| MICHAEL PAULE DC |
| 102 S BROADWAY, TARRYTOWN, New York, 10591 |
| Phone: 914-631-4900 |
| Cell: 914-462-2069 |
| Fax: 833-525-2236 |
| tarrychiro@optimum.net |
| http://TARRYTOWNCHIROPRACTIC.COM |
SELECTED OCCUPATIONAL HISTORY
Clinical Director/Staff Chiropractor, Tarrytown Chiropractic, PLLC, Tarrytown, New York, 1994 – Present
Staff Chiropractor, Tarrytown Chiropractic Center, Tarrytown, New York, 1992 – 1994
EDUCATION AND LICENSURE
Doctor of Chiropractic, Licensed in the State of New York, License # X006879, 1992 – Present
Doctorate of Chiropractic, New York Chiropractic College, Glen Head, New York, 1991
Internship, New York Chiropractic College Outpatient Facility, Levittown, New York, 1990 – 1991
National Board of Chiropractic Examiners, Part III, 1991
National Board of Chiropractic Examiners, Part II, 1991
National Board of Chiropractic Examiners, Part I, 1991
Undergraduate Studies in Core Sciences, Mercy College, Dobbs Ferry, New York, 1985 - 1988
CERTIFICATIONS, QUALIFICATIONS, AND DIPLOMATES
MRI Interpretation Review Qualified – Cleveland University, Kansas City, 2022 - Present
Hospital Based Spine Care Qualified, 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. Co-credentialed through the ACCME (Accreditation Council for Continuing Medical Education), Cleveland University – Kansas City and the Academy of Chiropractic, Long Island, New York, 2018
Trauma Qualified – Cleveland University, Kansas City, 2017 – Present
SELECTED POST-GRADUATE EDUCATION
Primary Spine Care 14: Case Management and Documentation - 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. Cleveland University Kansas City, 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, Long Island, NY, 2024
Primary Spine Care 14: Case Management and Documentation - 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. Cleveland University Kansas City, 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, Long Island, NY, 2024
Primary Spine Care 14: Case Management and Documentation - 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. Cleveland University Kansas City, 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, Long Island, NY, 2024
Primary Spine Care 14: Case Management and Documentation - 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. Cleveland University Kansas City, 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, Long Island, NY, 2024
Primary Spine Care 14: Case Management and Documentation - 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. Cleveland University Kansas City, 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, Long Island, NY, 2024
Primary Spine Care 14: Case Management and Documentation - 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. Cleveland University Kansas City, 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, Long Island, NY, 2024
Primary Spine Care 15: Advanced MRI and X-Ray Documentation in Clinical Practice, 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. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
Primary Spine Care 15; Advanced MRI Interpretation in Clinical Practice, 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. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
Primary Spine Care 15; Ethics in Clinical Practice, 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. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
Primary Spine Care 15; Spinal CAT Scan Interpretation, Understanding the utilization of CAT Scan slicing and the reformatting when using bone and soft tissue windows. Correlating MRI to CAT Scan 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. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
Primary Spine Care 15; Connective Tissue/Strain Sprain Pathology, 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. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
Primary Spine Care 15; Advanced Spinal Biomechanical Engineering, 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. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
Primary Spine Care 15; Trends in Spinal Care, 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. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
Primary Spine Care 15; Documentation in Clinical Practice, 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. Cleveland University Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
Reimbursement Guidelines and Documentation, Advanced documentation based on clinical and testing findings that correlate to Evaluation and Management Guidelines. Evidence-Based necessity parameters for considering spinal imaging and electrodiagnostic testing. Academy of Chiropractic Post-Doctoral Division, Cleveland University Kansas City, College of Chiropractic, Long Island, NY, 2023
Documenting Trauma, The documentation of biomechanical and anatomical pathology with trauma patients. Clinically correlating diagnosis, demonstrative bodily injury-pathology and persistent functional losses. Academy of Chiropractic Post-Doctoral Division, Cleveland University Kansas City, College of Chiropractic, Long Island, NY, 2023
Coding and Care Planning, ICD -10, and CPT cross-coding requirements form the acute stage through rehabilitation, including home care. The documentation of passive vs. active care in chronic and trauma case management. Cleveland University Kansas City, College of Chiropractic, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
Coding and Care Planning with Spinal Biomechanical Pathology, The documentation of short and long-term care, including demonstrative validation or spinal pathology in the clinical setting. Connective tissue pathological mechanisms in chronic and traumatic etiology. Cleveland University Kansas City, College of Chiropractic, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
The Safe Use of X-Ray in a Clinical Setting, Utilizing the guidelines created by the American College of Radiology and the evidence in the scientific literature for case management involving x-ray. Understanding the standards for safe radiation exposure when creating a demonstrative spinal biomechanical diagnosis and ruling out anatomical pathology. Cleveland University Kansas City, College of Chiropractic, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2023
Spinal Biomechanics and Anatomical Pathology Grand Rounds. The long-term clinical outcomes of chronic LBP with hypermobility due to ligament laxity was reviewed with evidenced based literature. Potential interventions and their expected outcomes were presented. Cleveland University - Kansas City, 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, 2023
Spinal Biomechanics and Anatomical Pathology Grand Rounds. Chiropractic Diagnosis and Management of Motor Vehicle Crash Injuries, A review of the ligament, biomechanical and neurologic implications of a chronic cervical spine conditions, age dating cervical spine pathology and acute cervical spine injury including cervical spinal cord edema. The methods to determine stability and co-management with medical specialists was reviewed. Identification of the biomechanical ligament injury associated with the structural compromise, disc herniation with traumatic annular fissures and triage for neurosurgical consultation was reviewed. Cleveland University - Kansas City, 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, 2022
2023 Demonstrative Documentation Requirements, Analyzing the requirements in anatomical diagnostic imagery to communicate spinal pathology. Integrating technology, clinical findings, and advanced graphic tools to communicate a diagnostic conclusion. Cleveland University Kansas City, 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, 2022
MRI Spine Advanced Clinical Case Grand Rounds, Clinical case review of MRI including intra and extra-dural findings inclusive of the disc and vascular anatomical lesions. Differentially diagnosing central cord lesions, and spinal cord vascular lesions in both acute trauma and degenerative presentations. Cleveland University Kansas City, 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, 2022
Non-Specific Spine Pain, Chiropractic and Outcomes, 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. Cleveland University Kansas City, 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, 2022
Spinal Tumor MRI Interpretation, Diagnosing and documenting: Ependymoma, Astrocytoma, Hemangioblastoma, Lipoma, Meningioma, Neurofibroma, Schwannoma, Myxopapillary Ependymoma. Cleveland University Kansas City, 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, 2022
Demonstrative Narrative and Evaluation and Management Report Writing, Clinical record-keeping, why write clinical notes, the importance of context, what to include in a clinical note, tips for better clinical documentation, basic legal considerations, open clinical notes, how to keep documentation efficient. Cleveland University Kansas City, 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, 2022
Age-Dating Ligament/Connective Tissue Physiology and Pathology, 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. Cleveland University Kansas City, 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, 2022
Clinical Grand Rounds in Biomechanics, Digitizing, and Advanced Imaging: 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. Cleveland University Kansas City, 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, 2022
Medical-Legal Documentation: 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. Cleveland University Kansas City, 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, 2022
Chiropractic diagnosis of acute disc and ligament injury and the tools necessary for accurate diagnosis, prognosis, and treatment planning. Ethical and accurate medical legal reporting was also reviewed. Cleveland University Kansas City, 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, 2022
2022 Trends in Spinal Healthcare, 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. Cleveland University - Kansas City, 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, 2022
MRI Spine Clinical Case Grand Rounds, 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. Cleveland University - Kansas City, 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, 2022
Chiropractic vs. Physical Therapy vs. Medical Case Management and Outcomes, Analyzing evidence-based outcomes in triaging non-anatomical lesions. The analysis of neuro-biomechanical pathological lesions defines primary spinal lesions and removes the dogma of non-specific back pain. Managing collaborative relationships with medical primary providers and specialists in clinical practice. Cleveland University - Kansas City, 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, 2022
MSK Extremity Radiological Interpretation, Utilizing both MRI and x-ray in identifying via x-ray and advanced imaging extremity instabilities from ligamentous, osseous or neoplastic derangement. Cleveland University - Kansas City, 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, 2022
Demonstrative Narrative and Evaluation and Management Report Writing, 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. Cleveland University - Kansas City, 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, 2022
Ligament/Connective Tissue Physiology and 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. Cleveland University - Kansas City, 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, 2022
Stroke Evaluation and Risk Factors in the Chiropractic Practice, 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. Cleveland University - Kansas City, 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, 2022
Age-Dating Herniated Discs and Trauma, 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 collaborating 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. Cleveland University - Kansas City, 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, 2022
Clinical Grand Rounds in Spinal Biomechanics, 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. Cleveland University - Kansas City, 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, 2022
Neurosurgical Grand Rounds, 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, Myelomalacia, spinal cord edema, vacuum disc and other intra, and extra-dural lesions. Cleveland University - Kansas City, 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, 2022
Pathobiomechanics and Documentation, 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. Academy of Chiropractic Post-Doctoral Division, Cleveland University - Kansas City, Long Island, NY, 2022
Using Documentation and Ethical Relationships, 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. Academy of Chiropractic Post-Doctoral Division, Cleveland University - Kansas City, Long Island, NY, 2022
Spinal Biomechanical Engineering Clinical Application, 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. Academy of Chiropractic Post-Doctoral Division, Cleveland University - Kansas City, Long Island, NY, 2022
Spinal Biomechanical Engineering Clinical Grand Rounds, 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. Academy of Chiropractic Post-Doctoral Division, Cleveland University - Kansas City, Long Island, NY, 2022
Impairment Rating, The understanding and utilization of the protocols and parameters of the AMA Guide to the Evaluation of Permanent Impairment 6th Edition. Spine, neurological sequelae, migraine, sexual dysfunction, sleep and arousal disorders, station and gait disorders and consciousness are detailed for impairment rating. Herniated discs, radiculopathy, fracture, dislocation and functional loss are also detailed in relation to impairment ratings. Cleveland University - Kansas City, 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, 2022
Documentation, Demonstrative and Compliance, Elements of Evaluation and Management codes 99202-99203-99204-99205, inclusive of complexity of management and time components. Demonstrative documentation of spinal-related pain generators; spinal cord, thecal sac, myelomalacia, spinal nerve root insult, connective tissue, recurrent meningeal nerves. Cleveland University Kansas City, 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, 2022
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. Cleveland University Kansas City, 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, 2022
Diagnosing and Case Management, 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. Cleveland University Kansas City, 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, 2022
