Adam Shafran, DC C.I.C.E.

Evidence-Based demonstrative documentation for creating successful patient-centered collaborative care. Using "reputation building" through effective documentation to develop relationships with MD PCPs, MD Specialists, ERs, and Urgent Care Centers. Using demonstrative evidence will eradicate the Non-Specific Back Pain "Dogma,” allowing chiropractic utilization to increase based on the evidence.

Spinal imaging techniques to assess spinal structures and detect abnormalities. The sequences also identify ancillary findings such as renal, ovarian, extradural, and intradural tumors. Careful evaluation of spinal MRIs can reveal critical pathologies beyond musculoskeletal issues. Analyzing the morphology of the abdominal aorta to determine potential stroke risks

Identifying and diagnosing spinal segmental lesions in the facet, joint capsules involving ligamentous mechanoreceptors, and spinal proprioceptors. The central segmental motor control mechanism with upper motor neuron involvement with disparate efferent effects and demonstrative diagnostic tools to differentially diagnose the primary lesion. The statistical outcome of treating biomechanical spinal lesions

Identifying and diagnosing spinal segmental lesions in the facet, joint capsule involving ligamentous mechanoreceptors, and spinal proprioceptors. The central segmental motor control mechanism with upper motor neuron involvement with disparate efferent effects and demonstrative diagnostic tools to differentially diagnose the primary lesion. The statistical outcome of treating biomechanical spinal lesions.

creating a professional bio and CV, essential for establishing credibility in the medical-legal field. Incorporating outcome statistics from cases helps demonstrate your work's real-world impact, especially in the medical legal arena. Getting published in the National Institutes of Health (NIH) using research, peer review, and adherence to scientific standards and enhances your reputation by validating your work within the healthcare community and increasing your authority in the healthcare community field.

Utilizing the evidence in the literature to age-dating spinal herniated discs and trauma. Including interpreting X-rays, MRIs in T1, T2, STIR and Fat Saturation sequences, and other imaging alongside understanding the evidence of joint pathology. Being able to collaborate with physicians or as a medical-legal expert. Accurate age-dating helps establish a prognosis for patient recovery. The process must be grounded in evidence-based rationale to ensure reliability. Mastering this skill enhances both clinical decision-making and legal credibility.

Clinical Grand Rounds for a case involve assessing disc, ligament, and spinal pathology. The process includes establishing a diagnosis, determining the prognosis, and developing a treatment plan. Special attention is given to conditions such as cord edema, myelomalacia, myelopathy, and tethered cords. Utilizing follow-up examinations as a step in crucial in refining the diagnosis and treatment approach. Adjustments to the treatment plan are made as new clinical findings emerge. This ensures that patient care remains dynamic and responsive to evolving spinal conditions

Spring 2025 Completed expert-level training in the diagnostic evaluation of Alteration of Motion Segment Integrity (AOMSI) in the cervical spine using AMA Guides (5th and 6th Editions). Emphasis was placed on the application of objective criteria including >3.5 mm of translational motion and >11° of angular rotation to identify functional segmental instability. The program detailed the biomechanical rationale for these thresholds and instructed on standardized methods for identifying ligamentous damage based on motion segment behavior. Proficiency was demonstrated in integrating radiographic findings into the impairment rating process and using motion analysis to support clinical and legal documentation.

Cervical Impairment Rating – AMA Guides to the Evaluation of Permanent Impairment, 5th and 6th Editions

Spring 2025 Participated in an intensive educational module addressing the legal, regulatory, and procedural implications of AOMSI analysis in trauma care. Learned how to apply objective measurements to support causation, permanency, and impairment in personal injury and workers’ compensation cases. Instruction included strategies for achieving Frye admissibility of digital motion analysis tools, the legal standards for expert witness qualification, and the use of calibrated systems for forensic-level imaging evaluation. Participants were trained to construct defensible reports and testify to clinical findings with biomechanical validity, reinforcing their credibility in litigation settings.

Spring 2025 Completed advanced instruction in the technical and clinical components of flexion-extension radiograph acquisition for AOMSI assessment. Focused on the avoidance of common errors such as poor patient effort, non-neutral positioning, and improper sagittal plane alignment. Emphasized the impact of these variables on the validity of diagnostic motion measurements and provided structured protocols for improving reproducibility and clarity in radiographic imaging. Gained hands-on guidance in instructing imaging facilities, refining standard operating procedures, and improving diagnostic yield for motion-based cervical spine pathology.

Focused on the evaluation of lumbar spinal instability through the application of Alteration of Motion Segment Integrity (AOMSI). Emphasized biomechanical principles and radiographic criteria for identifying translational (>4.5 mm) and angular motion abnormalities (>15°–25°, depending on segment) using flexion-extension radiographs. Included instruction on the use of these findings in accordance with the AMA Guides to the Evaluation of Permanent Impairment, 5th Edition (Range of Motion model) and 6th Edition (Diagnosis-Based Impairment model), with application to trauma documentation, impairment rating, and surgical triage

Addressed radiographic protocols for flexion-extension motion studies, measurement reproducibility, and standardization of lumbar instability thresholds. Included comprehensive review of key lumbar stabilizing ligaments (ALL, PLL, interspinous, supraspinous, ligamentum flavum, facet capsules) and their role in post-traumatic motion segment failure. Emphasized detection of overt instability and early translational micro-movements (≥1 mm), integrating clinical biomechanics with AMA Guides to the Evaluation of Permanent Impairment, 5th and 6th Editions.

Provided training in interpretation and documentation of lumbar segmental instability for personal injury, workers’ compensation, and disability claims. Included objective validation of motion abnormalities and application of radiographic findings to causation analysis, permanency evaluations, and impairment ratings under the AMA Guides to the Evaluation of Permanent Impairment, 5th and 6th Editions. Emphasized preparation of records and testimony meeting Frye and Daubert evidentiary standards.

Provided instruction in the interpretation of functional radiographs and their integration into the impairment evaluation process. Emphasized application of translational and angular thresholds established in the AMA Guides to the Evaluation of Permanent Impairment, including the 5th Edition’s Range of Motion model and the 6th Edition’s Diagnosis-Based Impairment framework. Included literature review of cadaveric biomechanical studies by Yoganandan, Ivancic, and Chazal, and use of AOMSI findings in permanent impairment documentation, clinical triage, and medico-legal reporting

Welcome and Strategic Orientation of the Program - An expanded overview establishing the scientific direction and operational philosophy of the meeting, emphasizing the integration of advanced biomechanical analysis, neuro-orthopedic science, and imaging frameworks to elevate spine-care assessment. Addressed the transition from symptom-based evaluation toward measurement-driven methodologies that enhance diagnostic reproducibility and interdisciplinary communication. Reviewed unified terminology, dynamic imaging applications in motion-based pathology, and structural methods for aligning clinical workflows with emerging evidence standards.

Comprehensive review of technological and scientific advancements transforming quantitative spine imaging, including the maturation of translational and angular displacement metrics, reduction of examiner variability, and development of computational image-processing systems. Discussed reproducibility research, multi-modality dataset integration (MRI, CT, dynamic studies), and structured pathways that enhance surgical planning, objectivity, and medico-legal defensibility through measurable biomechanical data.

