Garreth MacDonald, DC CCST, FPSC

A series of discussions on lawyers and doctors working together; Judge’s perspective, along with case presentations. Presentation of motion preserving surgery. Review of MRI reports with visual diagrams for patient and lawyer understanding and documentation.

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.

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

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.

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.

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.

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.

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.

Evidence-based studies in Modic Changes, Disc and Referred Pain, MRI and Cervical Musculature, Kinetic MRI Images, Neurological Innervation, MRI and Injury Mechanisms, Discogenic Pain, Annular Tears and Fissures, Asymptomatic Herniations.

Identify and oral examination of 60 MRI sequences (over 2500 images) of disc bulges, circumferential, radial, and transverse fissures, varices, and herniations inclusive of the following types: protrusion, extrusions (sequestered and migrated/comminuted extrusions). MRI sequencing for accurate interpretation with contemporary nomenclature and reporting.

Clinically correlate history, clinical findings, and advanced spinal imaging to conclude an accurate diagnosis, prognosis, and treatment plan in an evidence-based paradigm that passes a peer-reviewed panel. The case presented must emanate from contemporary practice utilizing accepted guidelines for sequence acquisition and collaboration if clinically indicated.

MRI, CAT Scan, and X-ray interpretation of shoulder, elbow, wrist, hand, and fingers. Identifying arthridities in upper extremities.

MRI, CAT Scan, and X-ray interpretation of shoulder, elbow, wrist, hand, fingers. Identifying tumors, fractures, dislocations, and infections in joints, including the long bones attached to the joints.

MRI, CAT Scan, and X-ray interpretation of shoulder, elbow, wrist, hand, fingers. Identifying soft tissue injuries in joints; labrum, meniscus, and ligament and tendon injuries.

MRI, CAT Scan, and X-ray interpretation of pelvis, hips, knee, ankle, foot, and toes. Identifying arthridities in lower extremities.

MRI, CAT Scan, and X-ray interpretation of pelvis, hips, knee, ankle, foot, and toes. Identifying tumors, fractures, dislocations, and infections in joints, including the long bones attached to the joints.

MRI, CAT Scan, and X-ray interpretation of pelvis, hips, knee, ankle, foot, and toes. Identifying soft tissue injuries in joints; labrum, meniscus, and ligament and tendon injuries.

Diagnosing and demonstrative reporting of the spinal cord, nerve root, thecal sac, disc recurrent meningeal nerve, myelomalacia, myelopathy, fracture, chemical radiculitis, and connective tissue pathologies, and osseous compression of nociceptors. Collaborative care with medical specialists on spinal pathology and medical-legal reporting requirements.

A literature review of the Biomechanics and Rear Impact Collisions, Different responses to pain and residuals from same occupants, functional anatomy, disc herniations and neural pathology, chronic pain, traumatic brain injuries, post traumatic stress and post traumatic nutrition

Spinal disc morphology of lamellar tracts and fiber orientation, the non-uniformity of discal zones with the chemical content of each. How Proteoglycans and Aggrecans are integral in disc hydration and age-dating pathology. Understanding the vascularization of the osseous end-plate, cartilaginous end-plate, and disc from birth through puberty is essential to accurately diagnosing disc pathology. Being able to relate disc herniations to end-plate fractures with central herniation and clinically correlating it to chronic back pain.

Determining and documenting the history of proximate cause, how to demonstratively document pain, weakness, and numbness using evidence-based protocols. The demonstrative documentation of MRI spine pathology and being able to differentially diagnose previous vs current pathology in prognosing permanencies. The clinical correlation of causality, demonstrative bodily injury, and persistent functional losses using emotional intelligence.

Identifying and diagnosing Schwannoma’s, Adenoma’s, Fibroid Leiomyomas and Uterine Sarcoma’s, Renel Cell Tumors, Renal Cysts, and Aortic Aneurysms. The physics of T1, T1 fat saturation, T2, T2 fat saturation, STIR, proton density, fast spin echo, echo gradient, coronal, sagittal, and axial. CT hounsfield units and diagnosing tumors.

