MRI Spine Atlas

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Contents
Table of Contents…………………………………………………………………………………………………………………………. 2
Introduction ……………………………………………………………………………………………………………………………….. 7
About the Author…………………………………………………………………………………………………………………………. 8
Acknowledgments……………………………………………………………………………………………………………………….. 9
MRI Acquisition Protocols……………………………………………………………………………………………………………. 10
Cervical Spine Anatomy ………………………………………………………………………………………………………………. 11
……………………………………………………………………………………………………………………………………………….. 12
Lumbar Spine Anatomy……………………………………………………………………………………………………………….. 13
……………………………………………………………………………………………………………………………………………….. 14
Lumbar Inferior Extrusion ……………………………………………………………………………………………………………. 15
Central Herniation 1 …………………………………………………………………………………………………………………… 16
Central Herniation 2 …………………………………………………………………………………………………………………… 17
Central Herniation 3 …………………………………………………………………………………………………………………… 18
Cervical Central Herniation 4 ……………………………………………………………………………………………………….. 19
C5-C6 Broad-Based Herniation Effacing the Spinal Cord ……………………………………………………………………. 20
C4-C5 Superior Extrusion …………………………………………………………………………………………………………….. 21
……………………………………………………………………………………………………………………………………………….. 21
C4-C5 Herniation with Cord Compression/Displacement…………………………………………………………………… 22
C4-C5 Extrusion Invaginating the Cord …………………………………………………………………………………………… 23
Modic 1 Change and Schmorl’s Node (T1 Verified) …………………………………………………………………………… 24
Metastatic Hypertrophic Tumor……………………………………………………………………………………………………. 25
C5-C6 Herniation………………………………………………………………………………………………………………………… 26
C5-C6 Broad-Based Herniation……………………………………………………………………………………………………… 27
Cervical Thecal Sac Abutment/Effacement of Subarachnoid Space……………………………………………………… 28
L5-S1 Left Nerve Root Abutment…………………………………………………………………………………………………… 29
Left Paracentral Extrusion……………………………………………………………………………………………………………. 30
……………………………………………………………………………………………………………………………………………….. 30
Epidural Fat ………………………………………………………………………………………………………………………………. 31
Compression Fracture with Bone Edema and Cord Displacement……………………………………………………….. 32
Thecal Sac Compression………………………………………………………………………………………………………………. 33
Myelomalacia [Mottled] Cord vs. Cord Edema? ………………………………………………………………………………. 34
Cervical Cord Mass Effect and Abutment ……………………………………………………………………………………….. 35

……………………………………………………………………………………………………………………………………………….. 35
Cervical Cord Mass Effect and Compression C6-7 …………………………………………………………………………….. 36
L4-L5 Intranuclear Cleft……………………………………………………………………………………………………………….. 37
Cervical Cord Compression…………………………………………………………………………………………………………… 38
Lumbar Right Lateral Recess Extrusion with Neural Canal Compression ………………………………………………. 39
L5 Extrusion Compressing the Thecal Sac and Severely Stenosing the Left Neural Canal…………………………. 40
Central Herniation ……………………………………………………………………………………………………………………… 41
Lumbar Central Canal Tarlov/Root Sleeve Cyst………………………………………………………………………………… 42
L4-L5 Inferior Left Extrusion Abutting the Thecal Sac and Severe Left Neural Canal Stenosis …………………… 43
Schwannoma (Nerve Sheath Tumor) Benign Tumor …………………………………………………………………………. 44
L5-S1 Superior Varices Secondary to Disc Extrusion………………………………………………………………………….. 45
Anterior Disc Herniation ……………………………………………………………………………………………………………… 46
……………………………………………………………………………………………………………………………………………….. 46
Broad-Based Herniation with Cord Compression……………………………………………………………………………… 47
Lumbar Tarlov/Root Sleeve Cyst …………………………………………………………………………………………………… 48
Acute Schmorl’s Node with Modic 1 Changes (Confirmed on T1)………………………………………………………… 49
L5-S1 Inferior Extrusion……………………………………………………………………………………………………………….. 50
Fragment Posterior to S1 …………………………………………………………………………………………………………….. 51
Cervical Broad-Based Herniation…………………………………………………………………………………………………… 52
……………………………………………………………………………………………………………………………………………….. 52
Cervical Spinal Cavernoma…………………………………………………………………………………………………………… 53
C6-7 Inferior Extrusion with Cord Compression ……………………………………………………………………………….. 54
C5-C6 Severe Stenosis secondary to disc ridge osteophyte and ligament flavum hypertrophy…………………. 55
L5-S1 Superior Extrusion ……………………………………………………………………………………………………………… 56
C2 Odontoid Fracture………………………………………………………………………………………………………………….. 57
L2 Body Metastasis with Posterior Displacement of Vertebral Body……………………………………………………. 58
L5-S1 Thecal Sac Compression and Right Nerve Root Compression……………………………………………………… 59
……………………………………………………………………………………………………………………………………………….. 59
Cervical Uncinate Arthropathy (Hypertrophy)…………………………………………………………………………………. 60
……………………………………………………………………………………………………………………………………………….. 60
Lumbar Extrusion (Suspicious for Fragmentation) ……………………………………………………………………………. 61
Metastasis T1 Body vs. Hemangioma (STIR Required) ………………………………………………………………………. 62
……………………………………………………………………………………………………………………………………………….. 62
Cervical Syrinx or Syringohydromyelia …………………………………………………………………………………………… 63
……………………………………………………………………………………………………………………………………………….. 63