Trends in Spinal Healthcare, 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. Cleveland University Kansas City, 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, 2022
MRI Spine Interpretation, 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. Cleveland University Kansas City, 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, 2022
Spinal Biomechanics; A Literature Perspective, 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. Cleveland University Kansas City, 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, 2022
Case Management of Mechanical Spine Pathology, 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. Cleveland University Kansas City, 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, 2022
Documentation in Medical Collaborative Cases, 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. Cleveland University - Kansas City, 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, 2022
MRI Spine Interpretation and Protocols, 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. Cleveland University - Kansas City, 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, 2022
Ethics and Medical Collaboration, 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. Cleveland University - Kansas City, 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, 2022
Documentation in a Medical – Legal and Insurances, 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. Cleveland University - Kansas City, 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, 2022
Trends in Spinal Healthcare, 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. Cleveland University Kansas City, 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, 2022
MRI Spine Interpretation Advanced Diagnosis, 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. Cleveland University Kansas City, 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, 2022
Spinal Biomechanical Engineering Analytics and Case Management, 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. Cleveland University Kansas City, 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, 2022
MSK Extremity Radiological Interpretation, 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. Cleveland University Kansas City, 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, 2022
Demonstrative Medical-Legal Documentation, The narrative report. How to effectively create medical-legal documentation and what the courts look for. Making your "4-Corner" (narrative) report demonstrable and build a reputation as an evidence-based provider. The step-by-step minutiae of building a report. Cleveland University Kansas City, 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, 2022
Managing Non-Anatomical Spine Pain, 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. Cleveland University Kansas City, 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, 2022
MRI Spine Clinical Grand Rounds, 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. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2022
MRI Spine Clinical Grand Rounds, 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. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2022
MRI Spine Clinical Grand Rounds, 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. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2022
MRI Spine Clinical Grand Rounds, 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. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2022
MRI Spine Clinical Grand Rounds, 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. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2022
MRI Spine Clinical Grand Rounds, 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. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2022
MRI Spine Clinical Grand Rounds, 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. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2022
MRI Spine Clinical Grand Rounds, 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. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2022
MRI Spine Clinical Grand Rounds, 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. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2022
MRI Spine Clinical Grand Rounds, 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. Academy of Chiropractic Post-Doctoral Division, Accreditation Council for Continued Medical Education in conjunction with The State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Cleveland University - Kansas City, Long Island, NY, 2022
Case Management, Spinal MRI and Documentation Documenting Herniated Discs, Age-Dating Disc Pathology, and Connective Tissue Pathology as Sequella to Trauma, Herniated Discs and Connective Tissue Pathology, differentially diagnosing herniated discs vs. normal and bulging discs and protruded, extruded and fragmented discs. Normal vs. Pathological connective tissues and age-dating herniated discs. Cleveland University Kansas City, 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, 2022
Case Management, Spinal MRI and Documentation, Case Management of Traumatic Spinal Injuries, Understanding flexion-extension cervical injuries and diagnosing connective tissue pathology. Determining impairments and the literature-based standard for permanent injuries. Cleveland University Kansas City, 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, 2022
Case Management, Spinal MRI and Documentation, Managing Herniated and Bulging Discs, Serious Injury in Non-Herniated Cases from Trauma, Spinal disc morphology, and innervation. Herniated, bulged, protruded, and sequestered disc characteristics and management. Literature-based documentation requirements for no-dis spinal injuries. Cleveland University Kansas City, 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, 2022
Case Management, Spinal MRI and Documentation, Herniated Discs and Permanent Brain Malfunction & Biomechanical Failure, A case-study of a post-traumatic herniated disc and related brain malfunction supported by contemporary literature, MRI acquisition, and necessity protocols. Cleveland University Kansas City, 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, 2022
Case Management, Spinal MRI and Documentation, Demonstrative Documentation of Disc Herniatian MRI Physics, Understanding the documentation requirements to demonstratively show spinal disc lesions in reporting pathology. Understanding the physics of a nucleus resonating in T1 and T2 weighted imagery. Cleveland University Kansas City, 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, 2022
Case Management, Spinal MRI and Documentation, Post-Traumatic Herniated Discs, Related Migraines-Headaches & Strain/Sprain Permanence’s, 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. Cleveland University Kansas City, 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, 2022
Case Management, Spinal MRI and Documentation, Documentation of Low-Speed Crashes in Determining Etiology of Serious Bodily Injuries, Documentation requirements during the evaluation, and management encounter to understand the etiology of spinal injuries. Having a complete understanding of the forces involved to conclude a differential diagnosis, while concurrent ruling malingerers, if applicable. Cleveland University Kansas City, 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, 2022
Extremity MRI & Xray Interpretation of the Shoulder, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures. Identifying fractures in adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022
Extremity MRI & Xray Interpretation of the Shoulder, Identifying fractures in adult and pediatric cases. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022
Extremity MRI & Xray Interpretation of the Elbow, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022
Extremity MRI & Xray Interpretation of the Wrist, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022
Extremity MRI & Xray Interpretation of the Hand, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022
Extremity MRI & Xray Interpretation of the Hip, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures. Identifying fractures in adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022
Extremity MRI & Xray Interpretation of the Hip, Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022
Extremity MRI & Xray Interpretation of the Knee, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures. Identifying fractures in adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022
Extremity MRI & Xray Interpretation of the Knee, Identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022
Extremity MRI & Xray Interpretation of the Hand, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022
Extremity MRI & Xray Interpretation of the Foot, Identifying normal anatomy on both MRI and x-ray, inclusive of osseous, connective tissue, and neurological structures, identifying fractures in the adult and pediatric cases. Differentially diagnosing various arthritic etiologies of osseous derangement. Differentially diagnosing various arthritic changes vs. benign and metastatic Tumors. Cleveland University Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2022
MRI Spinal Anatomy, Protocols and Disc Pathology, Normal anatomy of axial and sagittal views utilizing T1, T2, gradient and STIR sequences of imaging. Degeneration and annular fissures of discs in both trauma and non-trauma patients and the biochemical properties of joints in age dating pathology. Disc bulges from degenerative and sequela to osseous issues, herniation pathology and protrusion, extrusion, migrated and sequestered variations. Clinical scenarios as sequela to disc and pre-existing pathologies. Cleveland University – Kansas City, 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, New York, 2022
MRI Spine Interpretation, Herniated, bulged, extruded, protruded, sequestered and degenerative discs. The morphology of a pathological disc vs. normal morphology and the sequences required including T1, T2 and STIR for all spinal regions. Modic 1-2-3 changes detailed and the traumatic relationship. Cleveland University – Kansas City, 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, New York, 2022
Diagnosis and Management of Anterior Sacral Contusion, Overview and discussion of contusion of the anterior sacral ala in an elite college cross-country runner. Physical examination outlining range motion, neurological and orthopedic examination was reviewed and correlated to the subjective complaint of right sided lower back pain. Misdiagnosis was presented and long-standing symptoms resulting in possible cessation of play for this athlete. Discussion of interprofessional communication with the neuroradiologist and subsequent MRI order with slices through the anterior sacrum was reviewed and presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2022
Diagnosis and Management of Lumbar Disc Herniation, Case review of traumatically induced 10mm L5-S1 intervertebral disc extrusion was presented. Correlation of neurological examination including testing of myotomes, dermatomes and deep tendon reflexes was presented. Detailed review of sagittal T1, sagittal T2, axial T1, axial T2 as well as STIR images were presented. Clinical referral for surgical consultation was outlined and clinical rationale was presented. Review of the difference between anatomical and functional sources of pain were outlined with a focus on biomechanical parameters such as pelvic incidence. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2022
Diagnosis and Management of Lumbar Arachnoiditis, Outline of the causes of arachnoiditis in the human spine was presented. Specific focus was on a case of lumbar arachnoiditis involving the cauda equina evidenced on T1, T2 sagittal and axial MRI. Treatment options and lack of curative interventions were presented. Relevant anatomy of the lumbar spine including cauda equina, conus medullaris, filum terminale, dura mater, pia mater and arachnoid mater were reviewed in detail. Review of arachnoiditis and chiropractic adjustment were discussed as well as interprofessional coordination of care with interventional pain management and surgical consultation. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2022
Diagnosis and Management of Vertebral Osteomyelitis, Review of the causes of vertebral osteomyelitis was presented including findings on patient subjective complaint and objective findings on physical examination. Differentiation between plain film radiographs, T1, T2, flair and STIR weighted imaging was presented and discussed. Associated clinical findings including infections in adjacent areas including intervertebral discitis areas was presented. Causes of osteomyelitis including past surgical procedures, frequent injections, infection in an adjacent tissue, IV drug use and long-term corticosteroid use were presented. Anterior elements of the functional motor unit were outlined as the primary location of osteomyelitis. Correlation clinically to difficulties in identifying this clinical entity in its early stages was reviewed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2022
Diagnosis and Management of Schwannoma, Discussion of a case pertaining to traumatically induced pathology to the spine of a 59-year-old female. Outline of pathological reflexes and detailed physical examination best practices. Review of important imaging included CT axial, CT sagittal and CT coronal views as well as T2 FSE sagittal, T2 FSE axial and STIR sagittal MRI studies were reviewed and clinically correlated. Relevant cervical and lumbar spinal anatomy in the sagittal, axial and coronal planes was detailed on MRI and CT studies. Interprofessional communication with the spine surgeon was presented and reviewed of surgical intervention including ACDF (anterior cervical discectomy and fusion) procedure to the patient's cervical spine. Spine Management Group, LLC, Federation of Chiropractic Licensing Boards-PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, 2022
Spinal Biomechanical Engineering and Sagittal Balance of the Spine, Discussion of spine care in terms of engineering principles was presented. Biomechanical parameters such as pelvic incidence, sacral slope, pelvic tilt, and sagittal balance were outlined and presented. Spinal curvature and load distribution was presented mathematically and outlined using full spine plain film radiography. Comparative anatomy between primates and humans as well as humans of different ages was presented as examples of spinal compensation. Spinal rehabilitative principles were provided in group discussion. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences, Buffalo, NY, 2022