Identifying and diagnosing Osteoarthritis in hand, wrist, elbow, shoulder, foot, ankle, knees, hips on X-ray. Identifying and diagnosis erosive arthritis and Rheumatoid Arthritis on X-ray, MRI imaging, and ultrasound MRI in the hand, elbow, knee, and spine, Psoriatic and Lupus/Jaccoud Arthritis in the hand. Crystallin Arthropathy of the hand, Gout in the feet and spine, and Calcium Pyrophosphate Dihydrate Deposition Disease (CPPD) of the hand.Diagnosing of ankylosing spondylitis of the spine was also identified.

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.

Identifying and diagnosing spinal disc pathologies: bulged, herniated, protruded, extruded-comminuted, extruded-sequestered. MRI sequence protocols: T1, T1 fat saturation, T2, T2 fat saturation, STIR, proton density, fast spin echo, echo gradient, coronal, sagittal and axial. Triage of disc pathologies and collaborative care.

Understanding the morphology and physiology of connective tissue at the cellular and extra-cellular levels in building a foundation to understanding the function and interaction of ligaments, tendons, muscles, and bones, Identifying connective tissue pathology and the repair process with a foundation of r permanent aberrant sequella.

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

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

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,

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.

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.

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

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.

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.

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.

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.

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

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.

A literature review of the Biomechanics and Rear Impact Collisions, Different responses to pain and residuals from same occupants, functional anatomy, disc herniations and neural pathology, chronic pain, traumatic brain injuries, post traumatic stress and post traumatic nutrition.

Spinal Biomechanics in Clinical Practice, 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.

MRI Spine Sequence Acquisition and Interpretation, 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

Spinal Disc Microanatomy, 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

Interprofessional Collaboration on Mechanical Back Pain in Clinical Practice, 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

Spinal Biomechanical Engineering Analytic, 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

Demonstrative Reporting of MRI Spinal Disc 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

Accurately documenting your credentials based upon earned credentials.

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.

Communicating sub-specialties as awarded through formal academic accomplishments and utilizing that level of education to better understand and explain pathology.

How to use your initial patient documentation to conclude a case and ensure you are within the ethical boundaries.

The concept of whole person impairment was reviewed. The utilization of the AMA Guides to Permanent Impairment and how to accurately determine the appropriate percentage as also reviewed. A comparison of the 5th and 6th edition of the AMA guides was reviewed.

The diagnosis of acute spinal ligament injury and the resulting segmental hypermobility was discussed and reviewed. The chronic sequela of untreated biomechanical pathology was also reviewed.

The diagnosis of acute and chronic spinal ligament laxity and spinal joint instability was discussed along with the application to spine surgical planning and pain management procedures.

Understanding and including all historical elements; current history, past history, family history, and social history when documenting a 99201, 99202, 99203, 99204, and 99205. The application of time as the prime element as per Medicode in coding examinations and re-examination with face to face, review of records and the time necessary to document in an electronic health record.

An evidence-based approach to concluding accurate diagnosis, prognosis, and treatment plan, Eradicating the non-specific back pain dogma utilizing X-ray digitizing based on literature standards, Creating treatment plans with identifying the primary spinal lesions using evidence-based tools.

Understanding the concepts of normal vs. pathological movement of vertebral motor units in accurately concluding diagnosis on biomechanical pathology when considering excessive motion. An evidence-based approach to determining translation, angular deviation and rotations beyond pathobiomechanical limitations in the spine.

Understanding the utilization of CAT Scan slicing and the reformatting when using bone and soft tissue windows. Correlating MRI to CAT Scan when either creates an unclear conclusion to render a complete image of the morphology of the indeterminate pathology. Understanding the physics of CAT Scan and the radiation levels with different types of CAT Scan technology.

