David Collins DC, C.C.S.T., FSBT

2515 Northbrooke Plaza Dr. Suite 200, Naples, FL, 34119

Phone: 239-514-4004

Cell: 239-595-4636

Fax: 239-514-4044

david@healthquestnaples.com

http://www.healthquestnaples.com

Curriculum Vitae

 

Selected Occupational History

 

Clinic Director, Chiropractor, HealthQuest Chiropractic Clinic PC, Naples, FL, 2003-Present

Clinic Director, Chiropractor, Collins Chiropractic Clinic, Naples, FL, 1999 – 2003

Chiropractor, Sparling Chiropractic Clinic, Atlanta, GA, 1996-1998

Clinic Director, Chiropractor, Collins Chiropractic Clinic, Germantown, TN, 1980-1995

Education and Licensure

 

Doctor of Chiropractic, Licensed in the State of Florida, License #CH 007726, 1999-Present

Doctor of Chiropractic, Licensed in the State of Georgia, License #CHIR 0005666, 1996-Present

Doctor of Chiropractic, Licensed in the State of Tennessee, License #249, 1980-1998 (Retired)

Doctor of Chiropractic, Palmer College of Chiropractic, Davenport, IA, 1979

National Board of Chiropractic Examiners, Part I, 1978

National Board of Chiropractic Examiners, Part II, 1979

National Board of Chiropractic Examiners Part III, 1996

Bachelor of Science in Biology/Chemistry, University of Central Arkansas, Conway, AR 1972

Selected Post-Graduate Education and Certifications

 

Fellowship in Spinal Biomechanics and Trauma (FSBT)

A two-year intensive program of study consisting of extensive didactic work and hands-on rotations in medical offices and in surgery with eight (8) medical specialist, including interventional pain management, MRI tech, neuroradiology, orthopedic extremity surgery, orthopedic spine surgery, neurosurgery, family medicine/internal medicine and hospital emergency department. Academy of Chiropractic Post-Doctoral Division, Long Island, NY, Cleveland University-Kansas City, Chiropractic and Health Sciences, ACCME Joint Providership with the State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, July 2018

 

Trauma Qualified, Active Trauma Team, Academy of Chiropractic Post-Doctoral Division, Cleveland University-Kansas City, Long Island, New York, 2017-Present

Certified Chiropractor in Spinal Trauma (CCST), International Chiropractic Association, Life West Chiropractic College, Dallas, TX, 1992

PAIN MANAGEMENT ROTATION

Specialty Research in Pain Management – Clinical and Procedural – Growth of Interventional Pain Management Techniques and Current Trends in Pharmacological Management of Neuropathic Pain. ESI comparison to gabapentin in lumbosacral radicular pain – current trends and future progress of pain management interventions. Mode of action, required dosage, advantages and side effects profiles of currently available pharmacological approaches. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Therapeutic Effects of Spinal Injection Therapy - Facet, medial branch blocks, prolotherapy and epidural interventions utilization within the Medicare population, effectiveness on lumbar central canal stenosis with and without steroids and effect on prevention of spinal surgery, herniated disc, fibromyalgia and chronic musculoskeletal pain.   Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Adverse Events Associated with Injection Therapy – transforaminal and interlaminar epidural steroid injections, anesthesia technical considerations, effects on cervical radiculopathy midline versus paramedian approaches and perineurial injection of autologous conditioned serum. Review of FDA risk assessment.

Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Correlation of MRI Findings and Injection Outcomes - MODIC Changes on MRI and effectiveness of facet injection, facet joint signal change on MRI with fat suppression comparison with SPECT/CT. Discussion of Modic 1, 2 and 3 with correlation of clinical outcomes and patient selection criteria. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Therapeutic Effects of Botulinum Toxin and Dry-Needling in Myofascial Pain Syndrome – cost effectiveness, patient response and triage of therapeutic interventions. Physiological review of trigger point etiology and clinical presentation of acute and chronic pain. Functional response of intervention including relief and recurrence. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Systematic Review Technical Considerations in Cervical Epidural Analgesia - Chemical blockage of cervical nerve roots, review of anatomical structures and correlation with MRI imaging. Blockage effects on the respiratory, circulatory and neurological systems. Review of cervical epidural space (CES) borders and variants in patient population. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Trends in opioid analgesic abuse and mortality in the USA, Evaluation of Opioid Pain Management in Injured Children, assessment of opioid reporting in Veteran Affairs – Emergency visitation in pediatric injury, pain management and adoption of best practices. Trends in use of prescription opioid medication using RADARS (Research Abuse, Diversion and Addiction Related Surveillance System), comparison between legitimate pharmacy channels and diversion and abuse. Opioid use prevalence and incidents in Veteran Affairs, new prescriptions or long-term conversion and relationship to persistent growth in opioid use. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Electrodiagnostic Testing, Transforaminal Epidural Steroid Injection, Intra-articular Facet Joint Injection, Spinal Manipulation Post-Epidural Injection– Needle EMG, active versus chronic denervation in lumbar, cervical spinal pathologies and differential diagnosis of spinal stenosis and intervertebral disc herniation. Systematic review of facet joint injections, clinical trials and conservative therapy in lower back pain. Results of spinal manipulation post-epidural injection in the cervical spine. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Radiofrequency Ablation and outcome measures - medication, function and pain in relation to pain of spinal origin. Medial Branch Block as prognostic tool prior to lumbar facet radiofrequency denervation. Clinical comparison disc herniation, disc bulge, cervical and lumbar radiculopathy. Diagnosis and patient triage correlation to anatomical spine structures. Long, short term risk factors and outcomes in radiofrequency ablation.   Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Pain Management – Clinical and Procedural – Role of Cannabinoids in Pain Management – review of pharmacological, botanical or synthetic origins of cannabinoids. Mechanism of action in alleviation of pain including analgesic, anti-inflammatory effects, modular actions on neurotransmitters and interactions with prescribed or endogenous opioids. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

MRI PHYSICS

Specialty Research in MRI Physics – The Hardware – magnet types including permanent, resistive and superconducting magnets. Volume RF, surface, quadrature and phase array coils and other hardware necessary for the generation of MRI imaging. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in MRI Physics – Physics of Image Generation 1 – magnetization, excitation, relaxion, acquisition, computing and display. T1 relaxion and relaxation curves, T2 relaxation, phase and phase coherence, T2 relaxion curves. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in MRI Physics – Physics of Image Generation 2 – gradient coils, signal coding including slice encoding gradient, phase encoding gradient, Frequency encoding gradient. Gradient specifications and slice thickness. Filling k-space, k-space symmetry and k-space filling technique.   Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in MRI Physics – Physics of Image Generation 3 – pulse sequences, spine echo sequences including multi-slicing and multi-echo sequencing. T1, T2, proton density contrast and their applications. Turbo spine echo, fast advanced spine echo (HASTE) sequence and gradient echo sequence. Inversion recovery sequence including STIR and FLAIR sequence. Choosing the right sequence pros and cons, T1, T2 and PD parameters. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in MRI Physics – Physics of Image Generation – technical parameters and artifacts – repetition time, echo time, flip angle, inversion time, number of acquisitions, matric and field of view. Slice thickness, slice gap, phase encoding direction 1 and direction 2 and relation to bandwidth. Motion artifact, para-magnetic artifact, phase wrap artifact, susceptibility artifact, clipping artifact, spine and zebra artifacts. Effects on image quality and acquisition. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

 

NEURORADIOLOGY

Specialty Research in Neuroradiology – radiographic evolution of a Schmorl’s node – acute Schmorl’s node and progression to chronic stage comparison to serial MRI. Endplate fracture and acute presentation and correlation to clinical findings and pain patterns. Presentation in plain film radiograph and MRI images were compared and contrasted in both acute and chronic stages. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