Diagnosis and Management of Persistent Spine Pain, Overview and discussion of spinal anatomy including intervertebral discs, ligaments, spinal nerves, spinal cord, and facet capsule was presented. Emphasis was placed on differential diagnosis, physical examination and clinical correlation of injury mechanism and patient complaint. Specific outline of facet join injury and join effusion was demonstrated and discussed using T1, T2 and STIR weighted MRI scans of the lumbar spine with specific attention paid to the right L3 facet joint. Interprofessional communication in documentation and referral for interventional pain management consulting was presented with emphasis on facet or medial branch block injections. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, PACE, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2022
Medical and Interprofessional Communication, Detailed overview of medial legal communication in relation to patient subjective and objective clinical findings. Outline of direct and cross-examination techniques were presented. Overview of Voir Dire and Daubert hearings were outlined. Discussion of examination of proof in relation to causality, bodily injury, and persistent functional losses was reviewed. Court testimony flow, professional expectations, and court room etiquette were presented and emphasized. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University Kansas City, College of Chiropractic, Ft. Lauderdale, FL, 2022
Spine Management, Discussion and outline of case management workflows related to the management of acute and chronic spine pain with a particular focus on pain of traumatic origin. Evidence-based communication and Electronic Health Record processes were emphasized and presented. patient management and triage based on patient history, physical examination and imaging findings was outlined. Overview of interprofessional referral options including physical therapy, interventional pain management and spine surgery was discussed in detail. Spine Management was discussed by Dr. John Edwards, neurosurgeon, in relation to reducing escalation of non-urgent cases as well as creating space for patients with urgent need. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University Kansas City, College of Chiropractic, Ft. Lauderdale, FL, 2022
Documentation and Communication in Spine Management, Presentation of compliant healthcare documentation including E/M initial and re-evaluations, daily progress notes and medical-legal narrative reports was provided. Workflows detailing interprofessional referral language, advanced imaging requests and patient communication were detailed. Streamlined processes for creating and maintaining compliant, evidence based, patient centered clinical reporting was given. Emphasis was placed on the role of a Spine Management Physician in the processes of interprofessional communication and case management. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University Kansas City, College of Chiropractic, Ft. Lauderdale, FL, 2022
Histology and Physical Tolerance of Spinal Ligaments, Presentation of the histological structural organization of spinal ligaments including analysis of tropocollagen as the basis for anatomical structure. Review of the structural hierarchy of the spinal ligament from microscopic to macroscopic was included. Anisotropic properties of spinal ligaments were defined, and examples presented. A detailed review of spinal entheses was presented with emphasis on advanced imaging and chronic enthesopathy. New insights into the pathogenesis, diagnostic modalities, and treatment of spinal enthesitis were outlined and presented. Specific focus was on traumatic injury to the spinal entheses and the difference in formation of spinal osteophytes and enthesophytes. The biomechanics of the degenerative spine was detailed and reviewed in terms of clinical spine management. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University Kansas City, College of Chiropractic, Ft. Lauderdale, FL, 2022
Accident Reconstruction and Expert Reporting, Crash dynamics and basic physics formulas were presented and detailed. Review of biomechanical expert reports and included mathematics was discussed with context given to data collection and accuracy. Spinal injury thresholds were reviewed as well as the Law of Conservation of Energy and its relationship to crash dynamics. Specific mathematical examples were presented including workflows to review the accuracy of biomechanical expert reporting and mathematical formulas. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University Kansas City, College of Chiropractic, Ft. Lauderdale, FL, 2022
Degenerative versus Acute Ligament Laxity, An updated scientifically validated grading system for the identification of degeneration of the intervertebral disc and motion segment was presented. Details such as radiographic signs of disc degeneration including loss of disc height, osteophyte formation and diffuse sclerosis were provided. Grading examples were provided in radiographic and gross specimen form starting with Grade 0 (no degeneration) to Grade 3 (severe degeneration). Outline of the validity and interobserver agreement of this grading system was shown for both the cervical and the lumbar spine. Review and emphasis on the difference between osteophyte formation and enthesophytes was again outlined. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University Kansas City, College of Chiropractic, Ft. Lauderdale, FL, 2022
Chiropractic Science Research, Review and presentation of updated peer-reviewed medically indexed research supporting chiropractic management of spine pain was detailed. The timeline of publication was emphasized with three years being the maximum timeframe for up-to-date data. Comprehensive review of evidence supporting chiropractic management of spine pain patients in the Pain Management, Corrective, and the Health Maintenance Phases of care. Methods to communicate this evidence to the medical and legal communities were presented in the context of compliant patient centered clinical documentation. Efficiency of a Spine Management Physician versus conventional primary care was presented. Emphasis on the hierarchy of published evidence starting with Foundational Evidence up to Level 1 evidence was presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, Cleveland University Kansas City, College of Chiropractic, Ft. Lauderdale, FL, 2022
Clinical Grand Rounds, Chiropractic Management and the Carotid Space, Outline and discussion of the anatomical boundaries of the carotid space was presented. Review of the aortic arch, brachiocephalic trunk, common carotid, carotid bifurcation, internal carotid, external carotid, Circle of Willis, and vertebral artery pathways was demonstrated. Review of correlation of patient history, physical examination and findings on advanced imaging was presented. Clinical review of dysphagia and odynophagia were presented and discussed clinically in the context of the physical examination and patient pain patterns. Vascular anomalies and their general asymptomatic presentation were emphasized. Etiology of arterial dissections was outlined with emphasis on differentiating spontaneous versus traumatic characterization. Advanced imaging of carotid space pathology was presented with catheter angiography demonstrated as the gold standard. Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE, State University of New York at Buffalo School of Medicine, and Biomedical Sciences, Buffalo, NY, 2022
Clinical Grand Rounds, Chiropractic Management of Head and Neck Trauma, Review of types of tissue injured in head and neck trauma including muscle, nerve, intervertebral disc, ligament, spinal cord, vertebral body, artery or vein was presented. Clinical correlation of mechanism of injury, patient history, subjective complaint, physical examination, advanced imaging findings and electrodiagnostic testing was emphasized. Interprofessional communication and review of any diagnostic dilemmas was reviewed. Spinal compressive radiculopathy versus acute nerve injury without prolonged compression was presented. Differential diagnosis between ligament, intervertebral disc and nerve manifestations of ligament injury in the cervical spine. Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences, Buffalo, NY, 2022
Clinical Grand Rounds, Understanding Surgical Approaches and Techniques, Overview of Lumbar Interbody Fusion (LIF) as and established treatment for a range of spinal disorders such as degenerative pathologies, trauma, infection, and neoplasm was presented. Mechanical techniques and implant processes were discussed. Range of LIF approaches was outlined including posterior lumbar interbody fusion (PLIF), transforaminal lumbar interbody fusion (TLIF or MI-TLIF), oblique lumbar interbody fusion/anterior to psoas (OLIF/ATP), anterior lumbar interbody fusion (ALIF), lateral lumbar interbody fusion (LLIF). Review of Minimally Invasive Surgery (MIS) was discussed and detailed. Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences, Buffalo, NY, 2022
Clinical Grand Rounds, Chiropractic Spine Management and Pain Categorization, Review of published categorization of pain generation by the International Association for the Study of Pain including nociceptive, neuropathic and nociplastic sources. Discussion on the history and relevance of the Delphi process of conducting consensus-based research was presented. Origins of nociceptive, neuropathy and nociplastic sources of pain was outlined including non-neural tissue, the somatosensory nervous system as well as the categorization of pain syndromes with non-specific findings on physical examination and imaging studies. Review of the importance of quantitative testing, clinical examination and clinical correlation was presented and related to the academic approach to the categorization of pain. Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2022
Clinical Grand Rounds, Chiropractic Spine Management, Role of Diagnostic Injections in Spinal Disorders, Review and discussion of objective data derived from ordering diagnostic spinal injections. Patient triage in relation to facet joint injury, ligament laxity, radiculopathy, herniation of the intervertebral disc and scroiliitis was outlined. Patient injury data from physical examination, provocative testing and diagnostic imaging was correlated clinically with response to diagnostic block after appropriate referral to medical specialty. The sacroiliac joint as an underdiagnosed source of chronic lower back pain was outlined. Review of gold standard for diagnosis of sacroiliitis, fluoroscopy-guided block was presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences, Buffalo, NY, 2022
Clinical Grand Rounds, Chiropractic Management of Upper Extremity Neurologic Deficits and Pre-existing Intervertebral Disc Pathology, Review of the objectification of neurological deficits including loss of sensation, aberrant deep tendon reflexes, loss of strength and the presence of pathological reflexes was presented and discussed. Criteria for co-management in the presence of neurological deficits with the pain management physician and the spine surgeon was outlined. Detailed presentation on CPT coding and E/M documentation requirements were discussed and reviewed. Absolute and relative contraindications to chiropractic care were demonstrated and outlined. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences, Buffalo, NY, 2022
Clinical Grand Rounds, Trial Testimony and the Spine Management Patient, Discussion and presentation of the trial process and requirements of both the treating physician and expert physician was outlined. Emphasis was placed on detailed preparation of case flow and objective demonstrable findings. Review of courtroom proceedings including witness and expert testimony was included. Expert versus narrative reporting processes to prepare for court room questionings. Specific review of illustration of demonstrative evidence was outlined. Nation Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences, Buffalo, NY, 2022
Grand Rounds, Chiropractic Management, MRI Lumbar Spine, Axial Anatomy, Detailed review of anatomical structures on the axial slices of lumbar spine MRI were presented. The musculature presented included gluteus medius, psoas major, multifidus, iliacus, lumbar paraspinals and quadratus lumborum in both the T1 and T2 axial sequences. Traversing vs exiting spinal nerves were contrasted and compared to cervical spine. Neurological structures such as conus medullaris, caudia equina, filum terminal, ventral and dorsal nerve roots were identified. Visualization and discussion of benefit of T2 axial sequences in the identification of facet joint pathology was presented. Emphasis was placed on the structure and morphology of the intervertebral disc and spinal ligaments including anterior longitudinal ligament, posterior longitudinal ligament, facet capsule, interspinous, supraspinous, intertransverse and iliolumbar were detailed. The location and anatomical structure of the sacroiliac joint was presented and discussed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences, Buffalo, NY, 2022
Grand Rounds, Chiropractic Management, CT Lumbar Spine Anatomy, detailed review of anatomical structures in the axial, sagittal and coronal planes of CT of the lumbar spine. The musculature presented included gluteus Medius, psoas major, multifidus, iliacus, lumbar paraspinals and quadratus lumborum in both T1 and T2 axial sequences. Emphasis was placed on the structure and morphology of the hard tissues of the spine with particular focus on the facet joints and pars interarticularis. The location and anatomical structure of the sacroiliac joint was presented and discussed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, PACE, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences, Buffalo, NY, 2022
Spine Management Clinical Workflows, in-depth review and discussion of the Doctor of Chiropractic as a Spine Management Physician with specific focus on the diagnosis and management of spine pain of mechanical origin. Details were outlined in relation to triage of anatomical causes of spine pain such as fracture, tumor, infection. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT, 2021
