography, preparing for cross examination strategies, depositions, arbitrations, and testifying in court. Spine Research Institute of San Diego, California, 2013
Whiplash Injury Biomechanis and Traumatology: Principles of Impairment Ratings and Forensic Reporting. Report writing, documentation, incorporating outcome assessments and disability instruments, the application of the AMA guidelines, and using modern guidelines and best practices. Spine Reseach Institute of San Diego, California, 2013
Whiplash Injury Biomechanics and Traumatology: Management Principles in Personal Injury and Forensic Documentation. Auto crash reconstruction in low speed crashes: critical knowledge for today's forensic practitioners, historical documentation in personal injury and forensic medicine applications, Comprehensive physical examination of whiplash and traumatic brain injury, the latest radiographic examination methods and analysis techniques, CT examination of brain and soft tissue injuries, soft tissue healing times and implications for successful case management. Spine Research Institute of San Diego, California, 2013
Whiplash Injury Biomechanics and Traumatology: Whiplash Advanced Topics. Requisite and comprehensive biomechanics knowledge for forensic experts, In-depth analysis of brain, neck, and cervical spine trauma mechanisms, and all clinical syndromes and conditions resulting from whiplash (WAD/CAD). Spinal Research Institute of San Diego, California, 2013
SELECTED COMMUNITY SERVICE
Emergency Volunteer Health Practitioner 2020
Global Compassion Clinic- board of directors 2019
Health for the homeless – Seattle, WA, 2015
SELECTED TEACHING/INSTRUCTING/LECTURING
Adjunct Faculty, Physical Medicine Department, Bastyr University, Kenmore, WA 2005-2012
SELECTED MEMBERSHIPS
Academy of Chiropractic, Member, 2015 - Present
Washington State Chiropractic Association, Member, 2002, 2016 - Present
Homeof the USCD 
ResearchBrowse Chiropractic Conditions 
RegisterDoctors JOIN here