L5-S1 Nerve Root Compression …………………………………………………………………………………………………….. 64
L5-S1 Herniation in the Left Lateral Recess moderately stenosing the Neural Canal with Modic 1 Changes
indicating Acute Schmorl’s Node…………………………………………………………………………………………………… 65
C7-T1 Large Extrusion with a Mass Effect in the Left Lateral Recess Severely Stenosis the Left Neural Canal 66
L4-L5 Inferior Extrusion……………………………………………………………………………………………………………….. 67
L4-5 Superior Extrusion with Severe Varix………………………………………………………………………………………. 68
L4 Superior Endplate Fracture with Modic 1 Change ………………………………………………………………………… 69
L5 – S1 Inferior Extrusion …………………………………………………………………………………………………………….. 70
L4-L5 Annular Fissure………………………………………………………………………………………………………………….. 71
L4-L5 Central Herniation ……………………………………………………………………………………………………………… 72
C3-C4 Inferior Extrusion and congenital Fusion of C5-C6 …………………………………………………………………… 73
C5-C6 Inferior Extrusion ………………………………………………………………………………………………………………. 74
L3-L4 Modic Type 1 …………………………………………………………………………………………………………………….. 75
L3-L4 Modic Type 2 …………………………………………………………………………………………………………………….. 76
L3-L4 Modic Type 3 …………………………………………………………………………………………………………………….. 77
L5 – S1 Inferior Extrusion …………………………………………………………………………………………………………….. 78
L-Spine Multiple Nerve Root Compressions…………………………………………………………………………………….. 79
Lumbar Degenerative Spondylolysis ……………………………………………………………………………………………… 80
L2-L3 Large Focal Herniation Compressing the Thecal Sac …………………………………………………………………. 81
T11 – T12 Burst Hemangioma ………………………………………………………………………………………………………. 82
T5 – T6 Superior Extrusion with Cord Edema…………………………………………………………………………………… 83
Dilated Focal Central Canal ………………………………………………………………………………………………………….. 84
……………………………………………………………………………………………………………………………………………….. 84
L1 Burst Fracture………………………………………………………………………………………………………………………… 85
……………………………………………………………………………………………………………………………………………….. 85
L1 ……………………………………………………………………………………………………………………………………………. 85
L1 Burst Fracture………………………………………………………………………………………………………………………… 86
L4-L5 Bulge with Right L5 Root Sleeve Compressed with Acute Schmorl’s Node (STIR Confirmed)……………. 87
L4-L5 Psuedo-Disc and Spondylolesthesis with Thecal Sac Compression………………………………………………. 88
\ ……………………………………………………………………………………………………………………………………………… 88
L5-S1 Bulge Disc with Superimposed Herniation and Transitional S1 Vertebrate …………………………………… 89
……………………………………………………………………………………………………………………………………………….. 89
L2-L3 Right Extrusion ………………………………………………………………………………………………………………….. 90
……………………………………………………………………………………………………………………………………………….. 90
C6-C7 Broad-Based Herniation with Mass Effect of Cord …………………………………………………………………… 91

5
L4 Anterior Superior Fracture (Limbus) with Acute Schmorl’s Node…………………………………………………….. 92
Cervical Syrinx (Syringomyelia) …………………………………………………………………………………………………….. 93
Upper Thoracic Herniation…………………………………………………………………………………………………………… 94
L5-S1 Superior Extrusion Compressing the Thecal Sac ………………………………………………………………………. 95
C4-C5 Broad-Based Herniation Compressing the Cord………………………………………………………………………. 96
……………………………………………………………………………………………………………………………………………….. 96
……………………………………………………………………………………………………………………………………………….. 96
L4 Acute Schmorl’s Node with Modic 1 Change (STIR Confirmed)……………………………………………………….. 97
Thoracic Myxopapillary Ependymoma …………………………………………………………………………………………… 98
Lumbar Vacuum Disc ………………………………………………………………………………………………………………….. 99
L5-S1 Nerve Root Compression with L5 Pars Lysis and Hypertrophic Changes …………………………………….. 100
L3-L4 Lateral Recess/Proximal Neural Canal Extrusion ……………………………………………………………………. 101
C6-7 Broad-Based Herniation……………………………………………………………………………………………………… 102
C6-C7 Small Central Herniation …………………………………………………………………………………………………… 103
Lumbar Non-Diagnostic Slice………………………………………………………………………………………………………. 104
L5-S1 Herniated Disc with Large Epidural Fat Deposit……………………………………………………………………… 105
L2 Metastasis with Expansion …………………………………………………………………………………………………….. 106
L2-L3 Thecal Sac Compression…………………………………………………………………………………………………….. 107
L5-S1 Nerve Root Compression …………………………………………………………………………………………………… 108
L4-L5 Nerve Root Compression …………………………………………………………………………………………………… 109
Lumbar Chronic Compression Fracture with Anterior Wedging ………………………………………………………… 110
L2-L3 Disc Osteophyte Complex ………………………………………………………………………………………………….. 111
L5-S1 Inferior Extrusion……………………………………………………………………………………………………………… 112
L4-L5 Focal Herniation Superimposed on a Bulge …………………………………………………………………………… 113
C2-C3 Left-Sided Disc Osteophyte Complex and Bulge…………………………………………………………………….. 114
S1 Acute Schmorl’s Node with Modic 1 Changes (STIR Confirmed) ……………………………………………………. 115
L3 Hemangioma……………………………………………………………………………………………………………………….. 116
Cervical Schwannoma ……………………………………………………………………………………………………………….. 117
T7-T8 Right Lateral Herniation ……………………………………………………………………………………………………. 118
L1-L2 Discitis……………………………………………………………………………………………………………………………. 119
C5-C6 Far Right Disc Osteophyte with Severe Canal Stenosis and Mild Central Stenosis ……………………….. 120
L5-S1 Right Paracentral Herniation………………………………………………………………………………………………. 121
L4-L5 Central Herniation Superimposed on a Bulge Invaginating the Thecal Sac ………………………………….. 122
L2 and L3 Compression Fractures………………………………………………………………………………………………… 123
L3 Superior Endplate Post-Traumatic Schmorl’s Node …………………………………………………………………….. 124