Pain Management and the Chiropractic Adjustment, Current peer reviewed indexed research demonstrating the chiropractic adjustment's effect on the central nervous system and pain threshold was outlined and reviewed. Anatomical review and contemporary supportive research were discussed. Details of central nervous system response to the chiropractic adjustment were reviewed and demonstrated. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT, 2021
Corrective Spinal Care and Chiropractic Adjustment, Current peer reviewed indexed research demonstrating the chiropractic adjustment's effect on the biomechanical structure of the human spine during the corrective/ rehabilitative phase of care. Basic outline of biomechanical parameters in symptomatic and asymptomatic patients was reviewed with particular focus on pathobiomechanics in chiropractic practice. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT, 2021
Health Maintenance Care and Chiropractic Case Management, Current peer reviewed indexed research demonstrating the chiropractic adjustment's effect on the maintenance of the human spine. Details of indexed research reviewing Chiropractic's role in the reduction of narcotic utilization and decreased absenteeism from work due to disability. Communicating Health Maintenance Care to the medical profession and the public was emphasized. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT, 2021
Evidence Based Clinical Reporting, Overview of current CPT and ICD-10 coding guidelines pertaining to the evaluation and management of spine pain patients was presented. Timed codes, relevant diagnosis related to injured tissue was presented. Specific discussion of proper format of the Assessment portion of clinical documentation was presented. A review of the difference between daily progress notes and Evaluation and Management [E/M] reporting was provided. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT, 2021
Cervical Spine Clinical Workflows, Detailed review of workflows of a thorough patient history and identification of clinical red flags related to relative and absolute contraindications to chiropractic care was presented. Outline of neurological examination including pathological reflexes present during spinal cord compression, cervical stenosis and cervical myelomalacia was discussed. Normal vs abnormal measurement of range of motion objectifying spinal dysfunction was presented. Specific orthopedic testing related to specific muscle, nerve or intervertebral disc injury was discussed. Review of interprofessional triage and imaging decision tree was outlined with specific focus on the pain management physician and spinal surgeon. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT, 2021
Lumbar Spine Clinical Workflows, Detailed review of workflows of thorough patient history and identification of clinical red flags related to relative and absolute contraindications to chiropractic care was presented. Outline of neurological examination including pathological reflexes present during cervical and lumbar stenosis was discussed. Normal vs abnormal measurement of range of motion objectifying spinal dysfunction was presented. Specific orthopedic testing related to muscle, nerve or intervertebral disc injury was discussed. Review of interprofessional triage and imaging decision tree was outlined with specific focus on the pain management physician and spinal surgeon. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT, 2021
Interprofessional Clinical Documentation for the Primary Care Physician, Contemporary techniques to best communicate chiropractic care to the Primary Care Physician was discussed and presented. Analysis of the depth and scope of communication was emphasized with direct focus on the proper documentation management system including demographic sheets, imaging reports, most recent evaluation, and management reports. Discussion of appropriate timing for phone consultation was presented. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT, 2021
Clinical Documentation for the Spine Surgeon, Contemporary techniques to best communicate chiropractic care to the spine surgeon was discussed and presented. Analysis of the depth and scope of communication was emphasized with direct focus on the proper documentation management system including demographic sheet, imaging reports, most recent evaluation, and management reports. Discussion of appropriate timing for phone consultation was presented. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT, 2021
Clinical Documentation for the Pain Management Physician, Contemporary techniques to best communicate chiropractic care to the pain management physician was discussed and presented. Analysis of the depth and scope of communication was emphasized with direct focus on the proper documentation management system including demographic sheets, imaging reports, most recent evaluation, and management reports. Discussion of appropriate timing for phone consultation was presented. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT, 2021
Clinical Documentation for Attorney, Contemporary techniques to best communicate chiropractic care and permanent injury to the personal injury attorney was discussed and presented. Analysis of the depth and scope of communication was emphasized with direct focus on the proper documentation management system including diagnosis, response to treatment, causality and persistent functional loss was outlined. Discussion of appropriate timing for phone consultation was presented. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT, 2021
Spinal Biochemical Engineering, Detailed presentation of the progression of laboratory- based biomechanics into the clinical realm was outlined. Evidence based review of Pelvic Incidence and other sagittal balance parameters was presented. Regional sagittal balance and communication with the spine surgeon in the spine management practice was reviewed. Specific discussions were related to spinal sagittal balance and the non-surgical spine pain patient and correlated to the Corrective Care Phase of Chiropractic Care. An outline of the future of full spine biomechanical modeling was presented in relation to symptomatic and asymptomatic patients. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT, 2021
Objectifying the Biomechanical Spine Lesion, Review of ligament laxity and alteration of motion segment integrity was presented with specific correlation to the AMA Guides to the Evaluation of Permanent Impairment 5th and 6th Education. Correlation to the bodily injury, causality and persistent functional losses in the personal injury patient and communication with the attorney was outlined. Attention was paid to the differences between vertebral body translation and angular motion deficits between adjacent motor units was presented =. Specific details on measurement tools and analysis of the injured cervical and lumbar spines were discussed. National Spine Management Group, Cleveland University Kansas City, Chiropractic and Health Sciences, Federation of Chiropractic Licensing Boards, Buffalo, NY, Lehi, UT, 2021
Clinical Grand Rounds, Diagnosing Mechanical Spine Pain, Review specific cervical anatomy in the spine pain patient. Clinical correlation between plain film radiographs and MRI studies was reviewed including radiographic motion studies. Computerized Mensuration Analysis was outlined and discussed with findings correlating with normative translation and angular motion data. Review of the AMA Guides to the Evaluation of Permanent Impairment 5th and 6th Editions was presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Clinical Grand Rounds, Pathophysiology of Osteophyte Formation, Discussion and presentation of extraspinal and vertebral osteophyte formation such as Transforming Growth Factor Beta and the relationship to the initiation of osteochondrosis was outlined. Details of segmental osteophyte formation on regional biomechanics were reviewed. Peer reviewed evidence of the effects of spinal arthrodesis on adjacent segment degeneration, anterior and posterior osteophyte formation on regional. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Clinical Grand Rounds, Nomenclature and Morphology of Intervertebral Disc Pathology, Updated review and demonstration of intervertebral disc nomenclature related to intervertebral disc degeneration, trauma and other pathology. Specific attention aid to the agreed upon nomenclature between the Combined Task Forces of the North American Spine Society of Neuroradiology. Details were provided in comparison to intervertebral disc herniation and intervertebral disc degeneration. Radial fissures were reviewed and outlined including circumferential, transverse and radial pathology and its anatomical relation to the intervertebral disc. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Clinical Grand Rounds, Biomechanical Compensation and Intervertebral Disc Extrusion, Detailed review of MRI documented lumbar disc extrusion measuring 12mm including STRI, T1 and T2 sagittal and axial images. Presentation of radiographic biomechanical analysis outlining sagittal alignment and vertebral body rotations. Discussion of co-management of spinal pathology while considering both the biomechanical and anatomical components of spine pain. The radiographic review included lateral neutral, later flexion, lateral extension, and AP views. Clinical correlation and discussion of pre and post-surgical care was outlined. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Clinical Grand Rounds- Classification of Degenerative Disc Disease, Review of a radiographic rating system for objective assessment of intervertebral disc degeneration in the cervical spine. The degree of degeneration was organized based on loss of disc height, formation of osteophytes and the presence of diffuse sclerosis of adjacent vertebral bodies. Specific details of assessment were outlined and presented. Comparison of plain film radiographs to cadaver specimens was demonstrated and discussed. Review of interobserver validity of the grading system between observers was presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Clinical Grand Rounds, Mechanical Response of Damaged, Discussion of the biomechanical properties of cervical spinal ligaments under sub-failure loads. Ligaments discussed were the Anterior Longitudinal Ligament, Posterior Longitudinal ligament, and the Ligamentum Flavum. Deformations exceeding physiological limitations were presented and reviewed. Grade 1 and Grade 22 injuries were outlined and discussed. The presentation included observed ligamentous injury significantly compromising ligament ability to give tensile support within physiological spinal motion. Findings were clinically correlated to long term sequalae in Alteration of Motion Segment Integrity and the Evaluation of Permanent Impairment 5th and 6th Editions. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Clinical Grand Rounds- Mechanical Response of Damaged Human Cervical Spine Ligaments, Discussion of the biomechanical properties of cervical spinal ligaments under sub-failure loads. Ligaments discussed were the Anterior Longitudinal Ligament, Posterior Longitudinal ligament and the Ligamentum Flavum. Deformations exceeding physiological limitations were presented and reviewed Grade I and Grade II injuries were outlined and discussed. The presentation included observed ligamentous injury significantly compromising ligament ability to give tensile support within physiological spinal motion. Findings were clinically correlated to long term sequalae in Alteration of Motion Segment Integrity and AMA Guides to the Evaluation of Permanent Impairment 5th and 6th Editions. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Clinical Grand Rounds, Facet Joint Thresholds and Alteration of Motion Segment Integrity, Discussion of the predominant made of joint loading of the cervical facet joints during whiplash injury related to retraction tension on the facet joint capsule. Review of shear forces, translation of the inferior and superior facet joint as well as injury risk due to excessive stretching of spinal ligaments was presented. Overview and discussion of mechanical trauma to ligament tissue and subsequent microstructural damage not visibly detected was outlined, Threshold for microstructural changes during retraction, reduced ligament stiffness and uncovered strain was discussed in detail. Individual response to facet joint capsule response supported in the medical literature was presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Clinical Ground Rounds, Advanced Imaging Upper Cervical Spine and Documentation, Discussion and review of ligament injury in the upper cervical spine. Focus was on missed diagnosis due to lack of imaging and interprofessional communication. Discussion of upper cervical anatomy including occipital condyles, C1/C2 articulation in both MRI, plain film and CT scanning was presented using imaging slides. Clinical documentation was reviewed with particular attention paid to clinical documentation errors from other providers. Discussion on case management and interprofessional communication to correct documentation errors from other providers. Discussion on case management and interprofessional communication to correct documentation errors was emphasized. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Clinical Grand Rounds, Chiropractic Professional Liability Litigation, Discussion of thirty years of jury verdict data was reviewed and presented. The focus was on the rationale for claims against Doctor of Chiropractic and overall decisions rendered by jury pools. Outlining the risk factors associated with overly aggressive treatment, failure to diagnose and lack of interprofessional referral when medical necessities were presented with statistics. Comparison between chiropractic management and surgical management was outlined and detailed. Detailed analysis of causality versus correlation was presented and discussed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Clinical Grand Rounds, Inter-professional Communication with the Personal Injury Attorney, Review of the outlined of the initial and re-evaluation E/M reporting in an injured patient. Discussion targeted complaint reporting and interprofessional communication with the attorney. Specific methods of ensuring complaint reporting were discussed and outlined. Statutory language, permanency determination and impairment were presented and reviewed in contact of the final narrative report. Emphasis was placed on the objectification of persistent functional loss and casual relationship in the personal injury patient. Supporting medical evidence of intervertebral disc pathology including disc herniation, disc bulge and annular tear was provided. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Clinical Grand Rounds- Prevalence of Spinal Degeneration, Discussion of the clinical occurrence of spinal degenerative conditions such as Diffuse Skeletal Hyperostosis (DISH), central stenosis, foraminal stenosis, degenerative disc disease and osteoporosis was presented. Advanced imaging and plain film radiological utilization in the diagnosis of spinal degermation was outlined and reviewed. Acute versus degenerative conditions in the spine were reviewed and detailed in relation to traumatic and non-traumatic events. Consensus driven parameters in the identification and rating of degenerative change severity were discussed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Clinical Grand Rounds- Diagnosis of Lumbar Facet Syndrome, Overview of the most common pain syndrome in the lumbar spine including societal burdens was presented. Discussion of facet joint arthrosis being the most frequent facet joint pathology in the human spine. Outline of level of correlation between clinical symptoms, physical examination findings and degenerative spinal conditions were discussed. Presentation of diagnostic facet lock and the medical necessity of such a referral when indicated was outlined. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences, Buffalo, NY, 2021