Detailed analysis of segmental biomechanics including multi-planar motion, viscoelastic ligament behavior, facet-mediated load distribution, and stiffness gradients. Examined translational shear forces, rotational coupling, posterior ligament complex interactions, and collagen microstructure contributions to mechanical signatures. Linked foundational biomechanics to diagnostic interpretation, early instability detection, micro-failure identification, and aberrant movement analysis in traumatic and degenerative states.

Multidisciplinary panel evaluating classic and modern frameworks of spinal instability including displacement thresholds, ligament elongation mechanics, capsular insufficiency, and load-dependent failure patterns. Discussed diagnostic limitations of static imaging and demonstrated how dynamic measurement clarifies ambiguous presentations. Integrated predictive validity, treatment stratification, progression risk, and biomechanical interpretation for both conservative and surgical pathways.

Exploration of functional imaging modalities—kinematic radiography, motion-sensitive MRI, quantitative movement studies—as unified frameworks across disciplines. Included motion-pattern recognition, segmental stiffness abnormalities, recruitment sequencing, and translation of mechanical findings into conservative, interventional, and surgical decisions. Highlighted structured reporting systems that enhance communication and support defensible documentation.

Case-based review of integrated workflows across chiropractic, physical therapy, orthopedics, neurosurgery, and pain management. Demonstrated functional imaging correlations with MRI findings, diagnostic synchronization, reduction of redundancy, and timing optimization for interventions. Highlighted standardized mechanical thresholds as tools for escalation decisions and improved continuity in complex case management.

Scientific analysis of how objective diagnostic data strengthens referral pathways between conservative providers and surgical or interventional specialists. Covered evidence-based justification, documentation standards, predictive indicators, and communication models that enhance interdisciplinary acceptance. Reviewed common hurdles and data-driven solutions that improve referral efficiency and treatment continuity.

Review of diagnostic complexities in identifying non-union and failed fusion. Covered micro-motion thresholds, structural bone-integrity assessment, hardware load signatures, functional variability vs true non-union, and implications for revision surgery. Integrated dynamic studies with CT and MRI analysis to improve diagnostic resolution and patient-specific treatment planning.

Detailed discussion of capsular ligament neurophysiology, mechanoreception, nociception, and proprioceptive control. Reviewed elongation injury mechanics, rotational and shear vulnerability, inflammatory cascades, and chronic capsular laxity leading to segmental instability. Correlated imaging markers such as capsular hypertrophy, fibrosis, and facet spacing alterations with mechanical failure states.

- In-depth analysis of vertical shear instability, altered axial load transfer, annular deformation patterns, endplate mechanics, and multi-level ligamentous compromise. Demonstrated complex motion signatures—segmental recruitment delay, aberrant stiffness ratios, directional preference abnormalities—and integrated findings with neuromusculoskeletal examination, imaging, and treatment pathway determination.

Comprehensive review contrasting subjective symptom-driven assessments with objective mechanical and imaging-derived biomarkers. Discussed recall bias, examiner variability, and the superiority of quantifiable intersegmental motion data, correlated structural findings, and reproducible functional deviations. Highlighted applications for impairment rating, prognosis modeling, and legal defensibility.

Exploration of overt and subtle ligamentous microfailure, segmental coordination abnormalities, compensatory recruitment, and sensitization phenomena. Addressed challenges in correlating symptoms with imaging, detection of hidden dysfunctions, and communication of complex mechanical findings to adjusters, attorneys, and courts.

Expanded lecture on ligament visualization advancements in MRI, CT osseous integrity assessment, dynamic imaging innovations, and computational interpretation tools. Reviewed multi-modality integration, pattern recognition, and challenges in characterizing ligament injury with conventional static imaging alone.

Comprehensive scientific review of diffusion-based imaging, tract integrity quantification, microstructural signal deviations, and their relevance in traumatic, inflammatory, and metabolic brain injuries. Discussed scanner-variability constraints, white-matter susceptibility to shear injury, and correlations with cognitive and vestibular deficits.

Expanded coverage of GFAP, UCH-L1, neurofilament light chain, tau isoforms, and S-100 proteins. Included diagnostic windows, decay kinetics, assay variability, pathophysiology of biomarker release, and combined multi-marker approaches that enhance differentiation of acute vs residual injury states.

Translation of microstructural imaging findings into functional neurological interpretations. Reviewed region-specific tract disruption, network dysregulation (default-mode, salience, frontoparietal), and integration of neurocognitive testing. Discussed implications for prognosis, treatment selection, and legal documentation.

Discussion of modern software-enabled documentation, diagnostic templating, automated annotation, dataset integration, and error-reduction strategies. Reviewed clinical workflow optimization, multi-modal information harmonization, and medico-legal implications of precision documentation.

Detailed review of calibration science, geometric distortion modeling, magnification correction, parallax reduction, and calibration-marker methodology. Discussed measurement accuracy, reproducibility standards, cross-facility consistency, and calibration’s role in biomechanical interpretation and research validity.

Multidisciplinary analysis of supervised/unsupervised learning models, predictive analytics, feature extraction, pattern recognition, dataset bias, and validation requirements. Reviewed clinical applications in triage, outcome prediction, and automated structural abnormality identification, along with regulatory and medico-legal considerations.

Expanded lecture on advanced imaging correlation, mechanical threshold interpretation, surgical readiness assessment, preauthorization optimization, payer justification frameworks, and structured reporting that improves clarity and reduces denial rates. Highlighted medico-legal defensibility in surgical determinations.

Detailed exploration of consulting value for conservative providers, including diagnostic enhancement, documentation precision, deposition preparation, trial communication, impairment rating methodology, and bridging the clinical-legal divide through objective biomechanical analysis.

Highly detailed session on ICD/CPT precision, AMA impairment thresholds, anatomical correlation, and high-fidelity documentation structures. Reviewed the impact of incomplete documentation on payer disputes, legal outcomes, and clinical clarity, and provided best-practice strategies for defensible reporting.

Scientific review of Alteration of Motion Segment Integrity criteria, including tensile failure physics, viscoelastic tissue deformation, and posterior ligament complex compromise. Expanded discussion on radiographic variability, gray-zone cases, and advanced imaging correlations that improve repeatability and medico-legal defensibility in ligament-injury assessment.