 

Specialty Research in Neuroradiology – syringomyelia, fluid dynamics and spinal cord motion – scoliosis curve patters and syrinx characteristics versus Chiari I malformation. Normal MRI appearance and motion artifacts related to cerebral spinal fluid motion related phenomena and common appearances on MRI imaging. Syrinx wall and fluid motion and correlation to cardiac cycle with comparison between systolic and diastolic presentations. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

 

Specialty Research in Neuroradiology – Spinal Biomechanics, Thoracolumbar Deformity and Surgical Outcomes – full spine analysis, adjacent spinal biomechanics and its impact on surgical outcomes. Sagittal alignment pelvis to cervical spine and association with kyphosis and lordosis mechanical positioning. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neuroradiology – MRI and EMG comparison in denervated muscle diagnosis – lumbar spine pathology and age in relation to paraspinal muscle size and fatty infiltration. Fatty degeneration of paraspinal muscle in degenerative lumbar kyphosis and CT versus MRI digital analysis. Positive correlations with edema on MRI and fibrillations, positive sharp waves, denervation and the level of reduced recruitment pattern. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

 

Specialty Research in Neuroradiology – association between annular tear and disc degeneration – high intensity zone (HIZ) in lumbar disc and association to annular fissure on MRI. Identification of duel HIZ and its relationship to acute inflammation and calcified tissue and its association with discogenic pain patterns. Influence of phenotype, population size and inclusion sequence. T1, T2 and STIR imaging comparison and correlation. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

 

Specialty Research in Neuroradiology – degenerative cervical myelopathy – paraspinal muscle morphology, clinical symptoms and functional status. Review of fatty infiltration, asymmetry findings and correlation with clinical symptoms and functional scores. Review of complex anatomical arrangement of superficial and deep muscle layers in the cervical spine, correlation to MRI findings. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

 

Specialty Research in Neuroradiology – MRI Neurography, Diffuse Tensor Imaging (DTI) – diagnostic accuracy and fiber tracking in spinal cord compression. Review of spinal cord structural integrity, peripheral neuropathy and correlation to diffuse tensor imaging findings. Comparison in combining DTI with T2 and T2 alone and its value in magnetic resonance neurography. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

 

Specialty Research in Neuroradiology – Nomenclature and Classification of Lumbar Disc Pathology – modified Pfirrmann grading system and lumbar disc degeneration. Consensus driven description of intervertebral disc nomenclature including intervertebral disc bulge, herniation, protrusion, broad based disc herniation, extrusion and sequestration. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

 

Specialty Research in Neuroradiology – MRI evaluation of intradural tumor – neuroimaging of spinal tumors and correlation to histological study. Determining method of choice for evaluation, review of numerous types of intradural-extramedullary masses including meningioma and schwannoma. Signal intensities, contrast enhancement patterns, presence of cysts and other key differentiation findings of spinal cord tumors. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neuroradiology – Spinal Cord Compression, Myelomalacia, MRI Imaging and Clinical Correlation – positional cervical spinal cord compression and fibromyalgia. T1 and T2 weighted images, comparison of hypo and hyperintense signals and extent of intramedullary changes on MRI. Review of MRI findings associated with myelomalacia and discussion of correlation with clinical findings. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neuroradiology – MRI Characteristics of Lumbar Facet Synovial Cyst – formation characteristics of synovial cyst, relation to degenerative changes in spinal facet joints as demonstrated on MRI. Pre and post-surgical procedural MRI were reviewed and compared. Surgical management and subsequent resection were demonstrated. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

 

Specialty Research in Neuroradiology – Variability in MRI Diagnostic Error Rates – in depth review of quality of MRI imaging and comparison to consistent MRI diagnosis between facilities.   Errors of interpretation in the study examinations were considered and presented. Impact of radiological diagnosis, location of MRI study and reading radiologist and impact on treatment choice and clinical outcomes. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

ORTHOPEDIC SURGERY – EXTREMITY

Specialty Research in Orthopedic Extremity Surgery – Wrist Anatomy and Osseous Kinematics – normal kinematics using biplanar radiographic model were reviewed. Discussion of extensive database of carpal bone anatomy and kinematics from a large number of healthy subjects. 3-D motion of each bone was calculated for each wrist position and discussed. Database constructed including high-resolution surface models, measures of bone volume and shape, and the 3-D kinematics of each segmented bone. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery – Normal Motion of the Shoulder and Glenohumeral Instability – normal motion of the shoulder joint compared with clinical implications of glenohumeral joint instability including surgical recommendations. Review and overview of the anatomy of the glenohumeral joint, emphasis on instability based on the current literature. Description of detailed anatomy and anatomical variants of the glenohumeral joint associated with anterior and posterior shoulder instability. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery – Orthopedic Testing and Shoulder Pathology Diagnosis - use of orthopedic special tests (OSTs) to diagnose shoulder pathology and clinical examination. Review OST clusters, examination of methodology and illustration of their use in arriving at a pathology-based diagnosis. Discussion of examination of the biceps tendon and clinical relevance. Review of SLAP lesion and shoulder impingement syndrome were reviewed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery – Electrodiagnostic Testing and Carpal Tunnel Syndrome – Review of the most common mononeuropathy in the human body. Relationship between clinical findings, neurological examination and electrodiagnostic testing in the diagnosis of carpal tunnel syndrome. Acute and chronic symptoms including progression of the disorder were reviewed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery – Current Concepts in Elbow Disorders – Detailed anatomy of osseus, ligamentous and muscular structure of the elbow was reviewed. Common disease of elbow disorders and their treatment was discussed. Lateral epicondylitis and medial collateral ligament injury of the elbow were outlined. Rheumatoid arthritis, posttraumatic osteoarthritis, and elderly patients with comminuted distal humeral fractures. Surgical design and technique were outlined. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery – Differentiating Cervical Spine from Shoulder Pathology – anatomical review of cervical spine and glenohumeral joint focus on similarities and differences. Cervical disorders masking shoulder pain, cervical radiculopathy, cervical spondylotic myelopathy, facet and discogenic pain patterns were outlined. Details of shoulder pathology parsonage-tuner syndrome, subscapular neuropathy and thoracic outlet were presented. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery – MRI of the Shoulder and Shoulder Girdle – review of MRI analysis of scapular fracture. Detailed review of scapular function rehabilitation and training on chronic pain syndromes. Reliability of magnetic resonance imaging versus arthroscopy for the diagnosis and classification of superior glenoid labrum anterior to posterior lesions. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

 

Specialty Research in Orthopedic Extremity Surgery -Cataloging Movements of the Ankle, Hip and Spine - Review Standardization and Terminology Committee (STC) of the International Society of Biomechanics (ISB) and classification of joint kinematics. Standard for the local axis system in each articulating bone is generated and presented. Rationale for international standards among researchers was presented. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery -Cataloging Movements of the Shoulder, Elbow, Wrist and Hand - Review Standardization and Terminology Committee (STC) of the International Society of Biomechanics (ISB) and classification of joint kinematics. Standard for the local axis system in each articulating bone is generated and presented. Rationale for international standards among researchers was presented. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery – MRI and Diagnosis of Shoulder Disorders – normal and abnormal shoulder anatomy as viewed on MRI was presented. Review and presentation of MRI in the diagnosis and treatment of brachial plexus injury. Discussion of preganglionic avulsions and muscular denervation. Comparison of CT myelography to MRI myelography were outlined. Enhanced three dimensional T1 high-resolution isotropic volume excitation MR in the evaluation of shoulder pathology. Comparison with two-dimensional enhanced T1 fat saturation MRI were discussed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Extremity Surgery – Clinical Evaluation of Upper and Lower Extremity Pathology – review of relevant anatomy in shoulder, elbow, wrist, hip, knee and ankle was presented. Physical examination including orthopedic, neurological and range of motion testing was presented and compared with findings on MRI results. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