Clinical Grand Rounds, Patient Triage, testing and physical examination workflows - evidence based evaluation of the spine pain patient was outlined and presented. A thorough review of criteria for ordering plain film and advanced imaging was discussed and demonstrated. EMR and documentation workflows were discussed, and efficiency protocols were outlined and applied to evidence based physical examination procedures with and without a medical scribe. Details of reevaluations and clinical outcomes were reviewed and discussed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Types of Annular Fissures on Advanced and Plain Film Imaging, Detailed review of the structure and function of the human intervertebral disc was presented including annulus fibrosis, nucleus pulposus, cartilaginous endplate and sharpey's fibers. Diagrams as well as MRI images were outlined and reviewed in both the cervical and the lumbar spines with particular focus on the difference between degenerative and traumatically induced changes. High intensity zone (HIZ) as a characteristic of injury to the posterior aspect of the annulus fibrosis best visualized on T1, T2 and STIR images was outlined, discussed, and reviewed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences, Buffalo, NY, 2021
Aberrant Spinal Motion and Degenerative Disc Disease, Research analysis of mechanic factors as etiology of intervertebral disc degeneration. Review of spinal tissue mechanics and their relation to mechanical stress was discussed and correlated to abnormal changes in the structure and composition of the intervertebral discs and their relationship to acute and chronic pain was presented. Clinical correlation between congenital malformations of the spine, including scoliosis, kyphosis, spina-bifada, spondylolysis and Klippel Feil syndrome), accidental back injury or ligament injury, occupational exposure and causing aberrant mechanical loading of lumbar spine, intervertebral disc degeneration visible on T1, T2, STIR MRI, sagittal and axial sequences was presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences, Buffalo, NY, 2021
Diagnosis of Ossification of Anterior Longitudinal Ligament, Discussion of the different types of Ossification of Anterior Longitudinal Ligament (OALL) including Segmental, Continuous and Mixed in the sagittal plane. Review of axial classification including Flat, Nodular and Globular was presented. Anatomy of spinal ligaments including the anterior and posterior longitudinal ligament and their attachments was outlined. Context of dysphagia, its progression, symptoms and need for referral was reviewed and outlined. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences, Buffalo, NY, 2021
Clinical Grand Rounds, Importance of Interprofessional Healthcare Communication and Teamwork, Discussion of the history of interprofessional healthcare and the acknowledgement by the World Health Organization was presented. Specific details on chiropractic academia and student perception of its importance were outlined. The growth and importance of both interprofessional education and communication was stressed and reviewed. The need for a clear professional identity to facilitate interprofessional education and communication was presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Clinical Grand Rounds, Chiropractic Management of Lumbar Disc Herniation, Review of the pathogenesis and morphological presentation of lumbar intervertebral disc herniation. Outline of patient history, physical examination including neurological and orthopedic evaluation as well as criteria for ordering and reading advanced imaging such as MRI and CT were presented. Plain film static and dynamic radiographic studies were reviewed. Patient centered; consensus driven clinical diagnosis including interprofessional communication was presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Clinical Grand Rounds, Chiropractic Management of Cervical Facet Syndrome, Review of the pathogenesis and morphological presentation of cervical facet syndrome. Outline of patient history, physical examination including neurological and orthopedic evaluation as well as criteria for ordering and reading advanced imaging such as MRI and CT were presented. Discussion involving ligamentous structures such as interspinous ligament, supraspinous ligament and facet capsules was presented. Plain film static and dynamic radiographic studies were reviewed as well as specific sclerotogenous referrals patterns of facet mediated pain. Patient centered; consensus driven clinical diagnosis including interprofessional communication was presented, specific presentation relating to diagnostic medial branch blocks and pain management referral was emphasized. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards, State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Clinical Grand Rounds, Chiropractic Management of Lumbar Facet Syndrome, discussion of the clinical presentation of lumbar facet syndrome with specific attention paid to the pathogenesis and differential diagnosis of lumbar disc herniation, disc bulge and radiculopathy. Review of patient history, mechanism of injury, physical examination including neurological and orthopedic evaluation as well as criteria for ordering and reading advanced imaging such as MRI and CT were presented. Discussion involving ligamentous structures such as interspinous ligament, supraspinous ligament and facet capsules was presented Plain film static and dynamic radiographic studies were reviewed as well as specific sclerotogenous referrals patterns of facet mediated pain. Patient centered; consensus driven clinical diagnosis including interprofessional communication was presented, specific presentation relating to diagnostic medial branch blocks and pain management referral was emphasized. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Diagnosis and Management of Post-Surgical Cervical Facet Syndrome, A case of persistent and worsening neck and left shoulder pain post-surgical fusion was presented. Pre and post plain film and advanced imaging slides were reviewed and correlated clinically to left sided mid-scapular pain. Physical examination including orthopedic and neurological testing was discussed in correlation to presenting symptoms. Differential diagnosis of radiculopathy, radiculitis, discogenic pain, scapular myofascial syndrome and thoracic intersegmental dysfunction was presented. Cervical facet joint referral patterns were reviewed and the outline of referral for diagnostic facet joint block was discussed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE, State University of New York at Buffalo Jacobs School of Medicine, and Biomedical Sciences, Buffalo, NY, 2021
Clinical Grand Rounds, Chiropractic Management of Cervical Myelopathy, Review of all relevant spinal anatomy in the cervical and lumbar spine including vertebral bodies, central canal, neuroforamen, ligamentum flavum, anterior and posterior longitudinal ligaments, facet capsule, interspinous ligament, supraspinous ligament, and spinal cord anatomy. Review of spinal cord anatomy included white and gray matter, ventral and dorsal nerve roots, spinal nerve including the dura mater, arachnoid mater, and pia mater. Specific review of patient history, mechanism of injury, physical examination including neurological and orthopedic evaluation as well as criteria for ordering and reading advanced imaging such as MRI and CT were presented in relation to cervical myelopathy, spinal cord compression and myelomalacia. Patient centered; consensus driven clinical diagnosis including interprofessional communication was presented, specific presentation relating to diagnostic outcomes management. Attention was given to MRI and CT myelogram in both the uncomplicated and complicated patient. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Chiropractic Diagnosis and Management of Lumbar Ligament Laxity, Detailed outline of injury thresholds of the anterior longitudinal, posterior longitudinal and ligamentum flavum was presented in the lumbar spine. Review of structural and physiological properties relating to stress/strain curve of the above ligaments. The outline of the toe region, linear region and failure region was demonstrated. Transversely isotropic material properties of spinal ligaments were included and correlated to chiropractic care and impairment rating using the AMA guides to the Evaluation and Management 5th and 6th editions. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Chiropractic Diagnosis and Management of the Pre-Surgical Patient, Outline, Analysis of spinal biomechanical parameters in a whole spine model of care. Review of the details of measuring Pelvic Incidence and discussion of history of its analysis. An outline of movement from a regional model of spine care to a full spine model was presented. Analysis of the components of the pre-surgical patient including muscle movements patterns, segmental mobility, spinal curvature and rotation in the coronal, sagittal and axial planes was presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Chiropractic Diagnosis and Management of the Post-Surgical Patient, Outline, and analysis of spinal biomechanical parameters in a whole spine model of care in post-surgical analysis of the spine pain patient. Review of the details of measuring Pelvic Incidence and discussion of history of its analysis in relation to sagittal balance and vertebral body rotation was discussed. The outline of movement from a regional model of spine care to a full spine model was presented particularly in the context of pain management strategies post-surgery. Analysis of the components of the post-surgical patient including muscle movement patterns, segmental mobility, spinal curvature and rotation in the coronal, sagittal and axial planes was presented. Interprofessional communication and co-management was emphasized. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Chiropractic Diagnosis and Management of Vertebral Compression Fracture, Review of the influence of osteoporosis on development of vertebral compression fracture was reviewed and detailed in comparison to neoplasm. Utilization of MRI as the gold standard for evaluating the age of and pathophysiology was discussed and presented. Absorptiometry was outlined and presented in relation to monitoring bone density. Interprofessional communication of absolute versus relative contraindications to conservative care and spinal manipulation was outlined and reviewed. Review of the three columns of vertebral architecture was detailed. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Chiropractic Diagnosis and Management of Whiplash Disorder, Outline, and discussion of Whiplash as a mechanism of injury with particular focus on damage to underlying tissue structures. Review of anatomy, with specific focus on surrounding muscular, supraspinous ligament, interspinous ligament, spinal nerve, spinal cord, facet capsule and dorsal/ventral nerve roots was presented. Clinical correlation to imaging studies and its influence on management of the Whiplash patient was reviewed. Focused attention was pa9id to Whiplash as a mechanism of injury and not a complete diagnosis. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Chiropractic Diagnosis and Management of Non-Specific Pain, Outline, and discussion of the mechanical origins of spine pain emphasizing common biomechanical parameters was presented. Review of chiropractic-based maintenance care in the management of patient centered spine pain was introduced. Introduction of a Spine Management Physician was presented outlining the natural history of a spine pain in the human population. Interprofessional communication and case management was emphasized with focus on societal burden of mismanagement was presented. National Spine Management Group, LLC, Federation of Chiropractic Licensing Boards - PACE. State University of New York at Buffalo Jacobs School of Medicine and Biomedical Sciences, Buffalo, NY, 2021
Specialty Research Rotation-Innervation and Blood Supply of the Intervertebral Disc, Discussion of the distribution of nociceptive nerve fibers in the cervical intervertebral discs. Correlation of chronic neck pain patients and the relationship to nociceptive nerve fibers and discogenic neck pain. The role of nociceptive nerve fibers in the pathogenesis of neck pain of cervical disc origin was discussed and outlined. ACCME Joint Sponsorship with the State University of New York Buffalo, Jacobs School of Medicine., Buffalo, New York, 2020
Specialty Research Rotation, Innervation and Blood Supply of the Intervertebral Disc, Pathological mechanisms of discogenic low back pain including sensory nerve in growth into inner layers of the intervertebral disc, upregulation of neurotrophic factors and cytokines, and instability. Outline of the inhibition of these mechanisms and the treatment of discogenic low back pain. Understanding the innervation and instabilities of diseased intervertebral discs and the role of inflammatory mediators was compared with healthy intervertebral disc anatomy. ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, Buffalo, New York, 2020