Diagnosing Active, Sequella, and Subsequent encounter codes for connective tissue pathology. The documentation elements required for 99202, 99203, 99204, and 99205. Developing ethical financial relationships for reimbursement in the medical-legal community and the documentation required. Using laws, regulations, and case law in contemporary practice to manage cases

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

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

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

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

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

Master-Class in ligaments; anatomy, physiology, vascularization, neurological innervation, tissue repair and how they all relate to clinical practice. Ligament pathology correlating to the mechanisms of patho-neuro-biomechanical lesions (vertebral subluxation complex). Also, how ligaments play a critical role in the chiropractic spinal adjustment and in defining the chiropractic spinal adjustment mechanisms

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

An overview of the evaluation and management process inclusive of utilizing electronic medical records to conclude evidenced-based conclusions with the utilization of macros. The importance of adhering to an academic standard and considering co-morbidities

Concluding a chief complaint, history and what needs to be considered in a physical examination. This covers in dept the required elements for chief complain, history of present illness, review of systems, and past, family, and/or social history. This module also covers the following components of a physical examination: observation, palpation, percussion, and auscultation

Detailing 99202-99205 and 99212-99215 inclusive of required elements for compliant billing. It reviews the elements for an extensive review of systems, cervical and lumbar anatomy and basic testing. The course also covers the basics of vertebra-basilar circulation orthopedic assessment

Reviewing complete motor and sensory evaluation inclusive of reflex arcs with an explanation of Wexler Scales in both the upper and lower extremities. The course breaks down testing for upper and lower motor neuron lesions along with upper and lower extremity motor and sensory testing examinations

Forensically detailing the S.O.A.P. note process for visit encounters and discussing the necessity for clinically correlating symptoms, clinical findings and diagnosis with the area(s) treated. It also details how to modify treatment plans, diagnosis, document collaborative care and introduce test findings between evaluations

This module discusses how to document a clinically determined treatment plan inclusive of both manual and adjunctive therapies. It discusses how to document both short-term and long-term goals as well as referring out for collaborative care and/or diagnostic testing. It also includes how to prognose your patient and determine when MMI (Maximum Medical Improvement) has been attained

Ethical financial relationship with lawyers and the documentation needed from the provider to define the relationship. Assignments, release of records, right to receive information, explaining statutes of limitations and document exchange are detailed.

What that means in contemporary clinical practice and how to ensure you have the legal authority to bill and collect based on necessary documentation

Detailing what an ethical relationship is for the doctor and attorney. It describes the differences in ethics for a lawyer and doctor and what constitutes a licensure violation in both practices. It also details how to ensure your documentation supports ethical relationships.

Managing cases where lawyers are unethical and understanding the Rules of Professional Conduct mandated for lawyers nationally. It helps you create business systems to manage these types for cases and work within the framework of the laws in each state to ensure compliance.

The “Rules of Professional Conduct” as mandated by license for lawyers and further defines documentation required for a doctor to use with cases involving lawyers. It also details the necessary documentation needed for a doctor to provide in detailing injuries to patients in an evaluation and management encounter and a final narrative for the courts.

This course offered a comprehensive and detailed exploration of the ABCDE method, a systematic approach to interpreting spinal MRI scans that is critical for improving diagnostic accuracy in spine care. The method is structured around five key components, Alignment, Bone, Cord, Disc, and Everything else, each representing an essential aspect of spinal health that must be carefully evaluated in every MRI study. Alignment focuses on assessing the overall spinal curvature and alignment, identifying abnormalities such as scoliosis, kyphosis, or lordosis, which can have significant implications for both diagnosis and treatment planning. The Bone component involves a detailed examination of vertebral bone integrity, including the detection of fractures, bone density variations, and the presence of osteophytes, which are crucial for understanding the structural stability of the spine. The Cord aspect emphasizes the condition of the spinal cord, including the identification of cord compression, signal changes on T2-weighted images that might indicate myelopathy, and the evaluation of any other abnormalities such as syringomyelia or intramedullary lesions. Disc evaluation centers on the intervertebral discs, focusing on disc height, the presence of disc bulges or herniations, and the integrity of the annulus fibrosus, all of which are vital for diagnosing conditions like disc degeneration or radiculopathy. Everything else encompasses additional factors that could influence spinal health, such as the condition of the endplates, presence of Modic changes, the degree of spinal canal stenosis, ligamentous integrity, and the presence of soft tissue abnormalities or edema. This component ensures that no potential pathology is overlooked. By deepening their expertise in MRI interpretation, participants became more proficient in making accurate diagnoses and developing effective treatment plans tailored to individual patient needs.

This course provided an in-depth exploration of axial MRI anatomy specific to the cervical spine, an essential area of expertise for healthcare professionals involved in spine care. Through detailed analysis and case studies, participants gained a comprehensive understanding of the axial plane imaging of cervical spine structures, including the vertebrae, intervertebral discs, spinal cord, and surrounding soft tissues. In addition to these critical spinal components, the course also focused on the interpretation of axial MRI scans that reveal important adjacent structures such as the paraspinal muscles, vascular structures like the vertebral arteries, and internal organs visible within the axial plane. The course covered the identification and implications of seeing structures such as the esophagus, trachea, and thyroid gland, which may be incidentally observed on cervical spine MRIs and could have clinical significance. Emphasis was placed on the importance of accurately interpreting these axial MRI scans to diagnose a wide range of cervical spine conditions, including disc herniations, spinal stenosis, and other pathologies that can significantly impact patient management and treatment outcomes. Participants were trained to assess not only the direct spinal structures but also the condition of nearby muscles, which can reflect compensatory changes due to chronic pain or injury. The recognition of altered muscle mass or signal changes can provide additional clues to the patient's overall spinal health and guide therapeutic decisions., Participants enhanced their diagnostic precision, particularly in identifying subtle yet clinically relevant findings that could influence the treatment plan. This comprehensive approach to axial MRI interpretation not only improved participants' technical skills but also their ability to collaborate effectively in interprofessional care settings, ensuring that all relevant aspects of a patient’s condition are considered in their care

a detailed case study focusing on the differential diagnosis and management of acute versus chronic nerve injuries in the lumbar spine was presented. The course provided an in-depth review of diagnostic tools, including the interpretation of motor strength assessments, MRI findings, and advanced electrophysiological testing such as electromyography (EMG) and nerve conduction velocity (NCV) studies. The course placed specific emphasis on the use of EMG to assess muscle denervation, reinnervation patterns, and the chronicity of nerve injuries. Participants learned to analyze key EMG parameters such as insertional activity, spontaneous potentials like fibrillations and positive sharp waves, and motor unit action potentials (MUAPs). These parameters are crucial for determining the extent of nerve damage, the age of the injury, and whether the nerve is undergoing reinnervation. The presence of fibrillations and positive sharp waves, for instance, indicates ongoing denervation, while changes in MUAPs can reveal the degree of reinnervation and the chronicity of the lesion. The H-Reflex study, a critical component in evaluating S1 radiculopathy, was also covered extensively. This technique involves stimulating the tibial nerve at the popliteal fossa and recording the reflex response from the soleus muscle. The course detailed how specific parameters such as latency (the time it takes for the reflex to occur), amplitude (the strength of the reflex), and side-to-side comparison of the H-Reflex are utilized to assess the integrity of the S1 nerve root. These measurements are instrumental in differentiating between acute and chronic lesions, as delays in latency and reductions in amplitude can indicate the presence of a chronic radiculopathy. Moreover, the course emphasized the importance of correlating these electrophysiological findings with clinical assessments and MRI results. MRI imaging was particularly valuable in visualizing the anatomical causes of nerve compression, such as disc herniation, spinal stenosis, or foraminal narrowing. Participants were trained to integrate these findings into a comprehensive diagnostic framework that informs targeted, evidence-based treatment plans

