Robert Jackson, DC FSBT

Detailed analysis of the 2022-2023 scientific literature supporting chiropractic management of the spine pain patient. Outline of supporting evidence in the pain management, corrective care and health maintenance phases of care was presented. Peer reviewed medically indexed papers were discussed and correlated to trends in research with emphasis on the RAND Corporation’s Center for Collaborative Research in Complementary and Integrative Health was presented.

Detailed discussion of the “gold standard” tests that objectify injury in the human spine. Assessment of muscle, tendon/ligament, intervertebral disc, spinal nerve, and boney injuries was presented and correlated to imaging findings. Physical examination findings examples were correlated for the compliant need for testing orders including but not limited to plain film radiographs, MRI, CT, EMG/NCV and Bone Scan.

Anatomy of the healthy intervertebral disc and its nerve supply was reviewed. An overview of the histological structure of the intervertebral disc was presented. Discussion of the chemical and histological make-up of the intervertebral disc including vascular, proteoglycan and extracellular matrix composition was outlined and presented. Specific innervation and vascularization patterns and their relation to pain generating injuries was explained.

Anatomy of the degenerative intervertebral disc and its nerve supply will be reviewed. An overview of the histological structure of the degenerating intervertebral disc was presented. Discussion of the chemical and histological make-up of the degenerative intervertebral disc including vascular, proteoglycan and extracellular matrix composition will be presented. Key differences between the healthy and degenerative disc will be outlined including neovascularization and the ingrowth of free nerve endings.

Detailed presentation of intervertebral disc nomenclature as outlined by the combined task forces of the North American Spine Society, the American Society of Spine Radiology, and the American Society of Neuroradiology. Specific classification parameters and descriptions of intervertebral disc bulge, protrusion, herniation, extrusion, sequestration, and traumatic disc bulge will be presented and reviewed. Differences in morphological description were presented with sagittal and axial MRI examples. Review of clinical correlation to etiology was discussed.

Presentation of the ligamentous structures of the human spine including but not limited to the anterior longitudinal, posterior longitudinal, intertransverse, facet capsular, ligamentum flavum, interspinous and supraspinous ligaments was outlined. Histological presentation will be provided with focus on regional adaptation to ligamentous microscopic structure with details presented on intracellular matrix and cytokine activity following traumatic events. Emphasis was placed on injury thresholds using the stress/strain curve as a guide.

Biomechanical alterations and their effect on spinal ligaments will be presented including isotropic and anisotropic changes in ligament function. Clinical correlation will be provided based on radiographic findings, traumatic events, and chronic compensatory pain patterns. Emphasis was placed on recent peer-reviewed evidence showing transection of one ligament in the spine has an influence on all others. Correlation to chiropractic care was emphasized.

Detailed overview of sagittal balance in both a whole spine and regional perspective will be presented. Correlation to segmental changes will be reviewed. Interprofessional communication with primary care and medical specialists will be outlined with focus on kyphotic, lordotic and pelvic parameters. Emphasis was placed on pelvic incidence, pelvic tilt, sacral slope, lumbar lordosis, thoracic kyphosis, T1 angle and cervical lordosis. Discussion of these biomechanical parameters within the corrective phase of chiropractic and communication with the spine surgeon was emphasized.

Overview and specific examples of interprofessional communication with the medical community were discussed. Common mistakes relating to speaking with primary care, interventional pain management and spine surgeons will be presented and reviewed. Emphasis will be placed on diagnosis and management of the spine pain patients within the pain management, corrective, and health maintenance phases of chiropractic care. Presentation was supported by examples published in the peer reviewed medically indexed scientific literature.

Presentation on the anatomy of medical-legal reporting and connective tissue diagnosis was provided. Overview of the care paradigm was presented including causal relationship, bodily injury, and persistent functional loss. Objectification of spinal injury and delineation between new and pre-existing conditions was outlined. Specific case reporting and timelines for accurate explanation of bodily injury was detailed.

Modernization of documentation workflows were presented with focus on E/M evaluations and care schedules. Medical necessity and clinical timing were outlined and addressed relating to diagnostic testing and specialist referral. The benefits of a using case findings to reach out to the medical community was addressed and compared to outreach processes.

Common pitfalls and risk factors related to professional liability will be reviewed including physical examination and diagnostic duties. Review of professional boundaries will be presented. Proper patient intake, examination and clinical behavior will be presented. Emphasis will be placed on adverse events risk factors such as hypertension and genetic connective tissue disorders including Marfans and Ehlers-Danlos Syndrome were outlined.