Specialty Research Rotation, Innervation and Blood Supply of the Intervertebral Disc, discussion of chronic low back pain and its socioeconomic burden was presented. MRI findings and the diagnosis of MRI were outlined. Assessment of the sensory innervation of the vertebral endplate and degenerative intervertebral discs was outlined. Specific features highlighting the difference between healthy and degenerative intervertebral discs such as cartilage degeneration and subchondral bone defects were discussed. ACCME Joint Sponsorship with the State University of New York Buffalo, Jacobs School of Medicine, Buffalo, New York, 2020
Specialty Research Rotation, Innervation and Blood Supply of the Intervertebral Disc, Investigation of effects of inflammatory cytokines, IL- ß, and TNF-α, on the expression of an angiogenic factor, vascular endothelial growth factor (VEGF), and neurotrophic factors, nerve growth factor (NGF) and brain-derived neurotrophic factor (BDNF), in human IVD degeneration was presented. Outline of Neurotrophins role in the survival, growth, differentiation, and function of neurons inside and outside of the intervertebral disc. further discussion was was outlined relating to the process of IL-1B being generated during IVD degeneration and may stimulate the upregulation of VEGF, NGG, and BDNF expression, resulting in angiogenesis and nerve in-growth during intervertebral disc generation. ACCME Joint Sponsorship with the State University of New York Buffalo, Jacobs School of Medicine., Buffalo, New York, 2020
Electrodiagnostics: Electromyogram/Nerve Conduction Velocity (EMG/NCV), Diagnosis & Interpretation: Anatomy and Physiology of Electrodiagnostics: An in-depth review of basic neuroanatomy 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. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island NY, 2019
Electrodiagnostics: Electromyogram/Nerve Conduction Velocity (EMG/NCV), Diagnosis & Interpretation: Nerve Conduction Velocity (NCV) Part 1: Nerve conduction velocity testing, the equipment required and the specifics of motor and sensory testing. This section covers the motor and sensory NCV procedures and interpretation including latency, amplitude (CMAP) physiology and interpretation including the understanding of the various nuances of the wave forms. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island NY, 2019
Electrodiagnostics: Electromyogram/Nerve Conduction Velocity (EMG/NCV), Diagnosis & Interpretation: Nerve Conduction Velocity (NCV) Part 2: Compound motor action potentials (CMAP) and sensory nerve action potentials (SNAP) testing and interpretation including the analysis and diagnosis of the wave forms. It also covers compressive neuropathies of the median, ulnar and posterior tibial nerves; known as carpal tunnel, cubital tunnel and tarsal tunnel syndromes. This section offers interpretation algorithms to help understand the neurodiagnostic conclusions. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island NY, 2019
Electrodiagnostics: Electromyogram/Nerve Conduction Velocity (EMG/NCV), Diagnosis & Interpretation: Needle Electromyogram (EMG) Studies: 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. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island NY, 2019
Electrodiagnostics: Electromyogram/Nerve Conduction Velocity (EMG/NCV), Diagnosis & Interpretation: Overview of EMG and NCV Procedures, Results, Diagnoses and Documentation. 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. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island NY, 2019
Traumatic Brain Injury and Concussion Overview: This section is an in-depth 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. Cleveland University - Kansas City, 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, 2019
Head Trauma and Traumatic Brain Injury Part 1: This section discusses 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. Cleveland University - Kansas City, 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, 2019
Head Trauma and Traumatic Brain Injury Part 2: This section continues with 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. Cleveland University - Kansas City, 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, 2019
Concussion And Electroencephalogram Testing: This section covers 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. Cleveland University - Kansas City, 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, 2019
Concussion And Electroencephalogram Testing Pathological Results: This module covers 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. Cleveland University - Kansas City, 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, 2019
Trends in Spinal Treatment, Migration of spinal care for mechanical spine issues from hospitals and medical specialists to trauma qualified chiropractors based upon published outcomes. Utilizing imaging studies in spinal biomechanics, pain models and clinical outcomes to determine a conclusive diagnosis, prognosis and treatment plan for triaging in a collaborative environment. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Loing Island, NY, 2019
Neurology of Spinal Biomechanics, Understanding the normal of spinal biomechanics and the neurotransmitters required for homeostasis. The interconnected role of Pacinian Corpuscles, Ruffini Corpuscles, Golgi Organ Receptors, Nociceptors, Proprioceptors and Mechanoreceptors in maintaining sagittal and axial alignment in the presence of mechanical pathology. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Loing Island, NY, 2019
MRI Age-Dating of Herniated Discs, The literature, academic and clinical standards to age-date herniated discs. The clinical correlation the pain patters with advanced imaging finings of bone edema, spurs based upon the Piezoelectric effect for remodeling, high signal on T2 weighted images, Vacuum Discs and disc heights in determining the time frames of the etiology of the spinal disc pathology. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Loing Island, NY, 2019
Creating Ethical Collaborative and Medical-Legal Relationships, Understanding the timely triage necessities based upon clinical and imaging outcomes and the documentation required for collaborative physicians to continue care. Ensuring that the documentation is complete, reflective of services rendered and clear for third party consideration in an admissible format to considered in a medical-legal environment. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Loing Island, NY, 2019
Central Innervation of Spinal Biomechanical Engineering, Understanding the lateral and ventral horn’s innovations of Pacinian Corpuscles, Ruffini Corpuscles, Golgi Organ Receptors, Nociceptors, Proprioceptors and Mechanoreceptors and the pathways through the spinal thalamic tracts through the periaqueductal region, the Thalamus into the Occipital, pre-frontal, sensory and motor cortexes and the efferently back through the Thalamus to disparate regions in creating spinal homeostasis, Pacinian Corpuscles, Ruffini Corpuscles, Golgi Organ Receptors, Nociceptors, Proprioceptors and Mechanoreceptors. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Loing Island, NY, 2019
Identifying Spinal Pathology of MRI, Utilizing T1, T2, STIR and Gradient studies in determining myelomalacia, intra and extra-dural tumors and systemic disease patterns affecting the spinal cord. When to use contrast post-operatively in identifying discal structures vs. adhesions on postoperative advanced imaging. MRI Interpretation of herniated, circumferential bulges, focal bulges, protruded, extruded, comminuted, sequestered and fragmented discs. When to consider a neurosurgical consultation based upon the correlation of imaging and clinical findings. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Loing Island, NY, 2019
Computerized Mensuration of Spinal Biomechanical Pathology, Understanding the algorithmic interpretation of spinal biomechanical pathology in a 3-D model and creating treatment plans, impairment ratings and teaching models based upon the vertebral motor unit angles. Determining sagittal and axial alignments in creating a normative baseline for treatment goals and outcomes. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2019
Neurosurgical-Chiropractic Collaboration on Spinal Pathology, Utilizing x-ray, MRI and other modalities of advanced imaging in conjunction with spinal biomechanical failure and clinical evaluation to collaboratively create treatment protocols for patients in both the operative and non-operative cases. Determining the boundaries of scope of care for both the chiropractor and neurosurgeon based upon a definitive diagnosis of the mechanical vs. an anatomical lesion. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2019
Documentation and Ethics in Medical-Legal Relationships, Creating ethical relationships based upon accurate documentation reflective of the casually related condition of the injured. Ensuring accepted credentials of the doctor based upon Voir Dire standards reflected in an admissible curriculum vitae. How to present demonstrative documentation in the courts reflective of the patient’s pathology. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2019
Coding, Documentation and Compliant Coding, Ensuring the correct codes are utilized in an evaluation and management encounter. The correct elements are utilized to support the level of E&M coded along with a self-audit program to ensure ethical billing occurs. Guidelines for history of present illness, primary complaint, review of systems, family, social and past histories are discussed and how to document the same. Cleveland University - Kansas City, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2019
Documentation - Carrier Mandates & How They Guide ER's and Lawyer Referrals, Documenting electrodiagnostics, concussion and disc pathology as reflective of clinical findings when collaborating with medical specialists in private practice and hospital settings or in the medical-legal arena. Ensuring complete documentation in the evaluation and management process for both the initial and re-evaluation processes. Academy of Chiropractic, Post-Doctoral Division, Long Island, New York, 2019
Evaluation and Management, 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. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019
Evaluation and Management, Concluding a chief complaint, history and what needs to be considered in a physical examination. This covers in dept the required elements for chief complaints, 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. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019
Evaluation and Management, Coding and Spinal Examination: 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. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019
Evaluation and Management, Neurological Evaluation: 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. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019
Evaluation and Management, Documenting Visit Encounters: 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. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019
Evaluation and Management, Case Management and Treatment Orders: 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. Cleveland University, Kansas City, Academy of Chiropractic, Post-Doctoral Division, Long Island, NY, 2019
Clinical Grand Rounds – Clinical Diagnosis of Traumatically Induced Intervertebral Disc Injury versus Pre-Existing Disc Bulge in the Cervical Spine – case review of pre-existing cervical spine degenerative disc disease, myelomalacia and spinal cord compression with superimposed central canal stenosis due to overlying traumatically induced cervical disc herniation. Discuss of Modic 1 changes and acute injury with associated foraminal canal stenosis and acute intervertebral disc herniation. Causality related to mechanism of injury, physical examination presentation and analysis of bodily injury was presented. Cleveland University – Kansas City, Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY, 2019
Clinical Grand Rounds – Traumatic Cervical Disc Herniation with Pre-existing Cervical Spinal Fusion – a case review of traumatically induced multi-level cervical disc herniation with below a pre-existing spinal fusion. Review of case history, physical examination findings, plain film radiographs, cervical spine MRI with particular attention paid to osteophyte and modic changes. Interprofessional communication both verbally and through proper evidence-based documentation was emphasized and discussed focusing on acute versus chronic spinal injury. Cleveland University – Kansas City, Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY, 2019
Clinical Grand Rounds – Differentiating Pre-existing vs Causally Related Spinal Injury using MRI – case review of traumatic injury to the cervical spine with underlying pre-existing traumatic injuries. Physical examination, neurological and orthopedic testing was clinically correlated to mechanism of injury, plain film radiographs and MRI studies. Comparison of T1, T2 and STIR views were reviewed in relation to intervertebral disc bulge, intervertebral disc herniation, Modic 1, Modic 2 and Modic 3 changes. Comparative review of causally related versus pre-existing changes was demonstrated. Cleveland University – Kansas City, Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY, 2019
Clinical Grand Rounds – Thoracic Intervertebral Disc Herniation with Subsequent Four Level Spinal Fusion T6-T10 – case review of multilevel intervertebral disc herniations in the thoracic spine with clinical correlation to mechanism of injury, physical examination findings, neurological examination and range of motion analysis. Differential diagnosis of facet syndrome, thoracic radiculopathy and discogenic pain including structural innervation of surrounding tissues and intervertebral discs with referral pattern was reviewed and discussed. Subsequent failure of chiropractic care and rehabilitation leading to multilevel thoracic spinal fusion was demonstrated and reviewed. Plain film radiographs and MRI evaluation of the thoracic spine sagittal and axial images in T1, T2 and STIR was demonstrated and clinically correlated to objective findings and subjective complaints. Interprofessional referral and documentation was outlined and discussed. Cleveland University – Kansas City, Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY 2019