This advanced course provided a thorough exploration of spine management through the detailed examination of two complex clinical cases. The course focused on the diagnosis, treatment, and interprofessional management of patients with significant spinal pathologies, emphasizing the importance of a multidisciplinary approach in optimizing patient outcomes. In the first case, the course covered the evaluation of a patient who sustained an injury from a motor vehicle collision. The course emphasized the diagnostic process, which included identifying a reversal of the usual lordotic curvature on cervical MRI, a key indicator of spinal trauma. Participants were guided through the treatment options, highlighting the role of imaging and clinical correlation in developing an effective management plan. The second case study involved a 75-year-old female patient with chronic low back pain and radicular symptoms following a laminectomy with L4-5 fusion. The course provided a comprehensive review of her long-term management, which included multiple imaging studies, conservative treatments such as medication and aquatic therapy, and surgical interventions. Particular attention was given to the challenges of managing spondylolisthesis and severe stenosis, as well as the right hip replacement that alleviated her lumbar spine pain. Through these case studies, the course reinforced the importance of integrating clinical findings, imaging results, and interprofessional collaboration in the management of complex spine conditions. Participants gained valuable insights into the decision-making process for both conservative and surgical treatments, as well as the critical role of ongoing patient monitoring and adjustment of care plans.

Coding and Care Planning, ICD -10, and CPT cross-coding requirements form the acute stage through rehabilitation, including home care. The documentation of passive vs. active care in chronic and trauma case management.

The documentation of short and long-term care, including demonstrative validation or spinal pathology in the clinical setting. Connective tissue pathological mechanisms in chronic and traumatic etiology.

Utilizing the guidelines created by the American College of Radiology and the evidence in the scientific literature for case management involving x-ray. Understanding the standards for safe radiation exposure when creating a demonstrative spinal biomechanical diagnosis and ruling out anatomical pathology.

The documentation of biomechanical and anatomical pathology with trauma patients. Clinically correlating diagnosis, demonstrative bodily injury-pathology and persistent functional losses.

Advanced documentation based on clinical and testing findings that correlate to Evaluation and Management Guidelines. Evidence-Based necessity parameters for considering spinal imaging and electrodiagnostic testing.

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

MRI Spine Advanced Clinical Case Grand Rounds, Clinical case review of MRI including intra and extra-dural findings inclusive of the disc and vascular anatomical lesions. Differentially diagnosing central cord lesions, and spinal cord vascular lesions in both acute trauma and degenerative presentations

Analyzing neuro-biomechanical pathological lesions defines primary spinal lesions and removes the dogma of non-specific back pain. Creating evidence-based demonstrative documentation in the creation of treatment plans

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

Report Writing, Clinical record-keeping, why write clinical notes, the importance of context, what to include in a clinical note, tips for better clinical documentation, basic legal considerations, open clinical notes, how to keep documentation efficient

Master-Class in ligaments; anatomy, physiology, vascularization, neurological innervation, tissue repair, and how they all relate to clinical practice. Ligament pathology correlating to the mechanisms of patho-neuro-biomechanical lesions (vertebral subluxation complex). Also, how ligaments play a critical role in the chiropractic spinal adjustment and in defining the chiropractic spinal adjustment mechanisms.

Case reviews concluding and accurate diagnosis, prognosis, and treatment plan utilizing evidence-based instrumentation and algorithms. Using demonstrative reporting of case findings to collaborate with co-treating physicians

A documentation discussion on meeting the requirements of the courts, carriers, and licensure boards in complete and accurate reporting. Ensuring the diagnosis, prognosis, and treatment plan are demonstratively documented

The utilization of X-Ray digitization to diagnose spinal biomechanical pathology and analyzing trends in healthcare when triaging mechanical spine pain. The role of credentials in interprofessional collaboration

The understanding and utilization of T1, T2, STIR, Proton Density, FSE, GRE imagine sequencing for conclusive diagnosing of fracture, tumor, infection, and disc pathology. Identifying herniation, protrusion, bulge, extrusion-migrated, and extrusion-fragments on MRI images

The understanding of the human spinal discal elements; annulus, nucleus pulposis, cartilaginous end plates inclusive of the neurology, visualization, differentiation from the neonate to adults. The understanding of the etiology of Modic changes on MRI and how spinal biomechanics are altered

Triaging neurologically compromised cases in conjunction with positive MRI images, and collaboratively managing cases with neurosurgeons in clinical practice. Post-operative management of spinal cases through full recovery

The analytics of spinal biomechanical engineering utilizing X-Ray digitizing for Alteration of Motion Segment Integrity and biomechanical pathology. Determining laxity of ligaments in connective tissue pathology and the long-term negative sequels of the pathology

The diagnosis, and reporting of spinal disc bulges, herniations, protrusions, extrusions, and fragments. Reporting varices, Modic 1, 2, and 3, posterior longitudinal, interspinous, and intertransverse ligament. Reporting the ligamentum Flavum and epidural fat as a space-occupying lesion

-Spinal Decompression Treatment Options, Programs and Protocols -Clinical Aspects of Spinal Decompression -Medical Outcome and Research Studies -Manual Technique methodology -Decompression: History and Today -Differences in Spinal Decompression Machines -Decompression vs. Traction and Surgery -Spinal Decompression for the Regulatory Community -Compliance: Billing and Coding

Spine Management Grand Rounds Internet Live and Regularly Scheduled Series - Histochemical and Traumatic Causes of Degenerative Disc Disease

Detailed review of the tenants of degenerative disc disease in the human spine. A review of metabolic factors including bone and cartilage remodeling, lipid metabolism and oxidative stress within the disc was presented. Outline of adverse biomechanical factors including levels of modic changes, reaction to microtrauma and responses to increased mechanical stresses due to loss of sagittal and coronal spinal balance. Discussion reviewing biochemical factors such as innate and adaptive immunity, inflammation and low-grade discitis were presented. Emphasis was placed on individual risk factors such as smoking and weight gain. Genetic factors were discussed and correlated to environmental risk factors for degenerative disc disease.

Correlating clinical findings with x-ray and advanced imaging to conclude and accurate diagnosis, prognosis and treatment plan. The utilization of demonstrative documentation in diagnostic testing to visualize pathology in the trauma and non-trauma case.

Ligament wound repair, collagen and elastin in injured ligaments, Wolfs Law, instability in spinal injuries, range of motion exam procedures, impairment ratings in ligament injury

Gaps in Care, Impairment ratings, Use of the AMA Guides to Impairment, Activities of daily living, duties under duress, functional loss.

Sway concussion testing, Starting slow with therapeutic interventions, Supplements for brain support, vitamin D, Omega 3’s, resveratrol, curcumin epigallocatechin-3-gallate (EGCG) and cold laser to speed healing

Visualization of the spinal disc thru windowing on CT scans, MRI ordering, ligament laxity analysis

Differentiation between Spinal Disc, Spinal Fractures and Spinal Instability. Ligament injury creating lifetime disability and impairment.