ORTHOPEDIC SPINE SURGERY

Specialty Research in Orthopedic Spine Surgery – Fusion Surgery and Lumbar Stenosis – efficacy of fusion and decompression surgery in patients with lumbar spinal stenosis. Review of degenerative spondylolisthesis and patient selection criteria. Discussion of correlation of MRI, CT findings and clinical evaluation. Review of sedimentation sign on MRI and indications of prognostic factors. Surgery versus nonsurgical treatment outlined and outcomes discussed. Compensation for lumbar spinal stenosis and clinical sagittal plane deformity was presented. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Posterior Lumbar Interbody Fusion and Adjacent Segment Degeneration (ASD) – adjacent segment degeneration as major consequence of spinal fusion. Review of occurrence and location with correlation between surgical outcomes were discussed.   Discussion of age, BMI and pre-existing stenosis in cranial adjacent segment as risk factors. ASD prevalence in radiographic evidence between cranial and caudal segments were reviewed. Presentation of risk factors and pre-operative radiological features. Facet sagittalization and tropism were discussed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Morbidity and Mortality Predictions in Spinal Surgery – Review of the Charlson Comorbidity Index (CCI) and the American Society of Anesthesiologist (ASA) Physical Status Classification System. Review of index outcomes and relation to costs of care. Discussion of index rating and likelihood of complications. Review of classification system in cerebral spinal fluid (CSF) leaks. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Spondylolisthesis, clinical and radiographic classifications - classification system that considers disc space height, sagittal alignment and translation, and the absence or presence of unilateral or bilateral leg pain was discussed. Detailed review of spondylolisthesis etiology, clinical presentation and imaging findings was reviewed. Review of inter and interobserver reliabilities of radiographic and clinical criteria. Review of consensus driven treatment options for degenerative spondylolisthesis presented. Transforaminal Lumbar Interbody Fusion (TLIF) in degenerative disc disease with associated spondylolisthesis grade I was reviewed and correlated. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Sagittal Alignment and Spinal Surgery, Clinical Outcomes and Follow up – discussion of outcomes and sagittal alignment in single unilateral transforaminal lumbar interbody fusion (TLIF). Detailed review of surgical TLIF procedure and associated mid and long-term clinical outcomes. Discussion and presentation of influence of pelvic incidents and lumbar lordosis mismatch and post-operative residual symptoms. Analysis of adjacent segment disease following fusion. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Complications and Outcomes in Adult Spinal Deformity Surgery – review of surgical approaches and complications in correction of adult spinal deformity. Relevance of age, comorbidities, blood loss, osteoporosis and smoking were discussed. Discussion of Cobb Angle, Sagittal Vertical Axis, Pelvic Tilt, Thoracic Kyphosis were reviewed and examined in relation to transpsoas lateral interbody fusion (LIF), percutaneous pedicle screw (PPS), transforaminal lumbar interbody fusion (TLIF). Comparison between minimally invasive and traditionally open procedures was provided and reviewed.   Discussion of minimally invasive surgery options were emphasized and outcomes reviewed with correlation to diagnosis and procedural coding. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Surgical Interventions in Lumbar Disc Herniation – review of differences in surgical treatment of recurrent lumbar disc herniation. Clinical correlation between plain film radiography, MRI studies and clinical presentation were reviewed. Data on frequency in management of recurrent lumbar intervertebral disc herniations presented. Duration of symptoms and influence of patient outcomes in sciatica patients undergoing micro-discectomy and decompressions. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Length of Stay in Lumbar Spinal Surgery – discussion on epidemiology of lumbar surgery outcomes and hospital stay. Correlation to clinical presentation and comorbidities were reviewed.   Outline of decompression and instrumental fusion in the lumbar spine. Review of costs of lumbar surgery, trends in hospital stay and costs both on a cumulative and daily basis. Comparison of the nationwide inpatient sample and national surgical quality improvement program databases for lumbar spine fusion procedures was reviewed and presented. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Pre-Surgical Planning and Implant Design – 3-D printing and surgical planning discussion a variety of historical materials in the creation of patient specific implants based on unique individual anatomy.   Historical trends in the creation of prosthetics with 3-D modeling software using neuroimaging data. Review of treatment complex spinal pathologies and surgical planning was discussed. Outline of current and future barriers to global implementation and commercialization was reviewed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Spine Surgery Procedures in Medical Specialty Training – discussion of current spine surgery training including fellowship programming in the United States. Accreditation Council for Graduate Medical Education (ACGME) cases logs were reviewed and discussed. Variability of procedures within programs and between medical specialty programs were outlined. Differential utilization between orthopedic and neurosurgical fellows was reviewed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Orthopedic Spine Surgery – Cerebral Spinal Fluid Dynamics, Central Nervous System Pathology and Intracranial Hypotension – pathophysiology and various craniospinal disorders. Directional phase contrast MRI (4D Flow) was reviewed along with the anatomical and physiological properties of cerebral spinal fluid. Specific disorders such as Alzheimer’s disease, hydrocephalus, Chiari Malformation and syringomyelia. Clinical correlation of CSF dynamics to understanding disease process was reviewed including normal and abnormal flow patterns. Recent advancements in fluid flow studies were outlined and presented. Signal intensity changes on MRI study in cervical spondylotic myelopathy was discussed and compared to normal parameters. Fluid dynamics patterns within syringomyelia and Chiari malformation was discussed and correlated to MRI findings and clinical presentations. Spinal microsurgical exploration surgery and resultant CSF leak and spontaneous intractable intracranial hypotension was reviewed and its pathoanatomical presentation outlined. Review of the natural and surgical history of Chiari malformation Type I in pediatric population and clinical correlation with MRI studies. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

NEUROSURGERY

Specialty Research in Neurosurgery – Anatomy and Physiology of the Blood Brain Barrier – Review of consequences of alterations in homeostatic control of the neuronal environment. Discussion of blood flow alterations and altered vessel permeability as determinants in the pathophysiology of brain injury. Review present day literature on the anatomy, development and physiological mechanisms of the blood–brain barrier. The blood brain barrier’s role in the maintenance of the extracellular environment. Vascular anatomy of the spinal cord was review in relation to the physiology of the neural environment. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neurosurgery – Spinal Cord Anatomy, Physiology and Vascular Reactivity – detailed review of the blood supply of the spinal cord, anatomy of the vascular system and physiology of blood flow. Pathophysiology of various conditions including Thoracic Aortic Occlusion and Spinal Cord Injury were discussed with specific relation to risk of neurological deficit. Severity and duration as an effect was reviewed and correlated clinically. Cerebral circulation and aging, discussion of effects on cognitive functioning and cerebrovascular disease in aging. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neurosurgery – Upper Cervical Spine Anatomy and Cerebral Spinal Fluid Flow – MRI flow imaging and computational fluid dynamics in healthy patients with Chiari Malformations.   Review of abnormal cerebral spinal fluid flow oscillations and their effects on healthy patients. Discussion of nonlaminar complex spatial and temporal variations with associated pressure waves and pressure gradients causing syringomyelia, headaches and other clinical manifestations in Chiari I malformation. Microsurgical anatomy and internal architecture of brainstem in 3D images and surgical considerations. CSF hydrodynamic changes, spinal cord injury and development of post traumatic syringomyelia (PTSM). Impact of spinal cord nerve roots and denticulate ligaments on cerebral fluid dynamics in the cervical spine was reviewed and discussed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