Clinical Grand Rounds – Traumatic Cervical Disc Herniation and Associated Sternum Fracture – a case review of traumatically induced multi-level cervical disc herniation with associated Grade 2 Ligament Injury rated as sub-threshold. Review of case history, physical examination findings, plain film radiographs, cervical spine MRI and bone scan. Radiographic analysis and objectification of grade 2 sprain was presented and its correlation to the AMA Guides to the Evaluation of Permanent Impairment 5th edition was reviewed. Review of the purpose, function and positive findings on bone scan was reviewed and demonstrated using patient’s fractured sternum. Interprofessional communication both verbally and through proper evidence-based documentation was emphasized and discussed. Cleveland University – Kansas City, Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY 2019
Clinical Grand Rounds – Traumatic Disc Bulge and Associated Grade 2 Ligament Injury – A case review of traumatically induced cervical spine traumatic bulge of the intervertebral disc with concomitant grade 2 ligament injury was presented. Detailed anatomy and morphological presentation of normal and degenerative intervertebral disc presentation was demonstrated and reviewed. Review of morphological differences between disc bulge, disc herniation and disc protrusion was presented. Grade 1, Grade 2 and Grade 3 ligamentous sprains were reviewed and discussed. Radiographic analysis and objectification of grade 2 sprain was presented and its correlation to the AMA Guides to the Evaluation of Permanent Impairment 5th edition was reviewed. Interprofessional communication both verbally and through proper evidence-based documentation was emphasized and discussed. Cleveland University – Kansas City, Academy of Chiropractic, Buffalo, NY, 2019
Clinical Grand Rounds – 14 mm Cervical Disc Herniation with Spinal Cord Compression– a case review of traumatically induced 14 mmm acute cervical intervertebral disc extrusion with inferior migration resulting in severe right lateral canal stenosis, foraminal stenosis and spinal cord impingement. A detailed review of physical examination findings, neurological evaluation, MRI images and surgical triage was presented. Interprofessional communication both verbally and through proper evidence-based documentation was emphasized and discussed. Cleveland University – Kansas City, Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY, 2019
Clinical Grand Rounds – T11 Spinal Fracture – a case review of traumatically induced T11 vertebral body fracture post motor vehicle collision. A detailed review of patient history, neurologic examination, plain film radiographs and advanced imaging studies were discussed. Comparison of Modic 1 and Modic 2 changes on T1 and T2 weighted MRI were reviewed, discussed and compared to plain film images and CT scan images. Interprofessional communication both verbally and through proper evidence-based documentation was emphasized and discussed. Cleveland University – Kansas City, Academy of Chiropractic, Post-Doctoral Division, Buffalo, NY, 2019
Clinical Grand Rounds – Traumatically Induced Biomechanical Pathology with Secondary Underlying Multi-Level Cervical Intervertebral Disc Herniation, Case review of traumatically induced biomechanical pathology in the cervical spine in the absence of pre-existing degenerative change and ligament laxity. Review of underlying multi-level acute intervertebral disc herniation and clinical correlation to patient presentation. T1, T2 and STIR MRI review of acute intervertebral disc herniation in both sagittal and axial planes outlining correlation to radiologist report and electrodiagnostic findings. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2019
Clinical Grand Rounds – Traumatically Induced Cervical Central Canal Stenosis– A case review of traumatically induced acute cervical intervertebral disc extrusion with superior migration resulting in severe central canal stenosis and spinal cord impingement. A detailed review of physical examination findings, neurological evaluation, MRI images and surgical triage. Interprofessional communication both verbally and through proper evidence-based documentation. Academy of Chiropractic, Post-Doctoral Division, Cleveland University – Kansas City, Chiropractic and Health Sciences, Buffalo, NY, 2019
Connective Tissue Pathology, Spinal Biomechanics as Sequella to Trauma, MRI Spine Interpretation, Ordering Protocols & Triaging the Injure, The latest research on the 6 ways to age-date disc herniations and bulges from trauma inclusive of disc pathology nomenclature. MRI ordering protocols, inclusive of Dixon format and fat-suppressed images. The neurology and pathology of connective tissue and the sequella of trauma at the biomechanical level leading to bio-neuro-mechanical failure. Contemporary "evidenced-based building blocks" for triaging and in a collaborative environment. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2018
Spinal Biomechanical Engineering Digitizing, integrating automated mensuration into creating treatment plans and determining maximum medical improvement. A literature-based study of normal vs. abnormal motor until function. Determining ligamentous laxity, alteration of motion segment integrity and pathological stress units and whole person impairments based upon the literature and academic standards, Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2018
Science of the Chiropractic Spinal Adjustment and Vertebral Subluxation, The literature-based definitions of both the mechanisms the chiropractic adjustment and how it affects the central nervous system in pain pathways and systemic issues that is the arbiter for normal vs. abnormal function. The "physiological mechanisms" of how chiropractic spinal adjustment affects the peripheral and central nervous systems. Subluxation degeneration/Wolff's Law will be detailed from a literature perspective combined with the mechanism of subluxation (bio-neuro-mechanical lesion). A literature perspective on why "long-term" chiropractic care is clinically indicated as usual and customary to effectuate demonstrable biomechanical changes in the spine. An evidenced-based perspective of why physical therapy is a poor choice for spine as a 1st referral option for any provider inclusive of the literature. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2018
Documentation, Collaboration, and Primary Spine Care, An academic basis for documentation that is usual and customary across professions in collaborative care. Maintaining ethical medical-legal relationships based upon Voir Dire and Daubert standards with ensuring a "4-corners" inclusive report. Ensuring Primary Care Status based upon an academic standard. Cleveland University Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island NY, 2018
Documentation of the Trauma and Non-Trauma Case, Documenting primary and associated complaints, past history, allergies, medications, review of systems, previous treatment, family-social medical histories, previous tests and results, history or previous injuries and illnesses, on the job questionnaire, auto accident questionnaire, vital examination, neurological examination, orthopedic testing, test orders, prognosis and treatment plans. A detailed review of current CPT coding requirements for the proper documentation of E/M visits to properly code for billable patient services. Focused attention was paid to the performance of comprehensive patient history, physical examination, review of systems as well as determining the level of clinical decision making. Analysis of a properly organized E/M report was reviewed to demonstrate proper organization and language use. Academy of Chiropractic Post-Doctoral Division, Long Island, New York, 2018
Interprofessional Reporting and Case Documentation, Analysis of case flow, patient chart organization and EMR workflows to optimize the success and satisfaction of the patient encounter, feasibility of accurate and timely documentation as well as strategies to provide timely interprofessional clinical communication. Focus was provided on patient, primary care and medical specialty communication beginning at the initial visitation all the way through to the release from care. An internal compliance review to ensure complete documentation based upon the E/M level billed. Academy of Chiropractic Post-Doctoral Division, Long Island, New York, 2018
Spinal Biomechanical Engineering Analysis, Understanding spinal motor units as it relates to the Cartesian system and normal vs. pathological movement. Analyzing normal coupling functions of the spine in relations to gait and pelvic biomechanical function and determining stress units and standards of deviation of segmental dysfunction. Interpreting mensuration lines and block analysis beyond standards of deviation in spinal motor dysfunction about connective tissue failure. Cleveland University Kansas City, Chiropractic and Health Sciences, New York State Department of Education, Academy of Chiropractic Post-Doctoral Division, Long Island , NY, 2018
Spinal Biomechanical Engineering Pathology and Clinical Application, Integrating pathological function based upon the Cartesian system and digital mensuration in developing treatment plans with diagnosed connective tissue failures. Diagnosing corrective vs. clinical management scenarios when considering maximum medical improvement in both the chronic and acute, insidious and traumatically induced patient. Cleveland University Kansas City, Chiropractic and Health Sciences, New York State Department of Education, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2018
Documenting Trauma and Non-Trauma Cases & Triaging Disc Pathology, Triage, care and collaboration for herniated, bulged, protruded, extruded and fragmented spinal discs. Compliant documentation of evaluation and management of new and established patients inclusive of chief complaint, history of present illness, review of systems, past-family-social histories with case management protocols and the required elements. Clinically coordinating treatment with subjective complaints, clinical findings and diagnosis for each encounter. Cleveland University-Kansas City Chiropractic and Health Sciences, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2018
Medical-Legal Ethical Relationships, Documentation and Legal Testimony, Report writing for legal cases, the 4 corners of a narrative and documenting damages with understanding defense medical documentation and consistent reporting of bodily injuries. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018 Medical-Legal Ethical Relationships, Documentation and Legal Testimony, Part 2, Understanding report writing and the types of medical reports required for court inclusive of diagnosis, prognosis and treatment plans with requirements of reporting causality and permanency. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018 Medical-Legal Ethical Relationships, Documentation and Direct Testimony, Organizing your documentation and understanding all collaborative documentation and how it fits into your diagnosis, prognosis and treatment plan, Understanding the nuances of the functional losses of your patients related to their bodily injuries, Academy of Chiropractic, Post-Doctoral Division. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018 Medical-Legal Ethical Relationships, Documentation and Direct Testimony Part 2, Utilizing demonstrative documentation in direct examination and communicating the results of your care concurrently with the written documentation and reporting an accurate diagnosis for all images. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018 Medical-Legal Ethical Relationships, Documentation and Direct Testimony Part 3, The evaluation, interpretation and reporting of collaborative medical specialists’ results and concluding an accurate diagnosis inclusive of all findings and reviewing all images to ensure an accurate diagnosis. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018 Medical-Legal Ethical Relationships, Documentation and Direct Testimony Part 4, Determining and documenting disabilities and impairments inclusive of loss of enjoyment of life and duties under duress and the evaluation and validation of pain and suffering. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018 Medical-Legal Ethical Relationships, Documentation and Cross Examination Testimony, Reporting your documentation factually and staying within the 4 corners of your medical report and scope of practice inclusive of understanding how your credentials allow you to report your documentation. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018 Medical-Legal Ethical Relationships, A Documentation Relationship Between the Doctor and Lawyer, The level of organization required in a medical-legal case that accurately reflects the bodily injuries of your patients and the time constraints in rendering an accurate report. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018 Medical-Legal Ethical Relationships, Report Writing and Preparing for a Legal Case, Reviewing the facts of the case inclusive of your documentation, the defense medical examiner, medical specialists and the attorney to ensure accurate and consistent reporting. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018 Medical-Legal Ethical Relationships, Report Writing and Preparing for a Legal Case, Creating demonstrative evidence, visuals of your patient's bodily injuries inclusive of x-rays, MRI's, CAT Scans and electrodiagnostic findings, the spinal biomechanics of herniated disc with ipsilateral findings and contralateral symptomatology. Academy of Chiropractic, Post-Doctoral Division, Cleveland University-Kansas City, College of Chiropractic, Long Island, NY, 2018
Spinal Bio-Engineering Seminar, 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. Certification in PACE Recognized by The Federation of Chiropractic Licensing Boards, Weldon Spring, MO, 2018
Triage and Management of the Trauma and Non-Trauma Patient, Differentially diagnosing spinal issues in the trauma and non-trauma patient inclusive of spinal disc pathology utilizing x-ray, MRI, CAT Scan and clinical evaluations. Collaborative triaging protocols with neurologists, neurosurgeons, orthopedic surgeons, pain management and primary medical care providers with both mechanical and anatomical spinal pathologies. Academy of Chiropractic, PACE Approved for the Federation of Chiropractic Licensing Boards, Cleveland University, Kansas City Chiropractic and Health Sciences, Long Island, NY, 2018