Crushing can be good, Unawareness is the most critical human crash factor, Time as the most important crash factor

Clinically correlating history and clinical findings to biomechanical connective tissue pathology and advanced imaging with herniated, protrude, extruded, and bulging discs. Triaging trauma and chronic patients based upon clinical presentation and testing results

T1 and T2 relaxations, nuclear spins, phase encoding, spin echo, T1 and T2 contrast, magnetic properties of metals and the historical perspective of the creation of NMR and MRI

Normal anatomy of axial and sagittal views utilizing T1, T2, 3D gradient and STIR sequences of imaging. Standardized and desired protocols in views and sequencing of MRI examination to create an accurate diagnosis in MRI

MRI interpretation of bulged, herniated, protruded, extruded, sequestered and fragmented disc pathologies in etiology and neurological sequelae in relationship to the spinal cord and spinal nerve roots

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

MRI interpretation sequencing of the cervical, thoracic and lumbar spine inclusive of T1, T2, STIR and 3D gradient studies to ensure the accurate diagnosis of the region visualized

The clinical application of the results of space occupying lesions. Disc and tumor pathologies and the clinical indications of manual and adjustive therapies in the patient with spinal nerve root and spinal cord insult as sequelae

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images. Clinical indication for the utilization of MRI and pathologies of disc in both trauma and non-trauma sequellae, including bulge, herniation, protrusion, extrusion and sequestration

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of lumbar degeneration. With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl/'s nodes and herniations. Central canal and cauda equina compromise interpretation with management

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of lumbar herniations. With the co-morbities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl/'s nodes and herniations. Morphology of lumbar disc pathologies of central and lateral herniations, protrusions, extrusions, sequestration, focal and broad based herniations are defined and illustrated. Central canal and cauda equina compromise interpretation with management

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of cervical degeneration. With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl/'s nodes and herniations. Spinal cord and canal compromise interpretation with management

MRI slices, views, T1, T2, STIR Axial, FFE, FSE and sagittal images in the interpretation of lumbar herniations. With the co-morbidities and complications of stenosis pseudo-protrusions, cantilevered vertebrate, Schmorl/'s nodes and herniations. morphology of lumbar disc pathologies of central and lateral herniations, protrusions, extrusions, sequestration, focal and broad based herniations are defined and illustrated. Spinal cord and canal compromise interpretation with management

MRI slices, views, T1, T2, STIR Axial, FFE, FSE and sagittal images in the interpretation of degenerative spondylolesthesis, spinal canal stenosis, Modic type 3 changes, central herniations, extrusions, compressions, nerve root compressions, advanced spurring and thecal sac involvement from an orthopedic, emergency room, chiropractic, neurological, neurosurgical, physical medicine perspective

The Cartesian Coordinate System from the history to the application in the human body. Explanation of the x, y and z axes in both translation and rotations (thetas) and how they are applicable to human biomechanics.

Spinal biomechanical engineering of the lumbar spine. This includes the normal and pathobiomechanical movement of both the anterior and posterior motor units and normal function and relationship of the intrinsic musculature to those motor units. Nomenclature in reporting normal and pathobiomechanical findings of the spine.

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

Integrating spinal biomechanics and pathobiomechanics through digitized analysis.The comparison of organized versus disorganized compensation with regional and global compensation. Correlation of the vestibular, occular and proprioceptive neurological integration in the righting reflex as evidenced in imaging. Digital and numerical algorithm in analyzing a spine.

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.

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

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

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

The Cartesian Coordinate System from the history to the application in the human body. Explanation of the x, y and z axes in both translation and rotations (thetas) and how they are applicable to human biomechanics.

Spinal biomechanical engineering of the cervical and upper thoracic spine. This includes the normal and pathobiomechanical movement of both the anterior and posterior motor units and normal function and relationship of the intrinsic musculature to those motor units. Nomenclature in reporting normal and pathobiomechanical findings of the spine.

Spinal biomechanical engineering of the lumbar spine. This includes the normal and pathobiomechanical movement of both the anterior and posterior motor units and normal function and relationship of the intrinsic musculature to those motor units. Nomenclature in reporting normal and pathobiomechanical findings of the spine.

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

Integrating spinal biomechanics and pathobiomechanics through digitized analysis.The comparison of organized versus disorganized compensation with regional and global compensation. Correlation of the vestibular, occular and proprioceptive neurological integration in the righting reflex as evidenced in imaging. Digital and numerical algorithm in analyzing a spine.

Digitizing and analyzing the cervical spine in neutral, flexion and extension views to diagnose pathobiomechanics. This includes alteration of motion segment integrity (AMOSI) in both angular and translational movement. Ligament instability/failure/pathology are identified all using numerical values and models. Review of case studies to analyze pathobiomechanics using a computerized/numerical algorithm

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

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

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.

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

The application of spinal biomechanical engineering models in trauma and the negative sequelae it has on the central nervous system inclusive of the lateral horn, periaqueductal grey matter, thalamus and cortices involvement

The biomechanics of traumatic disc bulges as sequelae from trauma and the comorbidity of ligamentous pathology. Age-dating spinal disc pathology in accordance with Wolff’s Law.

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

The review of current literature standards in spinal trauma pathology and documentation review of biomechanical failure, ligamentous failure and age-dating disc pathology.

The forces in physics that prevail in accidents to cause bodily injury. Quantifying the force coefficients of vehicle mass and force vectors that can be translated to the occupant and subsequently cause serious injury

Factors that cause negative acceleration to zero and the subsequent forces created for the vehicle that get translated to the occupant. Understanding critical documentation of hospitals, ambulance reports, doctors and the legal profession in reconstructing an accident

The mathematical calculations necessary utilizing time, distance, speed, coefficients of friction and acceleration in reconstructing an accident. The application of the critical documentation acquired from an accident site.

Delta V issues correlated to injury and mortality, side impact crashes and severity of injuries, event data recorder reports correlated to injury, frontal impact kinematics, crash injury metrics with many variables and inquiries related to head restraints.

The understanding and utilization of the protocols and parameters of the AMA Guide to the Evaluation of Permanent Impairment 6th Edition. Spine, neurological sequelae, migraine, sexual dysfunction, sleep and arousal disorders, station and gait disorders and consciousness are detailed for impairment rating. Herniated discs, radiculopathy, fracture, dislocation and functional loss are also detailed in relation to impairment ratings

Integration of orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae.

Integration of cervical orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae.

Integration of cervical orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae

Integration of lumbar orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae.

how to integrate orthopedic testing in the clinical setting utilizing both simple and complex patient scenarios. It includes potential stroke, or vertebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process. How to integrate orthopedic testing in the clinical setting utilizing both simple and complex patient scenarios. It includes potential stroke, or vertebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process

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

CPT Coding Guidelines for Initial and Established Patients with particular attention paid to Patient History, Review of Systems, Social and Family History, Physical Examination, and Medical Decision making. Specific differences in coding levels and required elements for a 99202-99203-99204-99205, and a 99212-99213-99214-99215

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

Clinical case review of MRI’s including sagittal, axial, T1, T2, STIR, and proton density sequences. Identified will be the vertebrate, spinal cord, discs, nerve roots, thecal sac, posterior longitudinal ligament, epidural veins, and fat saturation pulses. Pathology will include bulges, herniations, protrusions, extrusions, myelomalacia, cord edema, and schmorl’s nodes

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

An in-depth review of basic neuro-anatomy and physiology dermatomes and myotomes to both the upper and lower extremities and the neurophysiology of axons and dendrites along with the myelin and function of saltatory for conduction. The sodium and potassium pump’s function in action potentials

An in-depth review of basic neuro-anatomy and physiology dermatomes and myotomes to both the upper and lower extremities and the neurophysiology of axons and dendrites along with the myelin and function of saltatory for conduction. The sodium and potassium pump’s function in action potentials

Nerve Conduction Velocity (NCV) Part 1: Nerve conduction velocity testing, the equipment required and the specifics of motor and sensory testing. This section covers the motor and sensory NCV procedures and interpretation including latency, amplitude (CMAP) physiology and interpretation including the understanding of the various nuances of the wave forms.

