Jose L. Llorens, DC

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

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

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. Federation of Chiropractic Licensing Boards, 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, New York,

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. Federation of Chiropractic Licensing Boards, 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, New York,

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. Federation of Chiropractic Licensing Boards, 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, New York,

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. Federation of Chiropractic Licensing Boards, 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, New York,

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

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. Federation of Chiropractic Licensing Boards, 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, New York,

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

Review of current research published in peer reviewed medically indexed journals focusing on traumatic injuries and how current literature affects the diagnostic conclusion and how to formulate treatment plans Florida Board of Chiropractic Medicine, American Academy of Medical Legal Professionals, Hollywood, Florida,

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

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

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. CMCS Post Doctoral Division, New Jersey State Board of Chiropractic Examiners, Long Island, NY,

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. CMCS Post Doctoral Division, New Jersey State Board of Chiropractic Examiners, Long Island, NY,

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. CMCS Post Doctoral Division, New Jersey State Board of Chiropractic Examiners, Long Island, NY,

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. CMCS Post Doctoral Division, New Jersey State Board of Chiropractic Examiners, Long Island, NY,

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. Federation of Chiropractic Licensure Boards, 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,

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

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. Federation of Chiropractic Licensure Boards, 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,

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of lumbar degeneration. With the comorbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. Spinal cord and canal compromise interpretation with management. Federation of Chiropractic Licensure Boards, 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,

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. Federation of Chiropractic Licensure Boards, 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,

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

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. CMCS Post Doctoral Division, New Jersey State Board of Chiropractic Examiners, Long Island, NY,

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. CMCS Post Doctoral Division, New Jersey State Board of Chiropractic Examiners, Long Island, NY,

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. CMCS Post Doctoral Division, New Jersey State Board of Chiropractic Examiners, Long Island, NY,

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. CMCS Post Doctoral Division, New Jersey State Board of Chiropractic Examiners, Long Island, NY,

MRI interpretation, physiology, history and clinical indications, bone scan interpretation, physiology and clinical indications, x-ray clinical indications for the trauma patient. CMCS Post Doctoral Division, New Jersey State Board of Chiropractic Examiners, Long Island, NY,

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. CMCS Post Doctoral Division, New Jersey State Board of Chiropractic Examiners, Long Island, NY,

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. CMCS Post Doctoral Division, New Jersey State Board of Chiropractic Examiners, Long Island, NY,

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. CMCS Post Doctoral Division, New Jersey State Board of Chiropractic Examiners, Long Island, NY,

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. CMCS Post Doctoral Division, North Dakota State Board of Chiropractic Examiners, Long Island, NY,

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. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, AACME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences and CMCS Post Doctoral Division, Buffalo, NY,

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. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, AACME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences and CMCS Post Doctoral Division, Buffalo, NY,

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. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, AACME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences and CMCS Post Doctoral Division, Buffalo, NY,

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. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, AACME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences and CMCS Post Doctoral Division, Buffalo, NY,

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, New York State Department of Education, Board for Chiropractic, AACME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences and CMCS Post Doctoral Division, Buffalo, NY,

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. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, AACME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences and CMCS Post Doctoral Division, Buffalo, NY,

MRI slices, views, T1, T2, STIR Axial, FFE, FSE and sagittal images in the interpretation of lumbar herniations. With the comorbidities 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. Federation of Chiropractic Licensure Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Long Island, NY,

AMA Guides 6th Edition, The understanding and utilization of the protocols and parameters of the AMA Guide to the Evaluation of Permanent Impairment 6th Edition. Kaplan Seminar, Orlando, FL,