 

Specialty Research in Neurosurgery – Compression and Degeneration in Chronic Nerve Root Entrapment – differentiation between peripheral nerves and spinal nerve roots and effects of electrostimulation. Discussion of various stimulating or recording neurosurgical implants and success vs failure rates. Review of the nerve root compression and its relation to consequences of disc herniation and acute compression during surgery. Maximum pressure level a spinal nerve root can sustain is reviewed. Discussion of microsurgical anatomy of lumbosacral nerve rootlets, Rhizotomy and chronic spinal cord injury. Review of qualitative grading of severity of lumbar spinal stenosis on morphology of dural sac on MRI studies, review of classification systems and the consideration of impingement of neural tissue. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neurosurgery – Anatomy of Circle of Willis, Cerebral Arteries and Stroke Etiology – discussion of stroke by embolism, source and cause in diagnosis and long-term treatment. Review of complex nature of embolus transport and its relation to etiology. Image based hemodynamics with discrete particle dynamics in relation to the distribution of emboli across the various cerebral arteries. Detailed anatomy of Circle of Willis reviewed and discussed with particular focus on size/inertia dependent trends in embolus distribution to the brain, distribution of cardiogenic versus aortogenic emboli among anterior, middle and posterior cerebral arteries, left versus right brain preference in cardio-embolus and aortic emboli transport and source-destination relationship for embolisms affecting the brain. Detailed review of the microsurgical anatomy of the posterior cerebral artery in three dimensional images. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

 

Specialty Research in Neurosurgery – Stroke Therapy, Implementation and Cost-Effectiveness – review of endovascular therapy in addition to standard care in acute ischemic vessel occlusion stroke. Comparison in National Institutes of Health Stroke Score (NIHSS) score, symptom onset, Alberta Stroke Program Early CT Score (ASPECTS) and occlusion location. Considerations in acute management and revascularization of tandem occlusions in acute ischemic stroke with literature review. Discussion of Transcirculation Pipeline embolization device deployment as a rescue technique. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neurosurgery – Surgical Approaches and Outcomes in Spine Surgery 1 – review of historical interventions, multilevel decompression and instrumented fusion in reduction of neural compression and spinal column stabilization. Discussion of morbidity and mortality in relation to surgical procedures. The use of the modified fragility index to predict 30-day morbidity and mortality from spine surgery. Differences in patient selection for minimally invasive versus open surgical procedures, and review of post-surgical outcomes. Morbidity, mortality and health care costs for patients undergoing spine surgery following ACGME resident duty-reform. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Neurosurgery – Surgical Approaches and Outcomes in Spine Surgery 2 Predisposing factors for dural tears in lumbar spine surgery including degenerative conditions, prior surgery and age related indicators were reviewed. Discussion and review of re-admission rages in spine surgery through metanalysis and systematic review. Bibliometric study of the most important minimally invasive (MIS) spine surgery papers including Level III and IV studies with focus on moving toward Level I and Level II. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

EMERGENCY MEDICINE

Specialty Research in Emergency Medicine – Emergency Medicine and Spine Pain – review of lack of guidelines for the management of lower back pain in the ED. Frequency of lower back pain visitation in the emergency department including environmental/sociocultural dimensions and physical/psychospiritual dimensions were reviewed. Discussion of utilization of significant healthcare resources with complete description of lower back pain characteristics, health services use in non-urgent lower back pain patients presenting to the ED. Managing spine pain in the ED using usual and customary medical intervention. Extent of appropriate CT and MRI scans in the hospital setting, accessibility reviewed in conjunction with presented national data. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – Medication Usage and Motor Vehicle Accidents – review of ADHD medication utilization and motor vehicle accident data and frequency of motor vehicle accident sin this specific patient population. Review of the prevalent and preventable cause of morbidity and mortality among patients and concepts of restricting based on prognostic factors. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – Emergency Department Imaging Perspectives – review of imaging protocols among a spectrum of clinical indications, perspective on aging populations and clinical complexity. Review of CT, MRI, plain film imaging and ultrasound and their relationships to internal medicine and musculoskeletal disorders examined on an emergency basis through patient generated national survey data. Details of specific contexts in which imaging has become concentrated and targeted efforts for optimization of utilization. considerations of utilization of CT in the emergency department and evaluation to increasing trends. Review of quality improvements in imaging utilization. Comparison between pediatric and adult imaging protocols and trends. Discussion and analysis of “Choose Wisely” recommendations and creating of guideline/policy/clinical pathways in New England EDs. MRI utilization in pediatric ED reviewed and analyzed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – Cauda Equina Syndrome and Other Emergent Conditions – traumatic injuries to the thoracolumbar spine and overall impact on emergency services. Discussion of exact definitions of Conus Medullaris Syndrome (CMS) and Cauda Equina Syndrome (CES). Diagnosis in acute phase and radiological findings clinically correlating with physical examination findings. Parameters for spinal regions of traumatic injury were presented and reviewed. Case presentations for neck and spine were included and reviewed with particular focus on differential diagnosis and case uniqueness. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – Emergency Medicine Residency Curriculum – review of Ohio State University Emergency Medicine Residency Program Musculoskeletal Emergencies Curriculum. Outline of the significant nature of musculoskeletal emergency presentations to ED. Details in the training required to master clinical experience, self-directed learning and small group didactics. Case study reviews and discussion was presented with particular focus on infection vs non-infections and traumatic vs non-traumatic presentations in ED. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – Opioid vs Non-Opioid Medications in the Emergency Department – discussion of limited evidence of long-term outcomes of opioids with non-opioid medication for chronic pain. Literature review on effectiveness for opioid interventions. Discussion of alternative recommendations, evidence demonstrating lack of benefit and poor long term outcomes. Variation in physician opioid prescriptions discussed.   Patterns of opioid initiation at first visits for pain in the ED in the United States including frequency and dosage. Emergency Department data concerning the persistent pain after motor vehicle accidents and comparison between opioid and NSAID prescribed in the ED. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – Concussion and Repeat ED visits – review of patients presenting to ED with concussion with re-visitation within 72 hours. Mechanism of injury including closed head injury, assault, fall and motor vehicle accidents discussed. Epidemiological evidence presented regarding number of visitations, characteristics and care paths reviewed. Discussion of adoption of a more comprehensive discharge plan to further prevent repeat visits was outlined. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – CDC Epidemiology of ED Visits in the United States, Adults Over 65 and Motor Vehicle Accidents – Evaluation of data from the National Hospital Ambulatory Medical Care Survey and frequency of ED visitation. Percentage of visits requiring hospital admission was reviewed along with patterns of need for critical care. Review of imaging ordering statistics and clinical diagnosis was discussed. Details of primary and secondary ED diagnosis presented in relation to sprain/strain, contusion and spinal pathology including herniated intervertebral disc, facture and spinal cord compression. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – National Hospital Ambulatory Medical Care Survey – a review of the current representative data on ambulatory care visits to hospital emergency departments in the United States. Demographics, residence, insurance class, chief complaint with focus on traumatic injury, diseases of the nervous and musculoskeletal systems were outlined. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – Lower Back Pain and Emergency Room Visits – detailed analysis of impact of lower back pain on ED globally. First systematic review of the trends in the literature including lower back pain as significant complaint and the variables in its definition.   Discussion of the proper diagnosis and triage of lower back pain and its current impact on ED management was reviewed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – Spinal Cord Injury without Radiographic Abnormality (SCIWORA) in Adults – case reports – detailed review of Spinal Cord Injury without Radiographic Abnormality was presented. Syndrome of post traumatic myelopathy demonstrable on MRI with no evidence of osseous injury on plain film or CT scan. Reporting of incidence was included with detailed discussion of case presentations, accurate diagnoses and triage was reviewed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – CDC Traumatic Brain Injury Data – Related Emergency Department Visits, Hospitalizations, Deaths – United States, 2007 and 2013 – traumatic brain injury, short and long term adverse clinical outcomes, death and disability reviewed and compared based on CDC data over a 7 year period. Mechanism of causation including motor vehicle accidents, falls and assault. Public health recommendations and interpretation of data was presented. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Emergency Medicine – CDC Data, Trends in Emergency Department Visits for Ischemic Stroke and Transient Ischemic Attack – relationship between stroke and statistical cause of death, type of stroke and prognosis related to recurrence was discussed. Specific definitions of ischemic stroke, transient ischemic attack with etiology and relationship to emergency visits were outlined and presented. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

