Christopher Cordima, DC

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.

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

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.

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.

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.

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.

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.

Determining the etiology of the patient's complaints in a traumatic or non-traumatic scenario. Analyzing the patient's past history and review of systems along with the performance of a complete orthopedic, neurological and clinical examination to correlate both past, current and causality issues to formulate an accurate diagnosis, prognosis and treatment plan. There is an emphasis on triaging both the trauma and non-trauma patients.

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.

Traumatic brain injury, pathophysiology, diagnosing, management and prevention strategies.

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.

Physician training to perform the Department of Transportation (DOT) medical exam and apply the Federal Motor Carrier Safety Administration (FMCSA) Medical Standards, advisory criteria, and guidelines when determining driving status.

Treatment documentation, patient encounters, medical necessity, consent, compliance, documenting Medicare and routine office visits, preventing common problems in trauma/injury treatment documentation, risk management strategies.

Review of the basic principles involved in producing MRI images shared by all MRI scanners.

Reviewing multiplanar images of MRI, the shades of gray and the differences between T1 and T2 weighted images. Reviewing the special MRI studies that have been created to help identify different pathologies, including fat suppression, contrast enhanced and functional MRI studies.

Contraindications to MRI, how to read an MRI report, the MRI appearance of DDD, ligamentum flavum hypertrophy, disc herniations, annular tears and post-disc surgical cases.

Evaluation, diagnosis, setting goals and treatments while utilizing outcome assessments.

Functional anatomy of the disc, including disc innervation, disc nutrition and structural composition.

MRI interpretation, detailed analysis of disc herniations and normal disc aging.

Normal disc aging, a discussion on the differences between normal disc aging and degenerative disc disease, internal disc disruptions, and nerve in-growth.

Basic principles of function based care, how to perform physical capacity testing, and how to prescribe specific exercises related to the patient’s ability to perform the tests.

Neuromuscular re-education overview. Medical necessity for stretching exercises and postural correction exercises.

Neuropathic pain syndromes, orthopedic evaluation, neurological work up and MRI interpretation.

Decompression therapy overview and objective review of the medical and chiropractic literature regarding its efficacy.

Sclerotogenous, myofascial, visceral and neuropathic pain syndromes. This included a review of the literature of Bogduk, Lord and Kuslich.

Neurological and physiological aspects of pain transmission and pain perception. In depth analysis of the innate pain modulation systems that, when activated, will reduce a patient's perception of pain without medication.

The biomechanics of low speed rear impact collisions, discussion of the S-shaped spine, general magnitudes of force, injury risk factors, and types of injuries resulting from these collisions.

Specific conditions and symptoms related to whiplash, including the etiology of neck pain and headache, radiculopathy, TOS, myofascial pain syndrome, fibromyalgia, post-concussive syndrome, and TMJ.

Defining wellness with respect to research, patient assessment, and clinical analysis and intervention. Identifying structural and neurophysiological effects of vertebral subluxation complex (VSC) in adaptive (stress) physiology and illness. Reviewing referenced literature, identifying scientific evidence relating chiropractic's health promotion and illness prevention benefits in relation to chiropractic adjustments and optimizing spinal motion.

Standards of chiropractic practice within Massachusetts: (MA laws, regulations, policy guidelines and professional conduct) and compliance planning, record keeping in clinical practice, outcome measures and federal recordkeeping requirements.

Injury biomechanics, human factors, diagnosis, evidence based treatment management, complicating factors, acute versus chronic management and objectives, clinical diagnosis and whiplash associated research.

How to properly document a case file, forensically examine insurance doctors and successfully rebut IME’s and peer reviews.

Fundamentals of the peer review process. Peer review report writing format and skill development. State/regional/national, chiropractic, and cross discipline treatment guidelines. Deposition and court room testimony skill development. Insurance industry red flags.

Review of current peer-reviewed literature and research affirming appropriateness of chiropractic care for spinal and nervous system health. Various clinical issues, such as proprioception, dizziness and the cervical spine, back problems and imaging, types of diagnoses of back pain, the recurrent nature of back pain, headaches, whiplash, chronicity and chiropractic care, chiropractic and neurology, stages of tissue injury and repair, physical impairment, disability.

Whiplash: advanced topics, basic and special concepts of biomechanics, experimental whiplash studies, soft tissue lesions and common syndromes. History taking, physical examination strategies. New developments in radiographic, CT and MRI evaluation of CAD trauma.

Chiropractic science, politics and philosophy.

Understanding pain, stages of healing for soft tissue injuries, therapeutic exercise protocols, management of soft tissue injuries such as sprains and acute cervical hyperflexion/hyperextension conditions, progressive dynamic lumbar stabilization, prevention and management of back pain through educating back school protocols.