Overview of professional reporting systems in the modern area including completion of clinical reporting timely, outline of clinical information to include in specialist referral and imaging orders will be presented. Details of interprofessional communication to the primary care physician, spine surgeon and interventional pain management provider was detailed and explained.

Recognized by Cleveland University College of Chiropractic, Approved for Continuing Medical Education [ACCME] – State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences,

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

Chiropractic as the First Option for Spine, A Literature-Based Standard, Creating literature-based documentation inclusive of history and a clinical examination that encompasses causality, diagnosis, prognosis and treatment plans. Ensuring the whole person impairment ratings are consistent with contemporary literature. PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY

Chiropractic as the First Option for Spine, A Literature-Based Standard, Spinal biomechanical engineering models related to pathobiomechanics and literature-based standards in creating an accurate diagnosis, prognosis, and treatment plan. Determining impairment ratings based upon alteration of motion segment integrity utilizing motion-imaging, and creating demonstrable evidence for continued treatment plans. PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY,

Chiropractic as the First Option for Spine, A Literature-Based Standard, Utilizing clinical findings in conjunction with advanced imaging and electrodiagnostic findings in managing collaborative relationships with medical specialists. Applying a literature standard to care to ensure conservative care as the first option. PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY,

Chiropractic as the First Option for Spine, A Literature-Based Standard, Managing spinal related cases based upon MRI findings of herniations, bulges, protrusion, extrusions (comminuted and fragmented) utilizing thin-sliced acquisition protocols. When to consider ordering T1, T2, Short Tau Inversion Radiant, proton density and Dixon sequencing for spinal related pathology. PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY,

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.

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.

MRI Interpretation of the spine. How to triage trauma and non-trauma with advanced imaging and document the necessity. Basics of MRI Spine Interpretation inclusive of all types of herniations, bulges.

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.

Morphology of healthy and traumatized connective tissue and the permanency implication of adhesions, spinal disc morphology in the healthy and pathological patient as sequella to trauma in relationship to bulges, herniations, protrusions, extrusions and sequestrations. Aberrant spinal biomechanics and negative sequella to trauma.

The ability of your electronic health records to convey tissue pathology while documenting case studies, field experiments, randomized trials and systematic literature reviews, Introducing evidence based macros in documentation to support the literature and necessity of care.

Analyzing segmental pathology, adjusting vs. mobilization with cervicogenic headaches, Opioid alternatives and case management of mechanical spine pain based upon outcome studies.

Literature reviews of mechanoreceptor, proprioceptor and nociceptor stimulation of later horn gray matter with periaqueductal stimulation affecting the thalamus and cortical regions with efferent distribution in disparate regions of the body in both pain and systemic stimulation.

Spinal Biomechanical Engineering and MRI Spine Interpretation, Integrating Spinal Biomechanical Engineering and MRI Spine Interpretation into a primary spine care model, inclusive of necessity and acquisition protocols. A comprehensive review the latest evidence in documenting mechanical issues, Texas Chiroprctic College Graduate Doctoral Program, PACE Recognized by The Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2017.

Contemporary Spine Research and Documentation, Central nervous system connection and the thalamus, hypothalamus connection in both ascending and descending central pathways with neuro-endocrine implications that have the mechanisms to be a component of Schizophrenia, Dementia and Alzheimer’s with a linear relationship to the chiropractic spinal adjustment and chronic pain, Texas Chiroprctic College Graduate Doctoral Program, PACE Recognized by The Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2017.

Credentials and Knowledge Base, The credentials and knowledge based from an academia perspective when cooperatively treating in a collaborative environment inclusive of understanding pathology and mechanical spine issues, Texas Chiroprctic College Graduate Doctoral Program, PACE Recognized by The Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2015.

Hospital Administration, Triage, Clinical Requirements and Collaborative Relationships with Medical Specialists, Understanding hospital and medical specialist's care paths for mechanical spine pathology and integrating the doctor of chiropractic in the hospital and allopathic treatment protocols, Texas Chiroprctic College Graduate Doctoral Program, PACE Recognized by The Federation of Chiropractic Licensing Boards, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2017.

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractc Post Doctoral Division, Long Island, NY, 2017.