 

Specialty Research in Emergency Medicine – US Emergency Department Use by Children – pediatric utilization of emergency medicine resources, description of trends on a national basis. Detailed analysis of specific demographics including race and resident status were reported and reviewed. Discussion in allocation of resources including insurance class and coverage were reviewed. Anticipated expansion of Medicaid was considered and reviewed. Estimates of nonurgent ED visits by children were presented and discussed. Academy of Chiropractic, State University of New York at Buffalo, Jacobs School of Medicine, 2019

PRIMARY CARE/INTERNAL MEDICINE

Specialty Research in Primary Care and Internal Medicine – Supply of Chiropractic Care and Visits to Primary Care Physicians for Neck and Back Pain – discussion of primary care visits and lower back pain. Expenditures and contributions to disability data.   Discussion of supply of chiropractic care in context of visits for lower back pain and primary care physicians. Estimated national impact of primary care visits and expenditures was outlined with a focus on chiropractic’s assistance in managing lower back pain. Defining an “episode” of lower back pain and relationship to collection of epidemiological data. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Primary Care and Internal Medicine – Safety of Chiropractic Care in Lower Back Pain and Migraine Headaches – review of adverse events associated with chiropractic care in the treatment of migraine. Outline of a prospective 3-armed, single-blinded, placebo RCT. Discussion of transient and mild events following chiropractic intervention. Randomized clinical trials and meta-analysis reviewed and discussed relating to the diagnosis and management of lower back pain including adverse event reporting. Risk of injury to the head, neck or trunk following an office visit for chiropractic spinal manipulation, as compared to office visit for evaluation by primary care physician.

Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Primary Care and Internal Medicine – Chiropractic and Pain Management in Primary Care – evaluation of the analgesic effects of spinal manipulation on both healthy and pain inflicted patients. Discussion of evidence of increased in pressure pain thresholds in musculoskeletal pain at both local and remote sites. Detailed knowledge of patient population regarding demographics and socioeconomic factors as well as disease-specific characteristics. Suggestion that lower back pain should not be seen as benign and self-limiting with focus on management. Describe the communication system surrounding the management of chronic pain from the perspectives of allopathic providers, acupuncture and chiropractor providers, and chronic musculoskeletal pain patients.   Chiropractic manipulative treatment (CMT) association with lower healthcare costs among multiply-comorbid Medicare beneficiaries with an episode of chronic low back pain was reviewed. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Primary Care and Internal Medicine – Perceptions of Chiropractic Care – demographic review of data on the perceptions of chiropractic care. Review of patient interest, trustworthiness, costs and frequency of visits was discussed. Nationally representative survey to compare characteristics and use of survey respondents with positive and negative perceptions of DCs and chiropractic care. Positive perceptions of DCs were more common than those for chiropractic care. US adults generally perceive DCs in a positive manner. Describe the preferences of older adults for low back pain co-management by MDs and DCs and identify their concerns for receiving care under such a treatment model. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Primary Care and Internal Medicine – Chiropractic and Post-Surgical Care and Care for Veterans – discussion of persistent post-surgical lower back and radicular pain response to chiropractic care. Relevant anatomy related to lower back pain and intervertebral disc injury was outlined and presented. Discussion and development of an integrated care pathway for doctors of chiropractic, primary care providers, and mental health professionals who manage veterans with low back pain, with or without mental health comorbidity, within Department of Veterans Affairs health care facilities. Support for the inclusion of chiropractic care as a component of multidisciplinary health care for low back pain, as currently recommended in existing guidelines with a focus on US Service Members. Discussion of availability of chiropractic care to military healthcare systems, referral and interprofessional communication models. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

 

Specialty Research in Primary Care and Internal Medicine – Effects of Chiropractic Care Combined with Medical Care, First Contact and Provider Type – differences in outcomes, patient satisfaction, and related healthcare costs in spinal, hip, and shoulder pain patients who initiated care with medical doctors (MDs) vs those who initiated care with doctors of chiropractic (DCs). Pain of muscuoloskeletal origin and epidemiology of reduced productivity. Comparison of data on health outcomes, patient satisfaction, and related healthcare costs in patients consulting differing first-contact care providers for musculoskeletal pain. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Primary Care and Internal Medicine – Integrating Chiropractic Care into Primary Care and Private Sector Healthcare Facilities – suggestion of a diverse role for chiropractors within conventional health care facilities. Discussion of chiropractic’s effectiveness for managing musculoskeletal disorders, particularly spine-related pain and disability. Descriptions of doctors of chiropractic who work in nongovernmental, private sector health care settings in the United States. Shared electronic health records, face-to-face informal consultations methods for interprofessional communication. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Specialty Research in Primary Care and Internal Medicine – American College of Physicians – Guideline Recommendations – Non-Invasive and Non-Pharmacological - American College of Physicians (ACP) developed this guideline to present the evidence and provide clinical recommendations on noninvasive treatment of low back pain. Systematically review the current evidence on non-pharmacologic therapies for acute or chronic non-radicular or radicular low back pain. Comparative benefits of non-pharmacological therapies in acute/subacute low back pain including exercise, spinal manipulation, lumbar supports, acupuncture, laser, ultrasound and traction. Discussion of first and second line therapies with reduction in opioid prescription. Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, ACCME Joint Sponsorship with the State University of New York at Buffalo, Jacobs School of Medicine, 2019.

Documentation in Medical Collaborative Cases, Concluding an E&M report in cases involving medical primary care providers of medical specialist 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. Academy of chiropractic, Long Island New York, March 2019

MRI Spine Interpretation and Protocols, contemporary acquisition protocols including slice thickness 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, extradural and dural pathology. Academy of chiropractic, Long Island, New York, March 2019

Ethics and Medical Collaboration, having referral relationships with emergency rooms, neurosurgeons, orthopedic surgeons, pain management specialist, neurologist, neuroradiologist and medical primary care providers based upon clinical dilemmas that processed after a thorough history, examination and imaging if clinically indicated to be 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. Academy of chiropractic, Long Island, New York, March 2019

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 carriers in the courts and ethical relationships that concurrently matches the standards of both contemporary academic requirements and contemporary literature-based. Academy of Chiropractic, New York, March 2019

 

Documenting Trauma and Non-Traumatic Cases & Triaging Disc Pathology, triage, care and collaboration for herniated, bulged, protruded, extruded and fragmented spinal disc. 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 in 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

 

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 evaluation. Collaborative protocols with neurologist, neurosurgeons, orthopedic surgeons, pain management and primary medical care providers with mechanical and anatomical spinal pathologies. Academy of Chiropractic, Cleveland University- Kansas City Chiropractic Health Sciences, Long Island, New York, 2018.