Nerve Conduction Velocity (NCV) Part 2: Compound motor action potentials (CMAP) and sensory nerve action potentials (SNAP) testing and interpretation including the analysis and diagnosis of the wave forms. It also covers compressive neuropathies of the median, ulnar and posterior tibial nerves; known as carpal tunnel, cubital tunnel and tarsal tunnel syndromes. This section offers interpretation algorithms to help understand the neurodiagnostic conclusions

The EMG process, inclusive of how the test is performed and the steps required in planning and electromyographic study. This covers the spontaneous activity of a motor unit action potential, positive sharp waves and fibrillations. The insertional activity (both normal and abnormal), recruitment activity in a broad polyphasic presentation and satellite potentials. This covers the diagnosing of patterns of motor unit abnormalities including neuropathic demyelinated neuropathies along with acute myopathic neuropathies. This section also covers the ruling out of false positive and false negative results

The clinical incorporation of electrodiagnostic studies as part of a care plan where neuropathology is suspected. It also covers how to use electrodiagnostics in a collaborative environment between the chiropractor as the primary spine care provider and the surgeon, when clinically indicated. This section covers sample cases and health conclude and accurate treatment plans based upon electro-neurodiagnostic findings when clinically indicated.

Analyzing spinal healthcare trends in both utilization and necessity and understanding the marketplace and how a clinical excellence level is reflected in a doctors' documentation and credentials. Treatment pathways in triaging spinal pathobiomechanics

An evidence-based understanding of time-related etiology of disc pathology considering the American Society of Neuroradiology's designation of protrusion, extrusion, and sequestration of spinal discs, T1, T2, STIR and Proton-Density weighted evaluation to diagnose spine form MRI accurately

Utilizing spinal mensurating algorithms to conclude a pathobiomechanical vs. normal spine in the absence of anatomical pathology. Clinically correlating a history and physical examination findings to x-ray biomechanical results in creating an accurate diagnosis, prognosis, and treatment plan.

Utilizing both MRI and x-ray to diagnose 1) Arthritis - Inflammatory and Degenerative, 2) Advanced cartilage assessment, 3) Rotator Cuff Tears, 4) Labral tears (shoulder and hip), 5) Tendon injuries and degeneration, 6) Meniscal tears, 7) Ligamentous injuries, 8) Common fractures, 9) Sports-related injury patterns, 10) Plantar fasciitis

The narrative report. How to effectively create medical-legal documentation and what the courts look for. Making your "4-Corner" (narrative) report demonstrable and build a reputation as an evidence-based provider. The step-by-step minutiae of building a report.

Treatment modalities centered upon "best-outcomes" in an evidence-based model considering chiropractic vs. physical therapy and chiropractic vs. medicine. Considerations of disability, pain reduction, functional improvement, drugs utilized, and side-effects are all considered

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

Correlating clinical findings and the patient history in determining the correct course of care in triaging the patient utilizing orthopedic and neurological evaluations in the clinical setting. Understanding the parameters for immediate referrals vs. following the continuum of care to determine the necessity for referrals

Elements of Evaluation and Management codes 99202-99203-99204-99205, inclusive of complexity of management and time components. Demonstrative documentation of spinal-related pain generators; spinal cord, thecal sac, myelomalacia, spinal nerve root insult, connective tissue, recurrent meningeal nerves.

Documenting Herniated Discs, Age-Dating Disc Pathology, and Connective Tissue Pathology as Sequella to Trauma Case Management, Spinal MRI and Documentation Documenting Herniated Discs, Age-Dating Disc Pathology, and Connective Tissue Pathology as Sequella to Trauma, Herniated Discs and Connective Tissue Pathology, differentially diagnosing herniated discs vs. normal and bulging discs and protruded, extruded and fragmented discs. Normal vs. Pathological connective tissues and age-dating herniated discs.

Understanding flexion-extension cervical injures and diagnosing connective tissue pathology. Determining impairments and the literature-based standard for permanent injuries.

Managing Herniated and Bulging Discs, Serious Injury in Non-Herniated Cases from Trauma Case Management, Spinal MRI and Documentation, Managing Herniated and Bulging Discs, Serious Injury in Non-Herniated Cases from Trauma, Spinal disc morphology, and innervation. Herniated, bulged, protruded, and sequestered disc characteristics and management. Literature-based documentation requirements for no-dis spinal injuries.

Herniated Discs and Permanent Brain Malfunction & Biomechanical Failure Case Management, Spinal MRI and Documentation, Herniated Discs and Permanent Brain Malfunction & Biomechanical Failure, A case-study of a post-traumatic herniated disc and related brain malfunction supported by contemporary literature, MRI acquisition, and necessity protocols.

Demonstrative Documentation of Disc Herniationand MRI Physics Case Management, Spinal MRI and Documentation, Demonstrative Documentation of Disc Herniationand MRI Physics, Understanding the documentation requirements to demonstratively show spinal disc lesions in reporting pathology. Understanding the physics of a nucleus resonating in T1 and T2 weighted imagery

Post-Traumatic Herniated Discs, Related Migraines-Headaches & Strain/Sprain Permanences Case Management, Spinal MRI and Documentation, Post-Traumatic Herniated Discs, Related Migraines-Headaches & Strain/Sprain Permanences, Relationship of headaches, and migraines to cervical spine disc herniation, clinical rationale for ordering MRI’s and the relationship of ligamentous pathology to spinal trauma.

Documentation of Low-Speed Crashes in Determining Etiology of Serious Bodily Injuries Case Management, Spinal MRI and Documentation, Documentation of Low-Speed Crashes in Determining Etiology of Serious Bodily Injuries, Documentation requirements during the evaluation, and management encounter to understand the etiology of spinal injuries. Having a complete understanding the forces involved to conclude a differential diagnosis, while concurrent ruling malingerers, if applicable.

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

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

Extremity MRI & Xray Interpretation of the Elbow, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors.

Extremity MRI & Xray Interpretation of the Wrist, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors.

Extremity MRI & Xray Interpretation of the Hand, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors.

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

Extremity MRI & Xray Interpretation of the Hip, Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors.

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

Extremity MRI & Xray Interpretation of the Knee, Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors

Extremity MRI & Xray Interpretation of the Hand, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors.

Extremity MRI & Xray Interpretation of the Foot, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors.

Chiropractic as the First Option for Spine, A Literature-Based Standard, Utilizing clinical findings in conjunction with advanced imaging and electrodiagnostic findings in managing collaborative relationships with medical specialists. Applying a literature standard to care to ensure conservative care as the first option.