Ethical, collaborative relationships with medical PCPs and specialists using advanced documentation and accurate reporting of imaging and advanced imaging. Creating a collegial relationship when conflicts arise in concluding accurate diagnosis to allow consensus and the evidence to determine final diagnosis

Utilization of thin slice acquisitions with T2 Fat suppressed, STIR, proton density, T1 and T2 sequencing for advanced identification of spinal disc lesions, herniations, bulges, protrusion, extrusion, and fragmentations. Better visualization of intradural and extradural lesions, neoplasms, and infections.

Interpreting and utilizing X-ray and MRI findings in creating demonstrative documentation. Advanced identification of spinal disc lesions, herniations, bulges, protrusion, extrusion, and fragmentations through computer graphics. Identification and demonstrative documentation of vertebral motor unit pathology and reporting demonstratively using computer graphics.

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.

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.

Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors.

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.

Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors.

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.

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.

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.

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.

Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors.

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.

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.

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, 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 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, 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 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 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

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 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

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

Recognized by Cleveland University-Kansas City, Chiropractic and Health Sciences with courses recognized by the ACCGME in conjunction with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences.

Primary Spine Care 5, The biological, neurological and mechanical mechanisms and pathways from the thrust to the dorsal horn and brain connection and how the brain processes the chiropractic spinal adjustment based upon the literature. Care paths of chiropractic and physical therapy from an outcome basis

Primary Spine Care 5, MRI Spine The spine-brain connection in managing chronic pain patients. Understanding how chronic pain negatively effects brain morphology and potential pathology as sequella. The role of chiropractic in preventing the loss of gray matter and the most recent evidence as outlined in indexed peer reviewed literature over the last 10 years verifying chiropractic’s role

Primary Spine Care 5, MRI Spine Interpretation of the spine. How to triage a trauma and non-trauma with advanced imaging and document the necessity. We will also cover the basics of MRI Spine Interpretation inclusive of all types of herniations and bulges.

Primary Spine Care 5, A literature based model for collaborating with hospitals, medical primary care providers and specialists. Reviewing the documentation requirements to communicate the diagnosis, prognosis and treatment plans with medical entities and having the evidence as a basis for those recommendations

This seminar covered the following topics; Mechanism of injury; Elderly with treatment and prognosis considerations; Disc injuries; Women vs. Men and differences in injury patterns and care; Arterial dissections and MVC; and medical research on residuals and prognosis from Whiplash and Spinal Trauma

Constructing and concluding an E&M (99202-99205) report that accurately reflects the history, clinical findings and management of trauma cases that concurrently meets the needs of both the carriers in the courts and ethical relationship that concurrently matches the standards of both contemporary academia requirements and a contemporary literature-based standard

Having referral relationships with emergency rooms, neurosurgeons, orthopedic surgeons, pain management specialists, neurologists, neuroradiologist and medical primary care providers based upon clinical dilemmas that processed after a thorough history, examination and imaging if clinically indicated to conclude diagnostic dilemmas. Utilizing evidence-based protocols and acquisition of images and treatment pathways, collaborating with medical specialists and primaries to conclude and accurate treatment plan

Contemporary acquisition protocols including slice thicknesses and sequences inclusive of the ordering process. Interpretation of axial, sagittal and coronal views in T1, T2 and stir views inclusive of the disc, spinal cord, extra-dural and intra-dural pathology

Concluding an E&M report in cases involving medical primary care providers of medical specialists that have complicated case histories, significant risk factors, and inconclusive findings. Triage and management of complicated cases requiring the clinical evaluation, advanced imaging and electrodiagnostics

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

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

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

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

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

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

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

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

Utilizing pain patterns, the high signal in the annulus, high signal outside the annulus, Modic changes, disc height, vacuum disc, sclerosis, Phirrman rating, facet edema, and previous MRIs to determine the chronicity of pathology., Master-Class in ligaments; anatomy, physiology, vascularization, neurological innervation, tissue repair, and how they all relate to clinical practice. Ligament pathology correlating to the mechanisms of patho-neuro-biomechanical lesions (vertebral subluxation complex). Also, how ligaments play a critical role in the chiropractic spinal adjustment and in defining the chiropractic spinal adjustment mechanisms

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.