L5-S1 Left Extrusion ………………………………………………………………………………………………………………….. 125
C4-C5 Osteophyte …………………………………………………………………………………………………………………….. 126
C5-C6 Central Herniation …………………………………………………………………………………………………………… 127
C6-C7 Annular Fissure -Central Herniation ……………………………………………………………………………………. 128
C5-C6 Disc Osteophyte Complex Compressing the Cord ………………………………………………………………….. 129
L4-L5 Synovial Cyst……………………………………………………………………………………………………………………. 130
C2 Destruction of Dens and Lateral Mass secondary to Rheumatoid Arthritis……………………………………… 131
T12 Acute Schmorl’s Node (STIR Confirmed) …………………………………………………………………………………. 132
L5-S1 Left Lateral Recess Extrusion………………………………………………………………………………………………. 133
C3-C4 Left Focal Herniation with Uncinate Hypertrophy………………………………………………………………….. 134
C4-C5 Central Herniation with Annular Fissure Indenting the Spinal Cord ………………………………………….. 135
C6-C7 Broad-Based Central Herniation Compressing Spinal Cord………………………………………………………. 136
C5-C6 Broad-Based Disc Osteophyte ……………………………………………………………………………………………. 137
C5-C6 Right Nerve Compression in the Neural Canal ………………………………………………………………………. 138
C6-C7 Hypertrophy Ligamentum Flava …………………………………………………………………………………………. 139
C6-C7 Central Herniation with an Annular Fissure ………………………………………………………………………….. 140
C3-C4 Central Herniation with Overlapping Endplate Due to Improperly Aligned Reference Line …………… 141
C4-C5 Broad-Based Herniation……………………………………………………………………………………………………. 142
T3-T4 Broad-Based Herniation ……………………………………………………………………………………………………. 143
C6-C7 Annular Fissure ……………………………………………………………………………………………………………….. 144
C1 Alar Ligament Edema ……………………………………………………………………………………………………………. 145
C5 Superior Endplate Fracture ……………………………………………………………………………………………………. 146
S1 Perineural Cyst…………………………………………………………………………………………………………………….. 147
L5 – S1 Metastasis Secondary to Melanoma………………………………………………………………………………….. 148
L3 Compression Fracture……………………………………………………………………………………………………………. 149
L2 Metastatic Pathologic Fracture……………………………………………………………………………………………….. 150
L2 Metastatic Pathologic Fracture CAT Scan [Same patient as previous chapter]…………………………………. 151
T12- L2 Myxopapillary Apendymoma…………………………………………………………………………………………… 152
Myelomalacia C4 -C6 ………………………………………………………………………………………………………………… 153

Science of Chiropractic

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Contents

Mechanism of the Chiropractic Adjustment. 4

The Mechanism of the Chiropractic Spinal Adjustment/Manipulation: 5

Osseous Mechanisms, Part 1 of a 5 Part Series. 5

The Mechanism of the Chiropractic Spinal Adjustment/Manipulation: 12

Ligaments and the Bio-Neuro-Mechanical Component, Part 2 of a 5 Part Series. 12

The Mechanism of the Chiropractic Spinal Adjustment/Manipulation: 20

Bio-Neuro-Mechanical Effect, Part 3 of a 5 Part Series. 20

The Mechanism of the Chiropractic Spinal Adjustment/Manipulation: 27

Subluxation Degeneration: Effect of Sagittal Alignment on Kinematic Changes and Degree of Disc Degeneration in the Lumbar Spine, Part 4 of a 5 Part Series. 27

The Mechanism of the Chiropractic Spinal Adjustment/Manipulation: 32

Chiropractic vs. Physical Therapy for Spine, Part 5 of a 5 Part Series. 32

Chiropractic Spinal Adjustment and the Brain Connection. 39

Chiropractic & Central Afferent Inhibition: 40

A Chiropractic Care Path & Mechanism for Chronic Pain, Tremors, Spatial and Inhibitory Distortion. 40

A Chiropractic Adjustment Has a Direct Effect of the Pre-Frontal Cortex of the Brain. 44

Verifying a positive effect of the chiropractic spinal adjustment on reflexes, memory, coordination and decision making. 44

Chiropractic, Chronic Back Pain and Brain Shrinkage: 49

A better understanding of Alzheimer’s, Dementia, Schizophrenia, Depression and Cognitive Disorders and Chiropractic’s Role. 49

Chiropractic has a Positive Effect on Depression and Anxiety. 57

How Does the Chiropractic Adjustment Work?. 59

A Literature Review of Pain Mechanisms & Brain Function Alteration. 59

Regaining Arms, Legs, Hands and Feet Function Through Chiropractic Care: The Brain Connection. 67

Research Proves Chiropractic Adjustments Affect Multiple Areas, Not Just the Area Treated. 69

(i.e.) Neck Treatment Reduces Pain in Low Back. 69

Research Proves Chiropractic Adjustments Affect Emotions, Learning, Memory, Consciousness, Motivation, Homeostasis, Perception, Motor Control, Self-Awareness, Cognitive Function, Voluntary Movement, Decision Making, Touch and Pain. 71