Neurology of Ligament Pathology- Normal Morphology and Tissue Damage, Connective tissue morphology, embryology and wound repair as sequalae to trauma. Full components of strain-sprain models and permanency implications with wound repair and osseous aberration with aberrant structural integrity. Cleveland University – Kansas City, 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, New York, 2018
Neurology of Ligament Pathology- Spinal Biomechanics and Disc Pathology, Disc pathology as sequella to trauma; herniation, extrusion, protrusion, sequestration and how the spinal unit as one system creates homeostasis to balance the pathology. Cleveland University – Kansas City, 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, New York, 2018
Neurology of Ligament Pathology- Neurological Innervation, The peripheral and central innervation of the disc and spinal ligaments of the dorsal root ganglion, spinal thalamic tracts, periaqueductal gray areas innervating the Thalamus and multiple regions of the brain. The efferent neurological distribution to disparate areas of the spine to create homeostasis until tetanus ensues creating osseous changes under the effect of Wolff's Law. Cleveland University – Kansas City, 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, New York, 2018
Evidenced Based Care in a Collaborative Setting; 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. Cleveland University – Kansas City, 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, New York, 2018
Current Literature Standards of MRI Spine Interpretation; 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, bulges. Cleveland University – Kansas City, 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, New York, 2018
Spine Brain Connection in Pain Pathways; 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. Cleveland University – Kansas City, 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, New York, 2018
Bio-Neuro-Mechanical Mechanism of the Chiropractic Spinal Adjustment; 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, Academy of Chiropractic Post-Doctoral Division. Cleveland University – Kansas City, 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, New York, 2018
Interprofessional Hospital Based Spine Care, Trends in hospital and emergent care in the healthcare delivery system inclusive of policies, hospital staffing and current care paths for mechanical spine issues. Texas Chiropractic College, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2017
Patient Intake, History and Physical Examination, Determining the etiology of the patient's complaints in a traumatic or non-traumatic scenario. Analyzing the patient's past history and review of systems along with the performance of a complete orthopedic, neurological and clinical examination to correlate both past, current and causality issues to formulate an accurate diagnosis, prognosis and treatment plan. There is an emphasis on triaging both the trauma and non-trauma patients. Texas Chiropractic College, Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2017
MRI Spine Interpretation and Spinal Biomechanics, Bulging, herniated, protruded, and extruded disc contemporary nomenclature, analysis, and differential diagnosis. Connective tissue physiology and pathology with aberrant biomechanical permanent sequelae, Texas Chiropractic College, Academy of Chiropractic, Melville NY, 2017
Contemporary Literature in Spinal Biomechanics, Normal vs. pathological biomechanical spinal motion both in a single motor unit, and coupling actions. An interdisciplinary approach to mechanical spine issues and evidenced-based care paths, Texas Chiropractic College, Academy of Chiropractic, Melville NY, 2017
Documentation of Spinal Trauma, Interdisciplinary approaches in documentation of spinal related injuries inclusive of connective tissue disorders, and biomechanical failure. Clinically correlating history, imaging, advanced imaging, and clinical findings to conclude an accurate diagnosis, prognosis, and treatment plan, Texas Chiropractic College, Academy of Chiropractic, Melville NY, 2017
Contemporary Literature of the Chiropractic Spinal Adjustment, The bio-neuro-mechanical scientific foundation of the spinal lesion and the neurological pathways, both in the lower and upper motor neuron pathways. The autonomic sequella of the vertebral subluxation and the effects of the correction and maintenance of those lesions, Texas Chiropractic College, Academy of Chiropractic, Melville NY, 2017
Stroke Anatomy and Physiology: Brain Vascular Anatomy, 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, 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, 2017
Stroke Anatomy and Physiology: Stroke Types and Blood Flow, 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, 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, 2017
Stroke Principles of Treatment an Overview for the Primary Care Provider, 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, 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, 2017
Clinical Evaluation and Protocols for Identifying Stroke Risk, 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, 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, 2017
Orthopedic Testing: Principles, Clinical Application and Triage, 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, 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, 2017
Orthopedic Testing: Cervical Spine, 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, 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, 2017
Orthopedic Testing: Cervical Spine, 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, 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, 2017
Orthopedic Testing: Lumbar Spine, 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, 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, 2017
Orthopedic Testing: Clinical Grand Rounds, how to integrate orthopedic testing in the clinical setting utilizing both simple and complex patient scenarios. It includes potential stroke, or vertebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process. How to integrate orthopedic testing in the clinical setting utilizing both simple and complex patient scenarios. It includes potential stroke, or vertebrobasilar insufficient patients and understanding the nuances in a clinical evaluation with orthopedic testing as a critical part of the evaluation and screening process. Texas Chiropractic College, 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, 2017
Primary Spine Care 2: Spinal Trauma Pathology, 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. Texas Chiropractic College, Academy of Chiropractic, Setauket NY, 2017
Primary Spine Care 2: Utilizing Research in 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. Texas Chiropractic College, Academy of Chiropractic, Setauket NY, 2017
Primary Spine Care 2: Chiropractic Evidence, Analyzing segmental pathology, adjusting vs. mobilization with cervicogenic headaches, Opioid alternatives and case management of mechanical spine pain based upon outcome studies. Texas Chiropractic College, Academy of Chiropractic, Setauket NY, 2017
Primary Spine Care 2: Chiropractic Spinal Adjustment Central Nervous System Processing, 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. Texas Chiropractic College, Academy of Chiropractic, Setauket NY, 2017
Spinal Trauma Pathology, Triage and Connective Tissue Injuries and Wound Repair, 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. Texas Chiropractic College, 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, New York, 2016
Spinal Trauma Pathology, Ligament Anatomy and Injury Research and Spinal Kinematics, 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, 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, New York, 2016
Spinal Trauma Pathology, Spinal Biomechanics, Central Nervous System and Spinal Disc Nomenclature, The application of spinal biomechanical engineering models in trauma and the negative sequelae it has on the central nervous system inclusive of the lateral horn, periaqueductal grey matter, thalamus and cortices involvement. Texas Chiropractic College, 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, New York, 2016
Spinal Trauma Pathology, Biomechanics of Traumatic Disc Bulge and Age Dating Herniated Disc Pathology, The biomechanics of traumatic disc bulges as sequelae from trauma and the comorbidity of ligamentous pathology. Age-dating spinal disc pathology in accordance with Wolff’s Law. Texas Chiropractic College, 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, New York, 2016
Spinal Trauma Pathology, Clinical Grand Rounds, 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, 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, New York, 2016
Spinal Trauma Pathology, Research Perspectives, 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, 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, New York, 2016
Spinal Biomechanical Engineering: Cartesian System, The Cartesian Coordinate System from the history to the application in the human body. Explanation of the x, y and z axes in both translation and rotations (thetas) and how they are applicable to human biomechanics. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, 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, 2014
Spinal Biomechanical Engineering: Cervical Pathobiomechanics, Spinal biomechanical engineering of the cervical and upper thoracic spine. This includes the normal and pathobiomechanical movement of both the anterior and posterior motor units and normal function and relationship of the intrinsic musculature to those motor units. Nomenclature in reporting normal and pathobiomechanical findings of the spine. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, 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, 2014
Spinal Biomechanical Engineering: Lumbar Pathobiomechanics, Spinal biomechanical engineering of the lumbar spine. This includes the normal and pathobiomechanical movement of both the anterior and posterior motor units and normal function and relationship of the intrinsic musculature to those motor units. Nomenclature in reporting normal and pathobiomechanical findings of the spine. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, 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, 2014
Spinal Biomechanics in Trauma, To utilize whiplash associated disorders in various vectors of impact and whiplash mechanisms in determining pathobiomechanics. To clinically correlate annular tears, disc herniations, fractures, ligament pathology and spinal segmental instability as sequellae to pathobiomechanics from trauma. The utilization of digital motion x-ray in diagnoising normal versus abnormal facet motion along with case studies to understand the clinical application. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, 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, 2014
Spinal Biomechanical Engineering & Organizational Analysis, 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. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, 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, 2014
Spinal Biomechanical Engineering: Cervical Digital Analysis, Digitizing and analyzing the cervical spine in neutral, flexion and extension views to diagnose pathobiomechanics. This includes alteration of motion segment integrity (AMOSI) in both angular and translational movement. Ligament instability/failure/pathology are identified all using numerical values and models. Review of case studies to analyze pathobiomechanics using a computerized/numerical algorithm. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, 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, 2014
Spinal Biomechanical Engineering: Lumbar Digital Analysis, Digitalizing and analyzing the lumbar spine images to diagnose pathobiomechanics. This includes anterior and posterior vertebral body elements in rotatioal analysis with neutral, left and right lateral bending in conjunction with gate analysis. Ligament instability/failure/pathology is identified all using numerical values and models. Review of case studies for analysis of pathobiomechanics using a computerized/numerical algorithm along with corrective guidelines. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, 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, 2014
Spinal Biomechanical Engineering: Full Spine Digital Analysis, Digitalizing and analyzing the full spine images to diagnose pathobiomechanics as sequellae to trauma in relation to ligamentous failure and disc and vertebral pathology as sequellae. This includes anterior and posterior vertebral body elements in rotatioal analysis with neutral, left and right lateral bending in conjunction with gate analysis. Ligament instability/failure/pathology is identified all using numerical values and models. Review of case studies for analysis of pathobiomechanics using a computerized/numerical algorithm along with corrective guidelines. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, 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, 2014
MRI Protocols Clinical Necessity, 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. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2014
MRI Interpretation of Lumbar Degeneration/Bulges, 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. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2014
MRI Interpretation of Lumbar Herniations, 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. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2014
MRI Interpretation of Cervical Degeneration/Bulges, 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. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2014
MRI Interpretation of Cervical Herniations, 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. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2014
MRI Interpretation of Degenerative Spine and Disc Disease with Overlapping Traumatic Insult to Both Spine and Disc, 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. New York Chiropractic Council, New York State Department of Education, Board for Chiropractic, Academy of Chiropractic Post Doctoral Division, Buffalo, NY, 2014
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Academy of Chiropractic, Active Trauma Team Member, 2017 - Present
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