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

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.

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

Overview of traumatic brain injury in concussion. It discusses that all brain injuries are traumatic and dispels the myth of a “mild traumatic brain injury.” Also, this covers triage protocols and the potential sequela of patients with traumatic brain injuries.

Gross traumatic brain injuries from trauma and significant bleeding with both epidural and subdural hematomas. There are numerous case studies reviewed inclusive of neurosurgical intervention and postsurgical outcomes.

Multiple case studies of gross traumatic brain injuries from trauma requiring neurosurgical intervention and also discusses recovery sequela based upon the significance of brain trauma. This module also concludes with concussion protocols in traumatic brain injury short of demonstrable bleeding on advanced imaging.

Concussion etiology and cognitive sequela where gross bleeding has not been identified on advanced imaging. It discusses the significance of electroencephalogram testing in determining brain function and pathology (if present). This module also covers the understanding of waveforms in electroencephalogram testing in both normal and abnormal scenarios.

Amplitude, conduction and conduction delays as sequela to traumatic brain injury to diagnose concussion and traumatic brain injury in the absence of gross bleeding and advanced imaging. This section covers electroencephalograms and event-related potentials which measures the brain response that is a direct result of specific sensory or motor events. It is a stereotype electrophysiological response to a stimulus and provides a noninvasive means of evaluating brain function. In this module multiple case studies are discussed with ensuing triage protocols pending the results.

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.

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.

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 seminar covered the following topics; Rear-End and Broadside MVCs, Uncinate process, Medical-Legal standards of care, Lumbar spine pain in MVCs, Arterial dissections, COVID-19, Post MVC trauma inflammation, Cervical spine trauma related to MVCs and Concussion/mTBI, Nutrition needs following mTBI and Sleep dysfunction following Whiplash and Spinal 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.

Spinal disc morphology, and innervation. Herniated, bulged, protruded, and sequestered disc characteristics and management. Literature-based documentation requirements for no-dis spinal injuries

A case-study of a post-traumatic herniated disc and related brain malfunction supported by contemporary literature, MRI acquisition, and necessity protocols.

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

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 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

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 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.

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.

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

Recent advancements in the science of Chiropractic and associated nutrition

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.

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.

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.

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.

Credentialed in hospital protocols, emergency room protocols, acute and chronic patient triage inclusive of MRI spine interpretation, spinal biomechanical engineering, head trauma, concussion, mild traumatic and traumatic brain injuries.

Michael D Freeman, MedDr, PhD, DC, MScFMS, MPH, MFFLM, DLM, FACE; Glen Zielinski, DC, DACNB, FACFN, CBIS; Tyrone Wei, DC, DACBR; Darrell C Brett, MD; Dr Aaron DeShaw, Esq; John K Maltby, DC, FICA

Gregg Friedman, D.C.

A clinical discussion of collaborating with neurosurgeons on spinal cord and spinal nerve root co-morbidities. Triaging cases with herniated, protruded, extruded, fragments discs and differentially diagnosing tethered cord, syringomyelia, traumatic Schmorl’s Nodes, Myelomalcia, spinal cord edema, vacuum disc and other intra, and extra-dural lesions.

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.

Age dating herniated discs and trauma is a critical skill for an expert in spine. It combines the clinical skills of interpreting X-ray, MRI, and other imaging modalities with a clinician's understanding of joint pathology. This level of expertise is critical when collaborated with other physicians or working in the medical-legal environment as an expert. Age dating pathology is also central to creating a prognosis on your patient's recovery and must be evidence-based in rationale

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.

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.

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.

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

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

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 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.

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.

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

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

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

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.

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.