Attention-Deficit Hyperactivity Disorder (ADHD) Outcomes Improve with Chiropractic Care. 73

Can a chiropractic exam or a multiple choice self-assessment test accurately predict the pressure of blood flow to the brain?. 75

Chiropractic Lowers Drug Use. 77

Chiropractic Improves Neck Pain in a Military Veteran Population & Lowers the Need for Opiates. 78

Chiropractic Reduces Opioid Use by 55% in Low Back Pain. 81

Chiropractic vs. Medical Advice, Bed Rest, Natural History/Resolution and Over-the-Counter Drugs for Low Back Pain. 85

Chiropractic vs. Oral Steroids vs. Muscle Relaxants: Outcomes for Low Back Pain and Sciatica. 88

Chiropractic as Primary Spine Care. 93

Chiropractic Verified as Primary Spine Care Providers. 94

Chiropractic vs. Medicine: Who is More Cost Effective & Renders Better Outcomes for Spine?. 97

Chiropractic’s Role in Decreasing Premature Death with Associated Back Pain. 100

Back Pain: Who Should Be Seen First & WHY. 103

Chiropractor vs. Medical Primary Care Doctor. 103

Choosing the right doctor can make the difference. 106

Back Pain: Chiropractic vs. Medical Doctors. 107

Who Get Better Results and Who is More Cost Effective?. 107

Chiropractic Connection to Organ Systems and Systemic Disease. 109

Chiropractic Spinal Adjustments, Changes in Organ Systems & Treatment of Disease. 110

A literature review and report on the positive effects of chiropractic on the autonomic nervous system, heart function and the circulatory system.. 110

Chiropractic and Successful Outcomes with Chronic Obstructive Pulmonary Disease. 116

Chiropractic Linked to Increased Immunity. 119

Sleep Disorder Improvements Have Been Linked to Chiropractic Care. 121

Chiropractic’s Mechanism in Pain Modulation and the Connection to Systemic Diseases. 124

A Literature Review and Synthesis on the Possible Effects of Chiropractic on Cancers, Systemic Diseases, Mental and Social Disorders and Sexual Behavior. 124

Fibromyalgia Improvement has been Linked to Chiropractic Care. 132

Neck and Low Back Pain. 135

1. Non-Specific (Mechanical Spine Pain) 136

Chiropractic Improves Neck Pain in a Military Veteran Population & Lowers the Need for Opiates. 136

Chiropractic Reduces Opioid Use by 55% in Low Back Pain. 139

Chronic Pain and Chiropractic: A 12-Week Solution & Necessity for Care. 143

Chiropractic Care is More Effective in Lowering Disability than Medical Care for Acute and Sub-Acute Low Back Pain. 147

Chiropractic vs. Physical Therapy in Treating Low Back Pain with Spinal Adjustments vs. Exercise Rehabilitation. 152

Chiropractic vs. Medical Advice, Bed Rest, Natural History/Resolution and Over-the-Counter Drugs for Low Back Pain. 153

Spinal Fusion vs. Chiropractic for Mechanical Spine Pain. 156

Chiropractic Care for Neck and Low Back Pain: Evidenced Based Outcomes. 159

Chiropractic Can Prevent Absenteeism in the Workplace from Chronic Pain. 161

Chiropractic vs. Oral Steroids vs. Muscle Relaxants: Outcomes for Low Back Pain and Sciatica. 164

Patient Outcomes Proves More Effective with Chiropractic Combined with Standard Medical Care Than Standard Medical Care Alone in the Military. 168

Harvard Report Points to Chiropractic Care for Pain Relief & The Safety of the Chiropractic Adjustment 170

1. Disc Pathology. 171

Efficacy of Chiropractic Care on Cervical Herniated Discs with Degenerative Changes in the Spine. 171

Chiropractic Outcome Studies on Treatment of Fragmented/Sequestered and Extruded Herniated Discs and Radicular Pain. 174

Acute and Chronic Herniated Discs Have Significantly Favorable Outcomes with Chiropractic Care. 177

Cervical Disc Herniation with Radiculopathy (Arm Pain): Chiropractic Care vs. Injection Therapy. 179

Disc Herniations and Low Back Pain Post Chiropractic Care. 181

III.         Failed back surgery. 183

Chiropractic as the Solution for Mechanical Spine Failure and Failed Back Surgery. 183

Headache. 187

Neck Pain (Torticollis), Headaches, Dizziness, Radiating Pain, Nausea, Depression, Confusion, Ringing in the Ears Show Good Outcomes with Chiropractic Care. 188

Geriatrics. 190

Chiropractic Care Improves Senses and Reduces Risks of Falling in the Elderly Population. 191

Chiropractic Protects an Aging Population from Loss of Function. 194

Integrative Care. 196

Chiropractic and Prescriptive Rights. Should Chiropractors Be Allowed to Prescribe Drugs?. 197

Stroke. 200

Chiropractic and Cervical Arterial Dissection: Causal Relationship or Medical Dogma?. 201

Care and Diagnosis. 205

1. Outcome Assessments. 206

Ranges of Motion as a Utility for Outcome Assessments. 206

Chiropractic Taking a Lead Role in Rendering Accurate Assessments for Spine. 206

Pregnancy. 213

Pregnancy, Low Back Pain and Chiropractic. 214

Pregnancy and Chiropractic: Care and Safety. 215

The Journal of the American Medical Association Suggest a Link between Pregnant Woman – Back Pain – Tylenol Use & ADHD: Chiropractic Offers a Solution. 216

