Hello Professionally Integrated! Here is a great study published in Brain Injury, July 2010. The authors looked at two groups. One non injured group, and one in a crash and symptomatic. They imaged these people in a supine, non weight bearing MRI and in an upright MRI. The evaluated Chiari. Chiari Type I malformation is traditionally defined as caudal herniation of the… Read More
Hello Professionally Integrated, I wanted you all to have this. This is a letter that got Published in “The Spine Journal” where I was the author. Many studies suggest car crashes can cause upper cervical damage. There was a paper that got published that eluded to the possibility that it will not cause damage. If a Insurance company tries to… Read More
Hello Professionally Integrated. Here is a finite element study where the authors evaluated C2-C3 during “whiplash” simulation. During the evaluation they recorder many ligamentous areas of the spine and how they react, or fail during a “whiplash” mechanism. This is important for us to know as it will only help us understand and identify common injuries in crashes that in… Read More
Here is a paper that I explain in this video Lumbar stenosis surgery compared to non surgical intervention has no better outcomes but increases bad side effects. I feel if our patients are happy with the care, than we can justify our treatment. Conclusion. We cannot conclude on the basis of this review whether surgical or nonsurgical treatment is better… Read More
Here is a great study where the authors looked at whiplash associated disorders (WAD) and TMJ pain and dysfunction. Professionally Integrated would like you to have this paper as it shows a clear relationship with car crashes, neck injuries and jaw pain. These authors have shown how the neck is closely related to the TMJ and in my opinion the… Read More
Here is a study Professionally Integrated wants you to be familiar with. This study shows how head and neck position and or direction of the impact, will increase the possibility of injury to the cervical spine. I feel this is important to know because in a trauma, like a car crash, knowing our patients head postilion is more clinically relevant… Read More
Here is a study that discusses the roles of the ligaments of the upper cervical spine. These are important to have on hand so if we see abnormal movement on a DMX or image, we can determine which ligament may be involved and what position may be better or worse for our patients. Transverse Ligament: The transverse ligament is the major… Read More
Being able to take our patients subjective complaints and correlate them to research is a wonderful starting point to 1) help our patients 2) validate our diagnosis 3) validate our treatment recommendations. This is the core at Professionally Integrated. To be the best doctors we can be to our patients. Here is a study where the authors examined lumbar instability,… Read More
Here is not a study but a story that I find interesting. I find it interesting that when a professional athlete injures a ligament in the extremity (not even in the spine where the CNS is at risk), it is fully accepted that 1) it hurts 2) the player can not function 3) may require surgery. No one is questioning… Read More
Here is a paper that basically discusses how too many factors in the real world are important when it comes to evaluating a patient. Many insurance companies will look at car damage. This paper looked at real world “black boxes” from car crashes and bodily injury. The authors basically concluded that patient position, if the car had a tow bar,… Read More
Dear Professionally Integrated, Here is a VIDEO and PAPER to educate on why “PAIN” and “SPASM” is not a full diagnosis. I have used this many times to educate why a patient with THIS DIAGNOSIS will need ongoing care. This explains how true spinal subluxations and injuries can cause pain and spasm. I use this to educate patients as to… Read More
Hello Professionally Integrated, Here is another video and break down of a paper to help educate your patients and improve documentation to help validate your care. In this paper that authors look at an evaluate many MRIs and they measure many areas to look at the difference between patients in pain and those not in pain. Understanding these findings help… Read More
Hello Professionally Integrated, So many different injuries can occur in car crashes. Body and head position can play a major role into potentially increasing damage to certain structures of the neck. As a member, you have access to this information to keep you informed which will only increase your confidence leading to excellence. Here is a paper where the authors… Read More
Hello professionally integrated, Here is a paper where the author discusses many papers that he has published on cervical and lumbar instability and the long-term consequences of this pathology. Many docs are taught to identify instability to increase the value of the motor vehicle claim. However, many docs do not understand what the long-term implications are and what we can… Read More