 

Evidence-Based Care in a Collaborative Setting; Primary Spine Care 5, a literature-based model for collaborating with hospitals, medical primary care providers and specialist, 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, Academy of Chiropractic Post-Doctoral Division, Cleveland University-Kansas City, Long Island, 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. The basics of MRI spine interpretation inclusive of all types of herniation’s, bulges, Academy of Chiropractic Post-Doctoral Division. Cleveland University-Kansas City, Long Island, New York, 2018

Spine Brain Connection in Pain Pathways; Primary Spine Care 5, MRI spine, spine-brain connection in managing chronic pain patients. Understanding how chronic pain negatively affects brain morphology and potential pathology as a sequelae. The role of chiropractic in preventing the loss of gray matter in the most recent evidence as outlined in indexed peer-reviewed literature over the last 10 years verifying chiropractic’s role, Academy of Chiropractic Post-Doctoral Division, Cleveland University-Kansas City, Long Island, New York, 2018

Bio-Neural Mechanical Mechanisms of the Chiropractic Spinal Adjustment; Primary Spine Care 5, the biological, neurological and mechanical mechanisms and pathways from the thrust to the lateral 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, Long Island, New York, 2018

Connective Tissue Pathology, Spinal Biomechanics as a Sequelae to Trauma, MRI spine interpretation, ordering protocols and triaging the injured, the latest research on six 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. To neurology and pathology of connective tissue and a sequelae of trauma at the biomechanical level leading to bio-neural-mechanical failure. Contemporary “evidence-based building blocks” for triaging in a collaborative environment. Cleveland University – Kansas City, Chiropractic and Health Sciences, Academy of Chiropractic, Post-Doctoral Division, Long Island, New York, 2018

Spinal Biomechanical Engineering Digitizing, integrated automated menstruation into creating treatment plans and determining maximum medical improvement. A literature-based study of normal versus abnormal motor unit function. Determining ligamentous laxity, alterations 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, New York, 2018

Science of the Chiropractic Spinal Adjustment and Vertebral Subluxation, the literature-based definition of both the mechanics of the chiropractic adjustment and how it affects the central nervous system in pain pathways and systemic issues that is the arbiter for normal versus abnormal function. “Psychological mechanism” of how the chiropractic adjustment affects the peripheral and central nervous systems. Subluxation Degeneration/Wolf’s law will be detailed from a literature perspective combined with the mechanism of subluxation (bio-neural-mechanical lesion) a literature perspective why “long-term” chiropractic care is clinically indicated as usual and customary to effectuate demonstrable biomechanical changes in the spine. And evidence-based perspective of why physical therapy is a poor choice for the spine as a first 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 New York, 2018

Documentation, Collaboration, and Primary Spine Care, an academic basis for documentation that is usual and customary cross professions in collaborative care. Maintaining ethical medical legal relations ships based upon Voir Dire and Duabert standards with ensuring a “4 corners” inclusive report ensuring primary care status based upon an academic standards. Cleveland University – Kansas City, chiropractic and health sciences, Academy of chiropractic post-doctoral division, Long Island, New York, 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, final examinations, neurological examination, orthopedic testing, test orders, prognosis and treatment plan. A detailed review of current CPT coding requirements for the proper documentation E/M visits to properly code for billable patient services. Focused attention was paid to the performance of a comprehensive patient history, physical examination, review of systems as well as determining the level of clinical decision-making. Analysis of a proper organized E/M report was reviewed to demonstrate proper organization and language use. Cleveland University – Kansas City, Academy of Chiropractic, Postdoctoral 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 medical specialty communications been getting the initial visitation all the way through to the release from care. And internal compliance review to ensure complete documentation based upon the Ian him level build, Cleveland University – Kansas City, Academy of Chiropractic, Postdoctoral Division, Long Island, New York, 2018

Spine-Brain Connection in Pain Pathways; Primary Spine Care 5, the spine brain connection in managing chronic pain patients. Understanding how chronic pain negatively affects brain morphology and pathology as a sequelae. 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. Academy of Chiropractic Post-doctoral Division, Cleveland University, Kansas City, Long Island, New York, 2018

Spinal Bioengineering 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 covert 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 structural analysis. The normal movement of gait are integrated in the total biomechanical approach to explain spine distortion, predictable functional scoliosis and lumbar disc failure. Case studies are demonstrated to radiographic analysis and physical findings to determine clinical solutions and soft tissue rehabilitation. PACE recognized By the Federation of Chiropractic Licensing Boards, Arlington Heights, Illinois, 2017

Ethics, Documentation and Research, Primary Spine Care, maintaining ethical interprofessional relationships based upon an evidence-based practice inclusive of triage, diagnostic and reporting. Creating through documentation that reflects your complete findings encompassing descriptive ICD 10 codes and concluding the presence or absence of pathology. Academy of Chiropractic Post-doctoral Division, PACE Recognized by the Federation of Chiropractic Licensing Boards, Long Island, New York, 2017

Bio-Neural-Mechanical Lesion’s and Spine Care, Primary spine care, Mechanical receptor, propriceptor, nociceptors innervation and control of spinal system with central nervous system action and interaction. The integration of the pain processing network and the HPA Axis (hypothalamus, adrenal and pituitary) with the chiropractic spinal adjustment, Academy of Chiropractic Postdoctoral Division, PACE Recognized by the Federation of Chiropractic Licensing Boards, Long Island, New York, 2017

Connective Tissue Pathology and Research, Primary Spine Care, utilization and spinal models considering the opioid abuse and various spinal models in contemporary healthcare. Care paths for mechanical spine pain and the evidence for conservative chiropractic care. Academy of Chiropractic Postdoctoral Division, PACE recognize By the Federation of Chiropractic Licensing Boards, Long Island New York, 2017

Connective Tissue Spinal Disc Permanent Pathology, Primary Spine Care, herniated, bulged, protruded and extruded discs, etiology and morphology. Age dating disc pathology inclusive of Modic changes, piezoelectric effect, Wolf’s law and redicular clinical presentation. Academy of Chiropractic Postdoctoral Division, PACE recognized By the Federation of Chiropractic Licensing Boards, Long Island, New York, 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 or PACE Recognized By the Federation of Chiropractic Licensing Boards.) ACCME Joint Providership with the State University of New York at Buffalo, Jacobs School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2017

Stroke Anatomy and Physiology: Stroke Types and Blood Flow, Various types of stroke identifying ischemia, hypoperfusion, infarct and penumbra zone and emboli. Cardiac etiologies and clinical features as precursors to stroke with associated paradoxical and emboli and thrombotic etiology. Historical and co-morbidities that have etiology in stroke inclusive of diabetes, coagulopathy; acquire and hereditary deficiencies, (Texas Chiropractic College and

PACE Recognize by the Federation of Chiropractic Licensing Boards,) ACCME Joint Provider- ship with State University of New York at Buffalo, Jacobs School of Medicine and Biomechanical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo New York 2017

Stroke Principles of Treatment an Overview for the Primary Care Provider, Stroke type and treatments performed by vascular specialist. The goal of treatment with the physiology of the infarct and number of zones and the role of immediate triage in the primary care setting. Detailing the compli”urser’s requirements for complete documentation. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post-Doctoral Division, Long Island, NY, 2017

Course Objective: To be able to document historical and clinical findings meeting the standards of academia, licensure boards, the courts and the carriers.

Course Goals: To teach the student how to compliantly document the findings of a complete evaluation, inclusive of clinical findings and management of the patient meeting the standards of academia, licensure boards, the courts and the carriers.