An extensive understanding of the injured with clinically coordinating the history, physical findings and when to integrate neurodiagnostics. An understanding on how to utilize emergency room records in creating an accurate diagnosis and the significance of “risk factors” in spinal injury. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2017.

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. [Texas Chiropractic College or PACE Recongized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2017.

MRI, Bone Scan and X-Ray Protocols, Physiology and Indications for the Trauma Patient, MRI interpretation, physiology, history and clinical indications, bone scan interpretation, physiology and clinical indications, x-ray clinical indications for the trauma patient. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2017.

Electromyography (EMG), Nerve Conduction Velocity (NCV), Somato Sensory Evoked Potential (SSEP), Visual Evoked Potential (VEP), Brain Stem Auditory Evoked Potential (BAER) and Visual-Electronystagmosgraphy (V-ENG) interpretation, protocols and clinical indications for the trauma patient. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2017.

Understanding the necessity for accurate documentation and diagnosis utilizing the ICD-9 and the CPT to accurately describe the injury through diagnosis. Understanding and utilizing state regulations on reimbursement issues pertaining to healthcare. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2017.

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY, 2017

Magnetic fields, T1 and T2 relaxations, nuclear spins, phase encoding, spin echo, T1 and T2 contrast, magnetic properties of metals and the historical perspective of the creation of NMR and MRI. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2017

Normal anatomy of axial and sagittal views utilizing T1, T2, 3D gradient and STIR sequences of imaging. Standardized and desired protocols in views and sequencing of MRI examination to create an accurate diagnosis in MRI. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

MRI interpretation of bulged, herniated, protruded, extruded, sequestered and fragmented disc pathologies in etiology and neurological sequelae in relationship to the spinal cord and spinal nerve roots. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

MRI interpretation of bone, intradural, extradural, cord and neural sleeve lesions. Tuberculosis, drop lesions, metastasis, ependymoma, schwanoma and numerous other spinal related tumors and lesions. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

MRI interpretation sequencing of the cervical, thoracic and lumbar spine inclusive of T1, T2, STIR and 3D gradient studies to ensure the accurate diagnosis of the region visualized. New York Chiropractic Council, ACCME Joint Sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

The clinical application of the results of space occupying lesions. Disc and tumor pathologies and the clinical indications of manual and adjustive therapies in the patient with spinal nerve root and spinal cord insult as sequelae. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of lumbar degeneration. With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. Central canal and cauda equina compromise interpretation with management. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of lumbar herniations. With the co-morbities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. Morphology of lumbar disc pathologies of central and lateral herniations, protrusions, extrusions, sequestration, focal and broad based herniations are defined and illustrated. Central canal and cauda equina compromise interpretation with management. [Texas Chiropractic College or PACE Reconized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

MRI slices, views, T1, T2, STIR axial, stacking, FFE, FSE and sagittal images in the interpretation of cervical degeneration. With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. Spinal cord and canal compromise interpretation with management. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

MRI slices, views, T1, T2, STIR Axial, FFE, FSE and sagittal images in the interpretation of lumbar herniations. With the co-morbidities and complications of stenosis, pseudo-protrusions, cantilevered vertebrate, Schmorl's nodes and herniations. morphology of lumbar disc pathologies of central and lateral herniations, protrusions, extrusions, sequestration, focal and broad based herniations are defined and illustrated. Spinal cord and canal compromise interpretation with management. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

MRI slices, views, T1, T2, STIR Axial, FFE, FSE and sagittal images in the interpretation of degenerative spondylolesthesis, spinal canal stenosis, Modic type 3 changes, central herniations, extrusions, compressions, nerve root compressions, advanced spurring and thecal sac involvement from an orthopedic, emergency room, chiropractic, neurological, neurosurgical, physical medicine perspective. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

Spine, neurological sequelae, migraine, sexual dysfunction, sleep and arousal disorders, station and gait disorders and consciousness are detailed for impairment rating. Herniated discs, radiculopathy, fracture, dislocationa and functional loss are also detailed in relation to impairment ratings. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards'], ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

Connective tissue injuries and wound repair morphology focusing on the aberrant tissue replacement and permanency prognosis potential. [Texas Chiropractic College, PACE Recognized by The Federation of Chiropractic Licensing Boards] ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

Spinal ligamentous anatomy and research focusing on wound repair, future negative sequelae of abnormal tissue replacement and the resultant aberrant kinematics and spinal biomechanics of the spine. [Texas Chiropractic College, PACE Recognized by The Federation of Chiropractic Licensing Boards,] ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