Science of Chiropractic

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Table of Contents

The Authors. 5

Preface. 6

Brain Connection. 10

Chiropractic, Chronic Back Pain and Brain Shrinkage: A better understanding of Alzheimer’s, Dementia, Schizophrenia, Depression and Cognitive Disorders and Chiropractic’s Role. A Literature Review of the Mechanisms. 10

Non-Specific Back Pain, Mechanical Spine Pain, Primary Care Medicine and Chiropractic as Primary Spine Care. 19

Chiropractic Spinal Adjustments and the Effects on the Neuro-Endocrine System and the Central Nervous System Connection: A literature review and report 26

Chiropractic’s Mechanism in Pain Modulation and the Connection to Systemic Diseases: A Literature Review and Synthesis on the Possible Effects of Chiropractic on Cancers, Systemic Diseases, Mental and Social Disorders and Sexual Behavior. 31

Chiropractic Spinal Adjustments, Changes in Organ Systems & Treatment of Disease: A literature review and report on the positive effects of chiropractic on the autonomic nervous system, heart function and the circulatory system.. 40

Chiropractic Adjustment Indication. 47

Indications for Chiropractic Adjustment – Clinical Perspective. 47

Arthritis. 48

Arthritis Prevention and Chiropractic: Chiropractic prevents arthritis in accident victims, the elderly and the sedentary. 48

Low Back Pain, Arthritis and Chiropractic: A Clinical Correlation. 51

Arthritis and Low Back Pain: Chiropractic Care vs. Heat Treatment 53

Chiropractic Care for OA of the Hip – Patient Education vs. Manual Therapy. 55

Chiropractic and your Medical Doctor. 56

Balance and Movement 56

Balance and Movement and the Effect of Chiropractic Care: Utilization with the Elderly, Cerebral Palsy, the Athlete, and the General Population. 57

Balance, Chronic Pain and Chiropractic. 58

Increased Balance, Movement, and Kinematics as a Result of Chiropractic Care: A research conclusion that affects rehabilitation patients, athletes, balance disorders and increased production in the workplace. 59

Chiropractic care improves brain function and the body’s motor or movement ability: Research findings that redefine care for every rehabilitation patient for all motor disorders. 62

Cost Effectiveness. 64

Chiropractic Saves Federal and Private Insurers $15,897,840,000 and Adds $692,160,000 in Wages to Americans. 64

Work Injuries, Workers Compensation and Chiropractic: A solution to lowering health care costs in America. 66

Work Related Injuries, Recurring Low Back Pain, Chronic Care and Chiropractic Treatment: A Proven Solution to Save Federal, State and Private Insurers $2,871,485,223. 71

Disc Pathology. 73

Back and Leg Pain (Lumbar Radiculopathy) as a Result of Disc Herniation and the Long Term Effect of Chiropractic Care. 74

Sciatica (Leg Pain) & Lumbar Disc Herniation; Surgery vs. Chiropractic Care. 75

Herniated Discs, Radiating Pain and Chiropractic. 77

Cervical and Lumbar Disc Herniations and Chiropractic Care. 78

Disc Herniations, Bulges, Sciatic Pain and Chiropractic. 80

Disc Injury Causes Pain. 81

Disc Injury Causes Chronic Headache. 82

Chiropractic Management of Radiculopathy Due to Disc Herniation. 82

Spinal Manipulation versus Microdiscectomy in Patients with Sciatica. 83

Geriatrics. 83

Older American Utilization of Chiropractic Care. 83

Dizziness in Older Adults and Chiropractic Care. 84

Urinary Incontinence May Improve With Chiropractic Care: A 6 year “Case Report” study of 21 Cases. 86

Headaches. 87

Low Speed Accident Injury and Causality

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Preface. 3

Acknowledgements. 6

Soft Tissue Injury. 7

Soft Tissue Injuries: What are they and the Long-Term Impact of Bodily Injury. 8

Ligament Pathology as Sequela to Trauma Coupled with Alteration of Motion Segment Integrity (AOMSI) or Ligamentous Laxity. 13

Ligament Failure and Sprain/Strain Reported as Permanent in Whiplash. 16

One of the Most Important Diagnostic Test Results in Affecting Case Values in Soft Tissue Injury Cases. 19

Sprain/Strain is ONE Syndrome, Not Two Separate Pathologies, And Is Permanent. 23

Traumatic Ligament Laxity of the Spine and Associated Physical Impairment. 28

Motor Vehicle Collisions. 39

Low-Speed Collisions. 40

Conservation of Momentum: Where Does the Energy Go,          Part I 40

Conservation of Momentum: Where Does the Energy Go,           Part II 44

Motor Vehicle Accidents: Little or No Damage Collisions & Demonstrable Verification of Energy Transferences to Cause Bodily Injury. 48

Low-Speed Crashes and Missed Vehicle Damage: Standards to Demand in a Vehicle Inspection. 51

Low-Speed Crash Does Not Mean LOW ENERGY. 55

Low-Speed Damages and Injuries. 63

Tires. 71

Tires: Pressure, Stopping Distance and Causality – Part I 71

Tires: Pressure, Stopping Distance and Causality – Part II 76

Tire Skid Marks & Causality. 79

Accident Reconstruction. 83

Crash Dynamics and Accident Reconstruction Q & A’s. 83

Accident Scenes & Police Reports. 87

Why are Accident Engineering Reports Incomplete and/or Misleading?. 90

Intervertebral Disc Injury. 94

Age Dating. 95

Age Dating Disc Injury: Herniations and Bulges. Causally Relating Traumatic Disc Injury at Low Speeds. 95