Evidence Based Spine Care: Epidemiology of spine care, the opioid epidemic and spinal manipulation for pain management.  Functional neuroanatomy and neurochemistry of pain perception, including descending modulation of pain in the central nervous system.  Review of specific research outlining spinal manipulations influence on the central nervous system in the spine pain patient.  Clinical assessment and interprofessional communications relating to the diagnosis and management of the mechanical spine pain patient.  Academy of Chiropractic, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Denver, Colorado, April 2017

Evidence Based Spine Care:  Spinal biomechanics and response to trauma. Detailed review of spinal instability, mechanical spine trauma and global spinal biomechanical balance.  The influence of spinal sagittal curvature, pelvic incidence, sacral slope and pelvic tilt on conservative and surgical care outcomes. Clinical correlation with radiographic and advanced imaging findings specific to the spine pain patient. Academy of Chiropractic, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Denver, Colorado, April 2017

Evidence Based Spine Care:  Coordination of care and clinical documentation associated with interprofessional communication.  Focus on the safety of chiropractic management of the spine pain patient and review of research related to specific phases of care, acute intervention, corrective care and health maintenance care were reviewed.  Documentation and workflows related to an interprofessional team approach focusing on compliance and delivery in the modern practice environment.  Academy of Chiropractic, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Denver, Colorado, April 2017

Primary Spine Care Symposium-Interprofessional Spine Care, Clinical analysis anatomical versus biomechanical spine pain and clinical triage protocols. Relating current research trends In the Whole Spine Model of patients including normal versus abnormal sagittal curvature in the adolescent and adult spine, pelvic incidence as a parameter for spinal balance in the human spine and current methods of assessment. Patient centered approach to Evidence-Based Spine Care with a focus on diagnosis, prognosis and triage of the spine pain patient, Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville New York 2017

Primary Spine Care Symposium -- Connective Tissue and Spinal Disc Pathology, The morphology and pathology of connective tissue, inclusive of spinal disc disorders and prognosticating wound repair with permanency implications. Disc bulges, herniation, protrusion and extrusions classifications based upon contemporary literature and how to age date disc pathology, Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville New York 2017

Primary Spine Care Symposium -- Epidemiology Spine Pain, Review of the current Centers For Disease Control (CDC) data on the frequency of musculoskeletal pain in the United States population with emphasis on pain spinal origin. CDC guidelines on opioid medication were discussed and correlated to persistent pain syndromes. Research was reviewed showing the importance of managing the spine pain patient properly from the entry point of care with a concentration on maintenance spinal biomechanics, Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville New York 2017

Primary Spine Care Symposium -- Physiology and Anatomy of Spinal Manual Adjusting, Understanding the role mechanical receptors, proprioceptors and nociceptors with facets, ligaments, tendons and muscles in aberrant spinal biomechanics. MRI and imaging studies decompressing via a chiropractic spinal adjustment of the bio-neural-mechanical lesion and its effects on the central nervous system both reflexively and supratentorally. Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville, NY 2017

Primary Spine Care Symposium- Medical Legal Documentation, the contemporary documentation required in a medical-legal environment that is evidenced-based and meets the standards of the courts and academia. Utilizing the scientific data to support the diagnosis, prognosis and treatment plan while meeting the admissibility standards based upon a professionals credentials. Texas Chiropractic College Post-Doctoral Division, Academy of Chiropractic Post-Doctoral Division, Melville, New York, 2017

MRI on 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 spondylolisthesis, spinal canal stenosis, Modic type 3 changes, central herniations, extrusions, compressions, nerve root compressions, advanced spurring and thecal sac involvement from an orthopedic, emergency room, chiropractic, neurological, neurosurgical, physical medicine perspective.  [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016

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.  [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016

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. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], ACCME Joint Providership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, NY, 2016

Head Trauma, Brain Injury and Concussion, Brain and head physiology, brain mapping and pathology as a sequella to trauma. Traumatic brain injury, mild traumatic brain injury, axonal shearing, diffuse axonal injury and concussion are detailed in etiology and clinically. Clinical presentation, advanced diagnostic imaging and electrodiagnostics are detailed in analysis to create a differential diagnosis. Balance disorders that often occur as a result of trauma are also explored from clinical presentation to advanced imaging and differential diagnosis. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards],Academy of Chiropractic Post-Doctoral Division,Long Island, NY, 2016

Mild Traumatic Brain Injury, Traumatic Brain Injury and Concussion, Brain and head physiology, brain mapping and pathology as a sequella to trauma. Traumatic brain injury, mild traumatic brain injury, axonal shearing, diffuse axonal injury and concussion are detailed in etiology and clinically. Clinical presentation, contemporary and advanced diagnostic imaging and electrodiagnostics are detailed in analysis to create a differential diagnosis. Balance disorders that often occur as a result of trauma are also explored from clinical presentation to advanced imaging and differential diagnosis. [Texas Chiropractic College or PACE Recognized by The Federation of Chiropractic Licensing Boards], Academy of Chiropractic Post- Doctoral Division,Long Island, NY, 2016

New Blood Biomarkers Useful for Concussion Diagnosis, The utilization of GFAP and UCH-l-1 in determining, traumatic brain injury, mild traumatic brain injury and mild-moderate traumatic brain injury as a triage tool to manage head trauma patients, Accreditation Council on Continuing Medical Education in cooperation with Medscape, June 2016

 

Primary Spine Care -- Central Nervous System Process of Pain Physiology, Central neural pathways of pain and higher cortical responses to pain and the effect of high amplitude-low velocity forces on mechanical receptors and proprioceptors. They affect neuropeptides, hypothalamus, pituitary and adrenal axis when treating patients. Texas Chiropractic College, Academy of Chiropractic, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Melville New York, 2016

Primaries Spine Care – MRI, Bone, and Degeneration, the effects of trauma on spinal vertebral segments and the short and long-term sequela to morphology, identifying and diagnosing bone edema, spurring, type of degeneration in assessing biomechanical stability in conjunction with Modiic and Pfeiffer changes. Texas Chiropractic College, Academy of Chiropractic, Academy of Chiropractic, Recognized by the PACE Program of the Federation of Chiropractic Licensing Boards, Melville New York 2016

Primary Spine Care -- Hospital and Emergency Room Care, Identifying spinal lesions inclusive of cord and root lesions through examination and advanced imaging in creating and accurate diagnosis, prognosis and treatment plan to effectively in collaboration and coordination with medical specialists and emergency department physicians. Differential diagnosing and triaging this degenerative bulges, dramatic disc bulges, protrusions herniations, extrusions herniations and fragmented herniation along with managing traumatically induced pain as sequelae to degenerative disc trauma, Texas Chiropractic College, Academy of chiropractic, Academy of chiropractic, Recognized by the PACE Program the Federation of Chiropractic Licensing Boards, Melville New York 2016

 

MRI Spine Interpretation and Spinal Biomechanical Engineering-Primary Spine Care, Correlating spinal biomechanics secondary to trauma and MRI findings inclusive of herniation, bulging, protruded and extruded discs. Correlating co-efficient of forces translated form the bullet vehicle to the target vehicle to the occupant in determining causality of bodily injury, Academy of Chiropractic, PACE approved for the Federation of Chiropractic Licensing boards, Texas Chiropractic College, Las Vegas NV, 2015

Evidenced Based Inter-Professional Collaboration- Primary Spine Care, Chiropractic as Primary spine care based upon the literature conclusions and the documentation requirements to support those conclusions in an ethical collaborative environment inclusive of hospitals, emergency rooms, primary care medical doctors and medical specialists. Academy of Chiropractic, PACE approved for the Federation of Chiropractic Licensing boards, Texas Chiropractic College, Las Vegas NV, 2015

Contemporary Literature Review of the Chiropractic Adjusting Mechanisms- Primary Spine Care, The latest scientific evidence of the effects of the chiropractic spinal adjustment on the central nervous system, both upper and lower motor neurons. A comparative analysis of chiropractic vs. other modalities and therapies, Academy of Chiropractic, PACE approved for the Federation of Chiropractic Licensing boards, Texas Chiropractic College, Las Vegas NV, 2015