Dear Professionally Integrated, Here is a paper that shows differences on MRI’s in the cervical spine between crash patients and non crash patients. This is a significant finding and we should start asking our MRI radiologists if they can start mentioning this finding so we can document it and educate our patients. Plus, this study also shows that a LARGE… Read More
Hello Professionally Integrated, Here is a paper where the authors used ultrasound to compare muscle function of MVC patients and non MVC patients and their was a significant difference. Now, we need to look at why are some of these muscles active, non active, and stretched? Is it due to abnormal sagittal alignment, instability, etc?? This site has numerous papers… Read More
Hello Professionally Integrated, Here is a paper where the authors looked at a “whiplash like injury”, but they looked at the injury that was caused by the “whiplash”. The authors found that a specific injury was causing pain and a decreased quality of life, and that about 50% of patients that suffer a whiplash like injury, can not be cured… Read More
Hello Professionally Integrated, here is a paper that helps us understand what signs to look for on imaging that can lead to worse outcomes. I believe we need to educate our patients about how our care can help minimize LONG TERM health problems. “Not all patients with spinal cord compression due to cervical spondylotic myelopathy (CSM) have clinical symptoms and… Read More
Hello Professionally Integrated, Here is a paper where the authors looked at multiple dens fractures and basically found that sagittal alignment played a bigger role than the force of the impact. I feel this is a good study demonstrating that impact (like in crashes with little car damage) is not the main factor in injury. Lets take a look at… Read More
Hello Professionally Integrated, Here is a paper that will help you be a better Chiropractor and allow you to educate more patients and separate your clinic, from all the others in town. In this paper, the authors discuss how a loss of curve, cervical kyphosis, and/or instability is a condition that will lead to further problems and decrease the patient’s… Read More
Hello Professionally Integrated, Here is a great video you need to implement for patient education and VALIDATING your care. As a member you will be given what you need on a “silver platter” to educate, document, and increase your referrals based on your expertise. Abstract: Ligament injuries are among the most common causes of musculoskeletal joint pain and… Read More
Hello Professionally Integrated, Here is a paper where the authors evaluated many different changes associated with a car crash, one of them being a change in “Blood Velocity”. I hope you have always heard me say that “whiplash” is NOT a diagnosis, but a mechanism of injury. ‘Whiplash” can cause no injuries or death and everything in between. Be sure… Read More
Dear Professionally Integrated, Here is a paper where the authors examined a patient who was in a “very low impact” collision that caused a VERY serious injury. I use this paper in my notes and education of patients that no link has been made to car damage and bodily injury. This paper also discusses how important other factors are in… Read More
Hello Professionally Integrated, Here is a paper and breakdown for your notes and education. The authors looked at multiple criteria on what is needed to properly evaluate instability in the cervical spine. The authors did not mention C1/2 translation, but I have a paper on that topic coming out soon. Be sure to do a FULL examination, and history as… Read More
Hello Professionally Integrated, Here is a paper I authored and had published in the peer reviewed journal ” The Journal Of Legal Nurse Consulting”. In this paper I discuss Digital motion X-ray and some of the findings it can detect. I discuss how a loss of the cervical curve is linked to crashes as well as pathologies, both short and… Read More
Here is a reference for instability measurements according to AMA guidelines.   . . . You either need to log in or a different subscription to view this page. Sign Up Now!… Read More
Here is a study I helped author. This study shows that car crashes can and do cause instability. You have to make sure you are documenting this and being thorough with all your patients. Having more objective documentation to validate research and your clinical diagnosis helps is many ways. It helps us understand why our patients hurt and how to… Read More
Here is a brief definition on cervical instability. Be sure you measure your films and mention in your notes. This is NOT a self resolving injury. . On x-ray, instability is determined by measurement on a lateral view. Based on the AMA guidelines, the angle between two cervical vertebrae should not exceed 11°, and translation should not exceed 3.5mm. If… Read More
This patient was involved in a MVC. He complained of headaches and neck pain. Sounds like a “typical whiplash” patient, no? Well, he was evaluated and told he had “whiplash”. This patient came to my office and during the initial evaluation and history, I concluded that he had a specific, potentially more serious injury. I am glad I knew that… Read More