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

Chiropractic as the First Option for Spine, A Literature-Based Standard, Creating literature-based documentation inclusive of history and a clinical examination that encompasses causality, diagnosis, prognosis and treatment plans. Ensuring the whole person impairment ratings are consistent with contemporary literature.

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

Interpretation sequencing of STIR, T1, T2, Axial and Sagittal acquisitions. Landmarks, physics, and literature-based definitions of disc and osseous pathology, Visualizing, diagnosing, and documenting cervical and lumbar anatomy vs. pathology.

Visualizing, diagnosing, and documenting lumbar spine sequencing, disc herniations, neural canals, cauda equina, conus medullaris, nerve sleeves, canal stenosis grading, and vertebral width vs. height in determining segmental remodeling. Diagnosing thecal sac abutment, central canal root compression and ligamentum flava involvement

Case study visualizing, diagnosing, and documenting cervical spine sequencing, disc herniations, neural canals, cauda equina, conus medullaris, and vertebral width vs. height in determining segmental remodeling. Identifying the Pons, Occipital junction, and spinal cord to identify Chiari 1 malformations.

Visualizing, diagnosing, and documenting lumbar spine sequencing, disc extrusion type herniations, neural canals, cauda equina, conus medullaris, spondylolisthesis, degenerative spondylolisthesis, disc degeneration, neural canal and central root compressions, central canal stenosis. Varices vs. herniations, and multiple level disc pathology with biomechanical failures.

Visualizing, diagnosing, and documenting cervical spine sequencing, disc extrusion type herniations, neural canals, disc degeneration, thecal sac compression, central canal stenosis, cord displacement, reversal of cervical curve, Chiari 1 malformation. Identifying spinal biomechanical failure in MRI sequencing, with visualizing ligamentous pathology as cause for failure. Differentially diagnosing recent vs. older trauma based upon edematous signal in T1, T2, and STIR images.

Visualizing, diagnosing, and documenting cervical spine sequencing, multiple disc extrusion type herniations, vertebral remodeling, intradural tumor displacing the spinal cord visualized in T1, T2, and STIR sequences, neural canal stenosis, disc degeneration, thecal sac compression, central canal stenosis, cord displacement, reversal of cervical curve, Chiari 1 malformation, and identifying of inferior brain structures

Visualizing, diagnosing, and documenting 1) improper sequence acquisitions invalidating interpretation 2) incomplete study invalidating interpretation 3) visualizing, diagnosing, and documenting lumbar spine sequencing, multiple disc extrusion type herniations, vertebral remodeling, multiple thecal sac compressions, neural canal stenosis, disc osteophyte/ridging complex, central canal stenosis, spondylolisthesis. Identifying the spleen, liver, kidneys, inferior vena cava, and psoas musculature on imaging.

Visualizing, diagnosing, and documenting cervical spine sequencing, cervical spondylosis, pathological spinal biomechanics, reversal of lordotic curve, and vertebral width vs. height in determining segmental remodeling, central herniation, thecal sac compression of the cord, identifying tongue, epiglottis, hyoid cartilage, pharynx, thyroid. Reviewing fat saturation sequences for osseous metastatic tumors and advanced degeneration.

Visualizing, diagnosing, and documenting lumbar spine sequencing, degenerative disc disease, nerve root sleeve abutment, far lateral herniations vs. bulges, normal vs. dissected inferior vena cava aneurism, epidural fat as a space occupying lesion, facet arthropathy and edema, hypertrophy of ligamentum flava, and pseudo disc at the S1-S2 level.

Visualizing, diagnosing, and documenting cervical spine sequencing utilizing T1 weighted images for pathology, inclusive of advanced degeneration and tumor detection. STIR in a fat saturated image for ligamentous pathology inclusive of the posterior longitudinal, ligamentous flava and interspinal ligaments. Normal clivus and odontoid for cerebellar tonsil location. Cerebral spinal fluid (CSF) flow and the utilization of the spinal cord’s central canal for CSF transport.

Medical-Legal Ethical Relationships, Documentation and Legal Testimony, Report writing for legal cases, the 4 corners of a narrative and documenting damages with understanding defense medical documentation and consistent reporting of bodily injuries.

Medical-Legal Ethical Relationships, Documentation and Legal Testimony, Part 2, Understanding report writing and the types of medical reports required for court inclusive of diagnosis, prognosis and treatment plans with requirements of reporting causality and permanency.

Medical-Legal Ethical Relationships, Documentation and Direct Testimony, Organizing your documentation and understanindg all collaborative documentation and how it fits into your diagnosis, prognosis and treatment plan, Understanding the nuances of the functional losses of your patients related to their bodily injuries,

Medical-Legal Ethical Relationships, Documentation and Direct Testimony Part 2, Utilizing demonstrative documentation in direct examination and communicating the results of your care concurrently with the written documentation and reporting an accurate diagnosis for all images.

Medical-Legal Ethical Relationships, Documentation and Direct Testimony Part 3, The evaluation, interpretation and reporting of collaborative medical specialists results and concluding an accurate diagnosis inclusive of all findings and reviewing all images to ensure an accurate diagnosis.

Medical-Legal Ethical Relationships, Documentation and Direct Testimony Part 4, Determininig and documenting disabilities and impairments inclusive of loss of enjoyment of life and duties under duress and the evaluation and validation of pain and suffering.

Medical-Legal Ethical Relationships, Documentation and Cross Examination Testimony, Reporting your documentation factually and staying within the 4 corners of your medical report and scope of practice inclusive of understanding how your credentials allow you to report your documentation

Medical-Legal Ethical Relationships, A Documentation Relationship Between the Doctor and Lawyer, The level of organization required in a medical-legal case that accurately reflects the bodily injuries of your patients and the time constraints in rendering an accurate report.

Medical-Legal Ethical Relationships, Report Writing and Preparing for a Legal Case, Reviewing the facts of the case inclusive of your documentation, the defense medical examiner, medical specialists and the attorney to ensure accurate and consistent reporting.

Medical-Legal Ethical Relationships, Report Writing and Preparing for a Legal Case, Creating demonstrative evidence, visuals of your patient's bodily injuries inclusive of x-rays, MRI's, CAT Scans and electrodiagnostic findings, the spinal biomechanics of herniated disc with ipsilateral findings and contralateral symptomatology.

Accurate and compliant documentation of history and clinical findings inclusive of functional losses, loss of activities of daily living, duties under duress and permanent loss of enjoyment of life. Prognosing static vs. stable care, gaps in care both in the onset and in the middle of passive care with a focus on detailed diagnosing. The integration of chiropractic academia, the court system and the insurance reimburser’s requirements for complete documentation.

Forensic Documentation-Report Writing, Report writing in a medical-legal case inclusive of causality, bodily injury, persistent functional loss and restrictive sequela from trauma. Demonstratively documenting bodily injury utilizing models, graphs and patient image of x-ray and advanced imaging.

Forensic Documentation- Demonstrative Documentation, Demonstratively reporting spinal biomechanical failure and spinal compensation. How in a medical-legal environment to ethically report pre-existing injuries vs causally related current injuries and what is permissible in a legal proceeding.