Reporting in a Medical-Legal Environment: Causal Relation by Age Dating C4-C5 Herniated Disc in a Low-Speed Crash. 104

Causality. 107

Disc and Ligament Injuries: How Spinal Experts Document Causality. 108

Bulging Discs and Trauma: Causality and a Risk Factor. 115

Concussion. 125

Concussion: Diagnosis-Testing-Chiropractic. “New Testing is Available Using Biomarkers.”. 126

Chiropractic Spine Care. 131

Chiropractic Primary Spine Care: A Mandatory “future trend” for Chiropractic Success That Has Already Begun. 132

Workers Compensation and Chiropractic: A Solution for Lowering Healthcare Costs for the Acute and Chronic Care Patient. 140

Ranges of Motion as a Utility for Outcome Assessments: Chiropractic Taking a Lead Role in Rendering Accurate Assessments for Spine. 153

Evidence Based Demonstrative Evidence

of Bodily Injuries from Trauma

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Preface. 3

Acknowledgments. 6

Soft Tissue Injury. 7

Soft Tissue Injuries: What are they and the Long-Term Impact of Bodily Injury. 8

Ligament Pathology as Sequella to Trauma Coupled with Alteration of Motion Segment Integrity (AOMSI) or Ligamentous Laxity. 13

Ligament Failure and Strain-Sprain Reported as Permanent in Whiplash. 15

One of the Most Important Diagnostic Test Results in Affecting Case Values in Soft Tissue Injury Cases. 18

Strain/Sprain is ONE Syndrome, Not Two Separate Pathologies, And Is Permanent. 22

Traumatic Ligament Laxity of the Spine and Associated Physical Impairment. 27

Motor Vehicle Collisions. 38

Low-Speed Collisions. 39

Conservation of Momentum: Where Does the Energy Go, Part 1. 39

Conservation of Momentum: Where does it go, Part II 43

Motor Vehicle Accidents: Little or No Damage Collisions & Demonstrable Verification of Energy Transferences to Cause Bodily Injury. 47

Low-Speed Crashes and Missed Vehicle Damage: Standards to Demand in a Vehicle Inspection. 50

Low-Speed Crash Does Not Mean LOW ENERGY. 54

Low-Speed Damages and Injuries. 62

Tires. 70

Tires: Pressure, Stopping Distance and Causality – Part I 70

Tires: Pressure, Stopping Distance and Causality – Part II 75

Tire Skid Marks & Causality. 77

Accident Reconstruction. 81

Crash Dynamics and Accident Reconstruction Q & A’s. 81

Accident Scenes & Police Reports. 85

Why are Accident Engineering Reports Incomplete And/ Or Misleading?. 88

Intervertebral Disc Injury. 92

Age Dating. 93

Age Dating Disc Injury: Herniations and Bulges. Causally Relating Traumatic Disc at Low Speeds. 93

Reporting in a Medical-Legal Environment: Causal Relation by Age Dating C4-C5 Herniated Disc in a Low-Speed Crash. 102

Causality. 105

Disc and Ligament Injuries: How Spinal Experts Document Causality. 106

Bulging Discs and Trauma: Causality and a Risk Factor. 113

Concussion. 123

Concussion: Diagnosis-Testing-Chiropractic. “New testing is Available Using Biomarkers.”. 124

Chiropractic Spine Care. 129

Chiropractic Primary Spine Care: A mandatory “future trend” for chiropractic success that has already begun. 130

Workers Compensation and Chiropractic: A Solution for Lowering Healthcare Costs for the Acute and Chronic Care Patient. 138

Ranges of Motion as a Utility for Outcome Assessments: Chiropractic Taking a Lead Role in Rendering Accurate Assessments for Spine. 151

 

Serious Bodily Injury

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Table of Contents

Table of Contents…………………………………………………………………………………………………………………………. 2
Introduction ……………………………………………………………………………………………………………………………….. 6
About the Author/Acknowledgments ……………………………………………………………………………………………… 8
Numbering of Chapters/Articles……………………………………………………………………………………………………… 9
Whiplash Injury PROVEN at 4km/hr…………………………………………………………………………………………………. 10
Nerve Injury and Minor Traffic Accidents………………………………………………………………………………………… 11
BODILY INJURY AND ANATOMICAL VARIENTS………………………………………………………………………………….. 12
Nerve Injuries Cause Persistent Functional Loss……………………………………………………………………………….. 13
Spinal Stenosis INCREASES Bodily Injury…………………………………………………………………………………………..14
Is Compensation BAD for HEALTH?…………………………………………………………………………………………………..15
Topics Previously Covered & Available…………………………………………………………………………………………….16
Cervical Radicular Pain – UPDATE…………………………………………………………………………………………………. 17
Traffic Injuries – More Than Neck Pain……………………………………………………………………………………………. 18
Whiplash Injury Proven……………………………………………………………………………………………………………….. 19
Whiplash Risk Factors Identified……………………………………………………………………………………………………. 20
40% of Whiplash Pain Persists for 1 Year………………………………………………………………………………………… 21
REVIEW – Disc Herniations in Asymptomatic Population – 1974 through 2004………………………………………. 22
Combined Injuries……………………………………………………………………………………………………………………….. 23
Disc Herniation Causes Headaches…………………………………………………………………………………………………. 24
Topics Previously Covered & Available…………………………………………………………………………………………….. 25
Airbag Deployment Causes Injury………………………………………………………………………………………………….. 26
Occupant Factors Influence Injury……………………………………………………………………………………………………27
Females Injured More Than Males…………………………………………………………………………………………………..28
Blunt Abdominal Trauma Results in Organ Injury……………………………………………………………………………….29
Returning to Work After a Car Accident……………………………………………………………………………………………30
Bracing for Impact Influences Body Movements………………………………………………………………………………..31
Ligament Strength Lowered by Whiplash……………………………………………………………………………………………32
High Intensity Zone Identified on MRI……………………………………………………………………………………………..33
Head Position Influences Chronic Symptoms…………………………………………………………………………………… 34
Occupant Posture Influences Injury…………………………………………………………………………………………………35
Delayed Treatment of Shoulder Pain Affects Outcome……………………………………………………………………… 36
Topics Previously Covered & Available…………………………………………………………………………………………… 37