The application of spinal biomechanical engineering models in trauma and the negative sequelae it has on the central nervous system inclusive of the lateral horn, periaqueductal gray matter, thalamus and cortices involvement. [Texas Chiropractic College, PACE Recognized The by Federation of Chiropractic Licensing Boards,] ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post -Doctoral Division, Buffalo, NY,

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. [Texas Chiropractic College, PACE Recognized by The Federation of Chiropractic Licensing Boards,] ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

The review of case histories of mechanical spine pathology and biomechanical failures inclusive of case histories, clinical findings and x-ray and advanced imaging studies. Assessing comorbidities in the triage and prognosis of the injured. [Texas Chiropractic College, PACE Recognized by The Federation of Chiropractic Licensing Boards,] ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

The review of current literature standards in spinal trauma pathology and documentation review of biomechanical failure, ligamentous failure and age-dating disc pathology. [Texas Chiropractic College, PACE Recognized by The Federation of Chiropractic Licensing Boards,] ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY,

Differentially diagnosing mild traumatic brain injury vs. traumatic brain injury and the clinical and imaging protocols required to conclude an accurate diagnosis for head trauma. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY

Quantifying the force coefficients of vehicle mass and force vectors that can be translated to the occupant and subsequently cause serious injury. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY

Factors that cause negative acceleration to zero and the subsequent forces created for the vehicle that get translated to the occupant. Understanding critical documentation of hospitals, ambulance reports, doctors and the legal profession in reconstructing an accident. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards}, Academy of Chiropractic Post Doctoral Division, Long Island, NY

The mathematical calculations necessary utilizing time, distance, speed, coefficients of friction and acceleration in reconstructing an accident. The application of the critical documentation acquired from an accident site. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY

Delta V issues correlated to injury and mortality, side impact crashes and severity of injuries, event data recorder reports correlated to injury, frontal impact kinematics, crash injury metrics with many variables and inquiries related to head restraints. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post Doctoral Division, Long Island, NY

Integration of cervical orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY,

Integration of orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY,

Integration of lumbar orthopedic testing in the clinical setting to develop a differential diagnosis. Utilizing radiographic and advanced imaging inclusive of MRI and CAT scan findings to verify tissue pathology suspected by orthopedic testing conclusions and developing a treatment plan as sequelae. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY,

Integration of orthopedic testing in the clinical setting utilizing both simple and complex patient scenarios. It includes potential stroke, or vertebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process. How to integrate orthopedic testing in the clinical setting utilizing both simple and complex patient scenarios. It includes potential stroke, or vertebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards],ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post Doctoral Division, Buffalo, NY,

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post-Doctoral Division, Long Island, NY

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY

A course describing the structural and functional organization of the spinal-pelvic system. Fundamental and advanced concepts on spinal biomechanics are introduced by presenting a coherent spinal model describing normal segmental coupling, regional adaptation and global compensation. The clinical model is a structural and mechanical engineering approach based on x-ray physics, mathematics and statistical analysis. The normal movements of gait are integrated in this total biomechanical approach to explain spine distortion, predictable functional scoliosis and lumbar disc failure. Case studies are demonstrated to radiographic analyses and physical findings to determine clinical solutions and soft tissue rehabilitation. PACE Recognized by The Federation of Chiropractic Licensing Boards, Arlington Heights, IL

A detailed discussion on the functional anatomy of the disc, including disc innervation, disc nutrition and structural composition. The course continues with a discussion on basic interpretation of MRI.

A detailed analysis of disc herniations and normal disc aging.

A review of normal disc aging, a discussion on the differences between normal disc aging and degenerative disc disease, internal disc disruptions, and nerve in growth.

A discussion on neuropathic pain syndromes, orthopedic evaluation, neurological work up and MRI.

A discussion about the differences between Sclerotogenous, Myofascial, Visceral and Neuropathic pain syndromes. This will include a review of the literature of Bogduk, Lord and Kuslich.

An examination of spinal decompression therapy through an objective review of the medical and chiropractic literature regarding its efficacy.

A discussion on the principles of documentation to establish medical necessity for the treatments provided to patients.

Patient history, physical examination, objective testing, documenting ligamentous injury and communication with other providers.

Patient history, physical examination, objective testing, documenting ligamentous injury and communication with other providers.