Forensic Documentation- Reporting Direct Opinions, Cauality, bodily injury and persistent functional losses documented and reported in a medical-legal environment as your direct opinion. Avoiding hearsay issues to ensure ethical relationships

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

Forensic Documentation- Qualifications and Preparation of Documentation, How to prepare your documentation for courtroom testimony and ensuring your qualifications are documented properly on an admissible, professional curriculum vitae. How to include indexed peer-reviewed literature in medical-legal documentation,

Forensic Documentation- Reporting Patient History and Credentials,Preparing patient history in a medical-legal case based upon your initial intake forms and understanding the work, social, academic, household and social activities of your patient. Understanding and explaining your doctoral and post-doctoral credentials in the courtroom.

Forensic Documentation- Reporting Chiropractic Care and Injured Anatomy, Preparing demonstrative documentation in a medical-legal case to report the bodily injuries of your patients, inclusive of loss of function and permanent tissue pathology.

Forensic Documentation- Reporting Temporary vs. Permanent Issues, Preparing documentation in a medical-legal case ensuring that you can communicate permanent vs. temporary functional losses and permanent vs. temporary tissue pathology. How to maintain and explain ethical relationships in medical-legal cases

Forensic Documentation- Reporting Bodily Injury, How to report bodily injury and functional losses as supported by your credentials in a medical-legal case. Clinically correlating causality and permanent tissue pathology as sequela to trauma,

Forensic Documentation- Record Review and Documentation Reporting, How to report records of collaborative treating doctors and communicating your scope of practice in the management of your case. How to ethically report your role as a doctor in medical-legal cases,

Chiropractic-Legal Ethics, The academic and court standards for documenting an Evaluation and Management encounter with the utilization of accurate CPT Coding. Accurately documenting your credentials based upon earned credentials.

Chiropractic-Legal Ethics, The clinical standard for ordering diagnostic tests as indicated. This includes advanced testing as MRI, CAT Scans and electrodiagnostics as electromyogram, nerve conduction studies, vestibulo-electronystagmography and somatosensory evoked potentials. The failure to order indicated testing and how it creates a public health risk and will negatively reflect on your license and reputation.

Chiropractic-Legal Ethics, Documenting and communicating your credentials in a manner consistent with licensure boards and the courts. Communicating sub-specialties as awarded through formal academic accomplishments and utilizing that level of education to better understand and explain pathology.

Chiropractic-Legal Ethics, Understanding ethical relationships about anti-kickback laws, fee-splitting and appropriate hiring practices in the clinical arena. How to use your initial patient documentation to conclude a case and ensure you are within the ethical boundaries.

An in-depth understanding of the protocols in triaging and reporting the clinical findings of the trauma patient. Maintaining ethical relationships with the medical-legal community.

An extensive understanding of the injured with clinically coordinating the history, physical findings and when to integrate neurodiagnostics. An understanding on how to utilize emergency room records in creating an accurate diagnosis and the significance of "risk factors" in spinal injury

An extensive understanding of the physics involved in the transference of energy from the bullet car to the target car. This includes G's of force, newtons, gravity, energy, skid marks, crumple zones, spring factors, event data recorder and the graphing of the movement of the vehicle before, during and after the crash. Determining the clinical correlation of forces and bodily injury.

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

Electromyography (EMG), Nerve Conduction Velocity (NCV), Somato Sensory Evoked Potential (SSEP), Visual Evoked Potential (VEP), Brain Stem Auditory Evoked Potential (BAER) and Visual-Electronystagmosgraphy (V-ENG) interpretation, protocols and clinical indications for the trauma patient

Understanding the necessity for accurate documentation and diagnosis utilizing the ICD-10 and the CPT to accurately describe the injury through diagnosis Understanding and utilizing state regulations on reimbursement issues pertaining to healthcare

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

Integrating mechanical integrity in gravity, weight, load, levers, posture, mechanoreception, mechanotransduction, mechanobiology, tensegrity, neurology, blood flow, and DNA.

How To Evaluate Them & Causation, What do the science say? A Workshop

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.

The requirements for diagnosing based upon in an initial evaluation and management encounter ranging from a 99202 – 99205 that includes comorbidities, non-musculoskeletal, and sequellae to injury diagnosis.

The requirements for diagnosing imaging inclusive of static x-rays, biomechanical x-rays, and MRI. Documenting the clinical findings of disc bulge, herniation, protrusion, extrusion, and fragmentation. Coding, diagnosing, and documenting individual treatment encounters in the clinical setting.

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

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

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

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

Analyzing spinal healthcare trends in both utilization and necessity and understanding the marketplace and how a level of clinical excellence is reflected in a doctors' documentation and credentials. Treatment pathways in triaging spinal pathobiomechanics

An evidence-based understanding of time-related etiology of disc pathology considering the American Society of Neuroradiology's designation of protrusion, extrusion, and sequestration of spinal discs, Considering the signal intensity of discs in age-dating pathology and acquisition protocols for advanced spinal imaging

An evidenced-based model for spinal biomechanical engineering and pathobiomechanics considering the pathophysiological limits in translations, angular deviation, and rotational planes. Utilizing the Cartesian system in plotting vertebral points to demonstratively conclude an accurate diagnosis, prognosis and biomechanical treatment plan with the consideration of long-term care in the non-specific mechanical spine pain patient when necessary

Clinical Grand Rounds of herniated, protruded, extruded, sequestered, and bulging discs. Differentially diagnosing vascular vs. mechanical spinal lesions and the necessity for urgent vascular, neurological intervention, Collaborating in a team environment utilizing a neuroradiologist, electrophysiologist, and neurosurgeon with the chiropractor as the primary spine care provider.

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

Normal anatomy of axial and sagittal views utilizing T1, T2, gradient and STIR sequences of imaging. Degeneration and annular fissures of discs in both trauma and non-trauma patients and the biochemical properties of joints in age dating pathology. Disc bulges from degenerative and sequela to osseous issues, herniation pathology and protrusion, extrusion, migrated and sequestered variations

This course provides an integrated education for the Doctor of Chiropractic in the science and art of spine, posture, and lower extremity disorders. The total permutations of abnormal posture using formulas from probability theory will be delineated and a literature review on postural displacements as they correlate to patient conditions.

This course provides an integrated education for the Doctor of Chiropractic in the science and art of full spine disorders. Detailed literature reviews covering the sagittal plane of the spine during pediatric development through age related change occurring in senior populations will be presented

This course will cover neuropsychological testing, psychological defenses, neurological aspects of traumatic brain injuries, brain stem injuries, autonomic nervous system injuries (including associated impacts on the visual and inner ear systems), and advanced brain imaging.

This course will cover whiplash, spinal injury, and brain trauma caused by vehicle collisions and how to diagnose and treat related injuries.

This course provides an integrated education for the Doctor of Chiropractic in the Science and Art of chiropractic analysis and management of patients injured in motor vehicle collisions.An update-to-date review of research material will be presented supporting the utilization and efficacy of a variety of Chiropractic examination/documentation procedures, and treatment techniques across motor vehicle injury populations.