Disability Following Causally Related Lumbar Disc Surgery…………………………………………………………………. 38

Diagnosing ACUTE Disc Herniation on MRI………………………………………………………………………………………. 39

Concussion Found in Whiplash……………………………………………………………………………………………………… 40

Whiplash and Permanency – The Evidence……………………………………………………………………………………… 41

Post-Surgical Lumbar Spine Pain…………………………………………………………………………………………………… 42

Speed Bumps Cause Spinal Fractures………………………………………………………………………………………………. 43

MRI Evidence of Permanency in Traumatic Brain Injury……………………………………………………………………. 44

Upper Cervical Injuries During Whiplash………………………………………………………………………………………… 45

Clinician VS Radiologist Reads in Lumbar Disc Herniation…………………………………………………………………. 46

Whiplash Results in Ligament Damage in the Cervical Spine……………………………………………………………… 47

Strain-Sprain Update/Ligaments Do NOT Heal………………………………………………………………………………… 48

Disc Degeneration vs. Herniation………………………………………………………………………………………………….. 49

The Thecal Sac is a Pain Generating Structure…………………………………………………………………………………. 50

Pain Beginning After 24 Hours Lasts Twice as Long……………………………………………………………………………51

Risk Factors for Cervical Spine Injuries…………………………………………………………………………………………….52

UPDATE – Disc Injury Nomenclature – Version 2.0 – 2014………………………………………………………………….. 53

Thoracic Disc Herniation after Motor Vehicle Collision……………………………………………………………………… 54

Ordering MRIs Within 72 Hours………………………………………………………………………………………………………55

Out of Position Head Increased Tissue Damage

in Rear Impacts………………………………………………………. ………………………………………………..,,,,,,,,,,,,……..56

Innervation of Degenerative Disc – UPDATE 2016……………………………………………………………………………. 57

Connective Tissue Injury……………………………………………………………………………………………………………… 58

Diagnosing Radiculopathy – RESEARCH UPDATE – 2016

Causation Analysis of Low Speed Collision, Spine Fracture…………………………………………………………………. 59

Increased Nerves in Pre-existing Intervertebral Disc Disease……………………………………………………………… 60

Persistent Pain After Motor Vehicle Crashes & Fibromyalgia……………………………………………………………… 61

TRAUMA and MISSED SPINAL INSTABILITY……………………………………………………………………………………… 62

Spinal Injuries – MRI Is not enough……………………………………………………………………………………………….. 63

CHANGE……………………………………………………………………………………………………………………………………. 64

Chronic Widespread Pain After Motor Vehicle Collisions…………………………………………………………………… 65

Chronic Widespread Pain After Motor Vehicle Collisions…………………………………………………………………… 66

Heredity Causation to Disc Herniation and Degenerative Disc Disease………………………………………………… 67

Low Speed-Rear End Injuries………………………………………………………………………………………………………… 68

ACUTE Schmorl’s Node – UPDATE…………………………………………………………………………………………………. 69

Demonstrating Neck Muscle Injury using MRI…………………………………………………………………………………. 70

Nerve Root Injury without Disc Herniation……………………………………………………………………………………… 71

Sensory Nerves in Herniated Discs……………………………………………………………………………………………….. 72

LONG TERM IMPACT OF TRAFFIC CRASHES…………………………………………………………………………………….. 73

WHIPLASH INJURY RESULTS IN SUSTAINED IMPAIRMENTS……………………………………………………………..74

MRI vs. CT Scan………………………………………………………………………………………………………………………….. 75

Minor Trauma and Spinal Cord Injury……………………………………………………………………………………………. 76

Near vs. Far Side Crashes…………………………………………………………………………………………………………….. 77

Age Dating Disc Series # 1…………………………………………………………………………………………………………… 78

Age Dating Series # 2…………………………………………………………………………………………………………………… 79

Age Dating Series # 3…………………………………………………………………………………………………………………… 80

Age Dating Series # 4…………………………………………….. …………………………………………………………………… 81

Age Dating Series # 5……………………………………………………………………………………………………………………. 82

Age Dating Series # 6……………………………………………………………………………………………………………………..83

Age Dating Series # 7…………………………………………………………………………………………………………………… 84

Age Dating Series # 8…………………………………………………………………………………………………………………… 85

Age Dating Series # 9…………………………………………………………………………………………………………………….86

Age Dating Series # 10……………………………………………………………………………………………………………………..87

Age Dating Series # 11…………………………………………………………………………………………………………………. 88

Age Dating Series # 12…………………………………………………………………………………………………………………. 89

Age Dating Series # 13…………………………………………………………………………………………………………………. 90

Crash and Injury Statistic Reporting is Flawed……………………………………………………………………………………. 91

