Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 328

From the Desk of Dr. Mark Studin
Academy of Chiropractic
Preamble: Many of the issues I bring to you are very small, yet each issue is just that, an issue. If you take care of the small issues, then you will be able to build and more importantly, focus on the bigger issues...a larger practice and more family time.

"MRI Alert"

In reviewing many films with doctors nationally over the Web, there is a consistent theme that is recurring to the detriment of both an accurate diagnosis and your patients' potential outcomes, neural canals. The problem is that too many MRI technicians and radiologists that read the films are not visualizing the entire neural canal and are "extrapolating" the results. Another word for extrapolate is GUESS!! Remember, if they guess wrong, your patient gets hurt and you are potentially screwed if the patient gets hurt by your care.

If you have taken the MRI course and all of you should have by now, you can fix the problem. When reviewing the images, find your level on the sagittal in question of a space occupying lesion and then scroll far left and far right on the axial views. You MUST see the "keyholes" where the nerve roots reside in the superior part of the canal throughout the entire region. If you cannot see all of them, either the patient was crooked in the tube or there is a scoliosis.
 

When you cannot visualize the complete canal, mandate that the imaging company re-do the images and in the future, they should not conclude the scan without a complete visualization of the neural canals. This is HUGE...and...if you do not understand a word I just said and haven't taken the MRI course, you need to because this will dictate whether there are any complications with adjusting your patients and will dramatically change your treatment plan.

Rule #1: Only the best win.

Rule #2: If you are relying on rhetoric (aka bull crap) or philosophically believing that innate skill will cure everything through your adjustment, see rule #1.

I get too many calls from too many doctors who have blindly relied on ONLY the adjustment and ignored underlying pathology at the detriment of both their patients and their licenses. Innate ability will heal, but if trauma re-arranged their anatomy, you will have to alter your treatment plan. You will now need to be both a doctor and a chiropractor; they are not mutually exclusive.

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