Enduring material Return-to-Play: Oregon Concussion Education in compliance with the training requirements of ORS 336.485 and 417.875.

Defining traumatic brain injuries, clinical assessment, application of field testing and neurological testing, approaches to improving cognition, balance and vision issues, and RTP/RTS guidelines

How Insurers deny claims, medical doctors and chiropractors working together, documentation of injuries, proper use of medical-legal representation, IME reviews, concussions, post traumatic etiology and spine trauma.

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

Causality, Bodily Injury, Negative Acceleration Forces, Crumple Zones and Critical Documentation, Factors that cause negative acceleration to zero and the subsequent forces created for the vehicle that get translated to the occupant. Understanding critical documentation of hospitals, ambulance reports, doctors and the legal profession in reconstructing an accident.

Skid Marks, Time, Distance, Velocity, Speed Formulas and Road Surfaces, The mathematical calculations necessary utilizing time, distance, speed, coefficients of friction and acceleration in reconstructing an accident. The application of the critical documentation acquired from an accident site.

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

A detailed review of physical examination and assessment of traumatic thoracic and lumbar spine fractures using plain film radiograph and CT scans with and without contrast. Detailed review of mechanism of injury, emergency department records and radiology reports were presented. Errors in fracture site, description and omission on plain film study by the radiologist were reviews. Analysis of potential spinal instability in the cervical spine was discussed and a detailed referral for computerized mensuration analysis was demonstrated.

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.

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.

The anatomy and physiology of the brain and how blood perfusion effects brain function. A detailed analysis of the blood supply to the brain and the physiology of ischemia.

Various types of stroke identifying ischemia, hypoperfusion, infarct and penumbra zones and emboli. Cardiac etiologies and clinical features as precursor to stroke with associated paradoxical emboli and thrombotic etiologies. Historical and co-morbidities that have etiology instroke inclusive of diabetes, coagulopathy, acquired and hereditary deficiencies.

Stroke type and treatments performed by vascular specialists. The goals of treatment with the physiology of the infarct and penumbra zones and the role of immediate triage in the primary care setting. Detailing the complications of stroke and future care in the chiropractic, primary care or manual medicine clinical setting.

The neurological history and examination for identifying stroke risks with a focus on supra and infratentorial regions, upper and lower motor lesions, cranial nerve signs, spinal cord pathology, motor and sensory pathology and gait abnormalities. Examining genetic and family histories along with dissection risk factors. Stroke orthopedic testing and clinical guidelines pertaining to triage for the primary care provider.

Recognition of concussion, signs and symptoms, assessment, management and return to play protocols.

Examination of current literature regarding trauma, pain, and inflammation. Dealing with MMI and pre-existing conditions. Mild traumatic brain injuries (mTBI) was discussed with proper diagnosis, and best practices for documentation and treatment.

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.

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.

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

Introduction to coaches about the recognition of concussion, including signs & symptoms. When to take a player out of a game or practice and when to safely RTP.

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.

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.

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

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

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 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

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

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

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

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

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

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

Brain and head physiology, brain mapping and pathology as a sequella to trauma. Traumatic brain injury, mild traumatic brain injury, axonal shearing, diffuse axonal injury and concussion are detailed in etiology and clinically. Clinical presentation, advanced diagnostic imaging and electrodiagnostics are detailed in analysis to create a differential diagnosis. Balance disorders that often occur as a result of trauma are also explored from clinical presentation to advanced imaging and differential diagnosis

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

Concept review of laser physiology, Newtonian concepts, wavelengths, mitochondria and ATP formation with Cytochrome C-Oxidase, quantum biological concepts, laser variables for the treatment of degenerative disc disease, low back pain, acute trauma, scar tissue and chronic pain

How Insurers deny claims, medical doctors and chiropractors working together, documentation of injuries, proper use of medical-legal representation, IME reviews, post traumatic etiology and spine trauma