 

MRI History and Physics, Magnetic fields, T1 and T2 relaxations, nuclear spins, phase encoding, spin echo, T1 and T2 contrast, magnetic properties of metals and the historical perspective of the creation of NMR and MRI. ACCME joint sponsorship with the state of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral division, Buffalo, New York, 2015

MRI Spinal Anatomy and Protocols, normal anatomy of axial and sagittal views utilizing T1, T2, 3-D gradient and STIR our sequences of imaging, standardized and desired protocols infuse and sequencing of MRI examination to create an accurate diagnosis and MRI. ACCME joint sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2015

MRI Disc Pathology and Spinal Stenosis, MRI interpretation of bulged, herniated, protruded, extruded, sequestered and fragmented disc pathologies and etiology and neurological sequelae in relationship to the spinal cord and spinal nerve roots. ACCME joint sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences,   Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2015

MRI Spinal Pathology, MRI interpretation of bone, intra-dural, extradural, cord and dural sleeve lesions, tuberculosis, dropped lesions, metastasis, ependymoma, schwanoma and numerous other spinal related tumors and lesions. CCME Joint sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences,  

Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2015

MRI Methodology of Analysis, MRI interpretation sequencing of cervical, thoracic and lumbar spine inclusive of T1, T2, STIR and 3-D gradient studies to ensure the accuracy diagnosis of the region visualized. New York Chiropractic Counsel, ACCME joint sponsorship with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences, Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2015

MRI Clinical Applications, the clinical application of the results of space occupying lesions. Disc and tumor pathologies and the clinical indications of manual and adjusted therapies of the patient was spinal nerve root and spinal cord insult as a sequelae. ACCME joint sponsorship the State University of New York at Buffalo, School of Medicine and Biomedical Sciences   Academy of Chiropractic Post-Doctoral Division, Buffalo, New York, 2015

Credentials and Clinically Correlating Causality, The significance documentation and credentials in personal injury field with a focus clinically correlating causality, bodily injury and persistent functional loss as a sequellae, Academy of Chiropractic Post-Doctoral Division, New York State Department of Education, Board for Chiropractic, Long Island, NY 2011

Functional Blood Chemistry Analysis, Functional range indication, Adrenal gland markers, Sugar disorders, Thyroid gland management, Gastrointestinal disorders, Liver and gallbladder assessment, Blood chemistry patterns, Lipid and Cardiovascular markers, Special test and tumor markers, Nutritional protocols, University Bridgeport College of Chiropractic, Post Graduate Department. Bridgeport, CT. Fort Lauderdale, FL. 2011

Neurodiagnostics, Imaging Protocols and Pathology of the Trauma Patient, An in depth understanding of the protocols and triaging and reporting the clinical findings of the trauma patient. Maintaining ethical relationships with the medical-legal community. CMCS Postdoctoral Division, New York Chiropractic Counsel, New York State Department of Education, Board for Chiropractic, Long Island, New York, 2010

Diagnostics, Risk Factors, Clinical Presentation and Triaging the Trauma Patient, An extensive understanding of the injured with clinically coordinating the history, physical findings and when to integrate neurodiagnostics. An understanding on how to utilize the emergency room records in creating and accurate diagnostic and the significance “risk factors” in spinal injury. CMCS Postdoctoral Division, New York Chiropractic Counsel, New York State Education Department, Board of Chiropractic, Long Island, New York, 2010

Crash Dynamics and Its Relationship to Causality, An extensive understanding of the physics involved in the transference of energy from the bullet car to the target car. This includes G’s of force, newtons, gravity, energy, skid marks, crumple zones, spring factors, event data recorder and the graphing of the movement of the vehicle before, during and after the crash. Determining the clinical correlation forces and bodily injury. CMCS Postdoctoral Division, New York Chiropractic Counsel, New York State Education Department, Board of Chiropractic, Long Island, New York, 2010

MRI, Bone Scan and x-ray Protocols, Physiology and Indications for the Trauma Patient, MRI interpretation, physiology, history and clinical indications, bone scan interpretation, physiology, and clinical indications, x-ray clinical indications for the trauma patient.

CMCS Postdoctoral Division, New York Chiropractic Counsel, New York State Education Department, Board of Chiropractic, Long Island, New York, 2010

Neurodiagnostic Testing and Protocols, Physiology and Indications for the Trauma Patient, Electromyography (EMG), Nerve Conduction Velocity (NCV), Somatosensory Evoked Potential (SSEP), Visual Evoked Potential (VEP), Brainstem Auditory Evoked Potential (BAER), and Visual-Electronystagmosgraphy (V-ENG) interpretation, protocols and clinical indications for the trauma patient, CMCS Postdoctoral Division, New York Chiropractic Counsel, New York State Education Department, Board of Chiropractic, Long Island, New York 2010

Documentation and Reporting for the Trauma Victim, Understanding the necessity for accurate documentation and diagnostic utilizing the ICD-9 and the CPT to accurately describe the injury through diagnosis. Understanding and utilizing state regulations on reimbursement issues pertaining to health care. CMCS Postdoctoral Division, New York Chiropractic Counsel, New York State Education Department, Board for Chiropractic, Long Island, New York, 2010

Documenting Clinically Correlated Bodily Injury to Causality, Understanding the necessity for accurate documentation, diagnoses and clinical correlation to the injury when reporting injuries in the medical-legal community. Documenting the kinesiopathology, myopathology, neuropathology, and pathophysiology in both a functional and structural paradigm. CMCS Postdoctoral Division, New York Chiropractic Counsel, New York State Education Department, Board for Chiropractic, Long Island, New York, 2010

Impairment Rating and the Law, the American Medical Association’s Guides to the Evaluation of Permanent Impairment, 6th Edition. Clinically coordinating spinal pathology and neurological function sequelae including station and gait, migraines, radiographic disorders and central nervous system disorders. New York Chiropractic College, Florida Chiropractic Association, Orlando FL, 2009

Collision Reconstruction for the Medical Practitioner, Collision analysis, delta V forces, the reconstruction of low-speed collision theory, biomechanics, physical parameters, occupant kinematic, restraints, human subject tolerances, and biomechanics of spinal injuries. Texas A&M University, Department of Engineering, American Academy Manual and Physical Medicine, Las Vegas, NV, 2002

The New Era in Whiplash and Spinal Trauma, Part 1, Review of new treatment protocols for acute soft tissue injuries. Life West Chiropractic College, Fort Lauderdale, FL, 2001

The New Era in Whiplash and Spinal Trauma, Part 2, Diagnosis, x-ray, MRI and documentation of soft tissue injuries. Life West Chiropractic College, Fort Lauderdale, FL, 2001

Whiplash & Spinal Trauma, Documentation and case management of acute cervical and lumbar soft tissue injuries. Life West Chiropractic College, Atlanta, GA, 1997

Cervical Spine Rehabilitation, Diagnosis and rehabilitation protocols of cervical spinal weakness. University of Florida, College of Medicine, Department of Health and Human Performance, Gainesville, FL, 1989

Lumbar Spine Rehabilitation Diagnosis and rehabilitation protocols of lumbar spinal weakness. University of Florida, College of Medicine, Department of Health and Human Performance, Gainesville, FL, 1989

Honors & Awards

Graduated Cum Laude, Palmer College of Chiropractic, 1979

Selected Memberships

American Chiropractic Association, Member,      2008-Present

Florida Chiropractic Association, Member,          2007-Present

Collier County Chiropractic Association,            2000- Present