Common Pain Generators 1 – Thecal Sac ………………………………………………………………………………………….92

Common Pain Generators 2 – Spinal Cord …………………………………………………………………………………………93

Common Pain Generators 3 – Facet Joint ………………………………………………………………………………………… 94

Common Pain Generators 4 – Spinal Ligaments………………………………………………………………………………….95

Common Pain Generators 5 – Spinal Disc ………………………………………………………………………………………… 96

Common Pain Generators 6 – Vertebra (Bone)…………………………………………………………………………………..97

Common Pain Generators 7 – Spinal Nerve Root Compression………………………………………………………………98

Common Pain Generators 8 – Chemical Radiculitis…………………………………………………………………………………99

Modic Bone Marrow Changes Modic Type 1 = Bone Marrow Edema

Inflammation……………………………………………………………………………………………………………………………….100

Modic Bone Marrow Changes Modic Type 2 = Chronic Degenerative Marrow

Change………………………………………………………………………………………………………………………………………..101

Modic Bone Marrow Changes Modic type 3 = Very Chronic Degenerative Sclerotic Marrow

Changes……………………………………………………………………………………………………………………………………….102

Ligament Injuries/Sprain 3 Grades of Sprain………………………………………………………………………………………103

Ligament Injuries/Sprain Demonstrable Injury to Supra & Interspinous ligaments………………………………104

Ligament Injuries/Sprain Demonstrable Injury to Anterior Longitudinal and Facet Capsule…………………..105

Acute Schmorl’s Node AKA: Acute Traumatic Endplate Fracture………………………………………………………..106

Not Traffic Accidents Motor Vehicle Crashes………………………………………………………………………………….107

Low-Speed Injury Incidence…………………………………………………………………………………………………………108

……………………………………………………………………………………………108

The Science of Chiropractic  Part 3     174 Pages $99.00 usd   Go Here to Purchase

 

TABLE OF CONTENTS

Introduction……………………………………………………………………………………..1

Acknowledgements……………………………………………………………………………..5

The Neurophysiology of Spinal Manipulation vs. Chiropractic Spinal Adjustments…………. 6

Biomechanical Pathology aka Vertebra Subluxation………………………………………….. 9

Diagnosing the Dysfunctional Lesions of the Spine Stroke Risks While Under……..………..11

Stroke Risks While Under Chiropractic Care Debunking the Myth that Chiropractic
Causes Stroke…………………………………………………………………………………...15
Chiropractic Care is More Effective in Lowering Disability than Medical Care for Acute
and Sub-Acute Low Back Pain………………………………………………………………… 18
Chiropractic & Central Afferent Inhibition: A Chiropractic Care Path & Mechanism
for Chronic Pain, Tremors, Spatial and Inhibitory Distortion…………………………………. 25

Should Chiropractic Follow the American Chiropractic Association/ American
Board of Internal Medicine’s Recommendations on X-Ray?.......................................................31

Efficacy and Adverse Effects of Chiropractic Treatment for Migraines………………………..40

Chiropractic Vertebral Subluxation……………………………………………………………..43

Efficacy of Chiropractic Treatment for Post-Surgical Continued Low Back and
Radicular Pain…………………………………………………………...………………………52

Deceptive Dogmatic Reporting Despite Successful Chiropractic Outcomes Revealing
the deception of low back pain naturally resolving…and the dogma of non-specific
back pain………………………………………………………………………………………....58

The Legal and Appropriate Use of X-Ray in Chiropractic………………………………………63
Chiropractic Adjustments Increases Maximal Bite Forces Through Effecting Cortical Changes………………………………………………………………………………………….96

Preventing Spinal Degeneration Through Chiropractic Care Subluxation Degeneration/Spondylosis Explained via Wolff’s Law………………………………………..99

Traumatic Myelomalacia Diagnosis & Collaborative Management Between the
Chiropractor as the Primary Spine Care Provider and the Neurosurgeon……………………..104

The Chiropractic Adjustment Changes Brain Function The Evidence of Increased
Muscle Strength is Added to Pain Sensitivity and Autonomic Changes………………………114

Chiropractors Reduce Costs by 40% if the 1st Option for Spine DC’s Would Save
the Healthcare System 1.86 Trillion Dollars Over 10 Years…………………………………..117

No Evidence Exists Between Chiropractic Care and Cervical Artery Dissection…………….122

Chiropractic Spinal Adjustment/ Manipulation
Manipulation vs. Mobilization Part 1 of 2…………………………………………………….126

Chiropractic Co-Management of Pre & Post-Spine Surgical Cases…………………………..134

Chiropractic Outcomes Drug Use, Disability & Non-Specific Back Pain…………………….142

Chiropractic Spinal Adjustments Increases Facet Gapping and Functional
Outcomes………………………………………………………………………………………146

Vertebral Subluxation Complex vs. Patho-Neuro-Biomechanical Lesion…………………….149
 
Chiropractic Care Lowered the Use of Opiates with Back Pain from 55% to 64%...................156

Frequency Protocols with Initial Chiropractic Care……………………………………………159

Necessary Use of Initial X-Rays in Chiropractic FACT SHEET………………………………163

Addictionology, Back pain, anD chiropractic………………………………………………………………………………166

Ordering MRIs in Chiropractic Practices………………………………………………………170

 

 

 

 

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Research

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Mark Studin DC, FASBE(C), DAAPM, DAAMLP
Magdy Shady MD, Neuro-Trauma Fellow, Neurosurgeon
Michal Schonfeld DC, DABCO
Robert Peyster MD, CAQ, Radiology, Neuroradiology
Don Capoferri DC, FSBT, DAAMLP
Candace Perkins MD, Neurology, Vascular Neurology
Patricia Roche DO, CAQ, Radiology, Neuroradiology

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