A review of current literature regarding the scientific basis of immunoneurological function in the human body and the effect chiropractic can have on systemic health

Posture assessment and rehab experience in a lecture/lab format, providing relevant posture facts and research and interactive exercises

Current concepts of brain injuries were discussed including assessment, diagnosis, treatment, management, legal implications, reporting, imaging studies and case studies

To describe and consensus-approaching advances in basic science and clinical trials research related to topics of nutrition, molecular biology, and metabolism that are appropriate for translation into clinical practice. To demonstrate and exemplify the actual clinical applications of new research and evidence so that physicians can apply this data to clinical practice and patient utilization and treatment compliance

A review of the current concepts in recognition, management and treatment of concussions in sports. Return to play criteria were discussed

Concept review of laser physiology, Newtonian concepts, wavelengths, mitochondria and ATP formation with Cytochrome C-Oxidase, quantum biological concepts, laser variables for the treatment of degenerative disc disease, low back pain, acute trauma, scar tissue and chronic pain

Mechanisms of injury and repair of whiplash and spinal trauma, evaluation and treatment of ligament sprains in the cervical spine, nutrition and repair of soft tissue injury, spinal trauma and biomechanics of TOS, use of upright MRI, and recent medical-legal research studies in the area of evaluation, diagnosis, and treatment of whiplash and spinal trauma

A review of current knowledge and concepts in whiplash trauma including pain and nutrition, mechanisms of injury, prognosis, phases of healing, and management

A review of the current scientific literature on brain injuries including, mild traumatic brain injuries, concussions, diagnosis, treatment and management strategies

Discovery in Auto Injury Cases;Depositions—what to ask, IMEs and treating physician IMEs, Bio-Mechanics of Accidents and Injuries; junk science and how or how not collisions cause injuries, and the use of Medical Experts

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

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

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

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

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 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

Clinical impact of case management choices and goals, significance of specific factors that affect patient injury and healing, critical research findings on key issues and insights with injury prognosis, the balance relationship between perception of pain, spinal joint mobility, adjusted technique, chiropractic diagnostics and adjustment management goals, and soft tissue injury issues with inflammation, pain, brain trauma and diet

How Insurers deny claims, medical doctors and chiropractors working together, documentation of injuries, proper use of medical-legal representation, IME reviews, post traumatic etiology and spine trauma

Focus on the AMA and ABIME standards for proper implementation and documentation. Report writing and rebuttal strategies were reviewed. Sample IME’s were reviewed and critiqued

The first class in the certification process for Chiropractic Sports Physician covering diagnosis of athletes in various sports, including concussions and return-to-play criteria.

Field assessment of sports injuries and their management including medical emergencies, procedures and on-field management.

A focus on extremity injuries in the athlete, proper assessment and diagnosis, treatment and management options were discussed. Case studies were presented

Used in the recent cases the example with direct questions to qualify as an expert in the eyes of the jury. Direct questions to preempt the defense cross-examination, to explain injury, and effective use of courtroom exhibits to explain your patience injuries. Cross examination questions, typical defense tactics and how to respond effectively

A focus on rear impact biomechanics, radiographic strategies, mild traumatic brain injuries, report writing, evidence based medicine concepts, peer reviewed literature review and DJD onset and delayed onset were discussed

A 5 day, 6000+ international attendees, 18 plenary sessions, 1818 poster presentations on various topics of pain and all the various methods and research on pain.

A 36 hour class focusing on the newest Impairment rating guides utilization. Attention was given to the proper use of the guides for different parts of the body, including cases to perfect the calculations

Use of demonstrative evidence with instruction in common pitfalls, avoidance of them and taking advantage of opponents weaknesses in medical legal proceedings

To improve the current understanding of whiplash trauma, related to whiplash injury and its sequelae. Topics included whiplash and post-traumatic headache, neurologic mechanisms of posttraumatic headache, use of the dynamic MRI for visualizing upper cervical functional abnormality and injury, biomechanics of neck pain and whiplash, and soft tissue injuries in the cervical spine facet joints, MRI assessment of cranialcervical ligaments and membranes after whiplash trauma.

Comprehensive and compelling narrative report construction as well as how to avoid common mistakes and pitfalls. The latest cutting-edge techniques and rebuttal strategies as well as critical forensic documentation skills and impairment requirements

A focus on rear impact biomechanics, radiographic strategies, mild traumatic brain injuries, report writing, evidence based medicine concepts, peer reviewed literature review and DJD onset and delayed onset were discussed

Critical history taking, risk analysis, and physical examination skills as well as other radiographic and advanced imaging including CET, MRI, scintigraphy, packed, SPECT, and others. Review of electrodiagnostic tests and their applications in whiplash in addition to therapeutic approaches to successful management of whiplash and mild dramatic brain injuries.

Review of current state of knowledge of the whiplash phenomenon, including all factors affecting injury risk in outcome. In depth biomechanics, traumatology, epidemiology, review of outcome studies, and common sick while I of whiplash, including brain injuries, pain syndromes, thoracic outlet syndrome, carpal tunnel syndrome, and chronic pain disorders as well as risk analysis

Update of current medical literature on whiplash, paper review issues, Quebec Task Force review, case reviews and junk science

Examination of attorney views on personal injury cases, evidence code, types of evidence, standards of admissibility for scientific expertise, tort principles, practice guidelines and standards-justifying care, accident collision reconstructionist and biomechanical experts, Independent medical examinations, depositions, and trial

Review of current state of knowledge of whiplash, whiplash and MS, whiplash and TMD, and brain injury

Clinical updates utilizing peer reviewed journal articles, canalith repositioning for benign paroxysmal positional vertigo (BPPV), whiplash related facet pain was reviewed

Various scientific papers were presented on current whiplash related topics including why all do not recover from whiplash injury, mechanical and physiological pathologic mechanisms of painful cervical facet capsule injury, whiplash injury epidemiology, and whiplash injuries with TBI

A focus on proper documentation and recordkeeping was reviewed with emphasis on communication with other services including attorneys and medical providers

A focus on current research literature knowledge on whiplash injury at low speed collisions, including whiplash mechanics

Examination of the biomechanics associated with whiplash-related disorders and injuries. Topics included the anatomical and neurophysiological aspects of the injured tissues, biomechanics and traffic accident reconstruction, injury mechanisms, head/neck kinematics, and pain issues. The course also examined several case studies and issues of liability

Focus on restoring function, difficulty diagnosing the cause of back pain, and a cute mechanical back pain and soft tissues sub failure injuries, recent literature reviews of spinal manipulation, recent clinical trials, neurology and the cervical spine, causes of disturbed proprioception, neural plasticity, segmental control of nociception, tissue injury and repair, and degeneration.

Focus on anatomy of soft tissue injuries, physics and biomechanics of injury, structures injured in whiplash, ACR, damage related to injury and variablility, healing of soft tissue injuries, pain from WAD, diagnosis and treatment, and medical studies for WAD

A review of radiographic mensurations, CT imaging, MRI imaging, use of SPECT and VF imaging

A continuation of review of neurologic principles of injury mechanisms including suprasegmental descending inhibition of nociception, altered thresholds and supersensitivity, neuroplasticity, referred pain, central canal stenosis, three phases of healing, fibrosis of repair, and concepts of motion.

A review of neurology principles and how they relate to trauma cases. Review of current medical literature in relation to neurology and treatment management of trauma cases

CCST

. A review of current journal articles by the authors including Neurogram SPECT quantification in the detection and treatment of MTBI, conservative treatments in whiplash, proper application of vehicle damage to refute injuries, the probability of causation in litigation, and neuropsychological evaluation and treatment of patients with Whiplash-induced MTBI

A review of the current scientific literature on Whiplash including diagnosis, injury management and treatment, prognosis and soft tissue repair