Academy of Chiropractic Personal Injury & Primary Spine Care Program

Quickie Consult 881
Clinical Information 209 CI

From the Desk of Dr. Mark Studin
Academy of Chiropractic
Preamble: many of these issues are small, yet each issue is just that… an issue. If you take care of the small issues, then the larger issues often take care of themselves and you can focus on the larger issues… a larger, more profitable practice and more family time.

“Flexion/Extension Images and Ligament Laxity Issues”

“Pain is only 1 piece of the puzzle” Mark Studin 2017

1.  Do I repeat the flexion - extension films at the end of care and measure at that time?  I assume yes - yes, in order for the impairment to be PERMANENT it must be measured at MMI. 

2.  What if he is asymptomatic but when we repeat the films at the end of care there is still the asymmetrical loss of motion present?  Would he still qualify for an impairment if he has no pain or limitation in function? Yes, remember it is about the FUTURE harm and degeneration that occurs.  Most amputees are asymptomatic as well...

3.  Most flexion extension happens in the lower cervical spine, correct, as most rotation happens in the upper cervical spine?  So, are we really expecting to see symmetrical balancing of flexion across all segments of the C-Spine on the flexion films?  (same for extension) - YES - majority of rotation = C1/2

4.  I remember from the dinner seminar you are saying less 11 degrees of segmental motion was impairment but in the webinar, you saying something about 0.6mm was the threshold for impairment for angular.  What am I missing?  - .6mm = Ligament Injury, it must reach a threshold of 3.5mm in CS or 4.5 in TS/LS in translation or > 11 degrees to be RATEABLE.  Just because you have a LAX LIGAMENT does not mean it is RATEBALE at 25% by the GUIDES. 



Adjunct Associate Professor of Chiropractic, University of Bridgeport, College of Chiropractic
Adjunct Professor, Division of Clinical Sciences, Texas Chiropractic College
Educational Presenter, Accreditation Council for Continuing Medical Education Joint Partnership with the State University of New York at Buffalo, School of Medicine and Biomedical Sciences

Academy of Chiropractic
US Chiropractic Directory
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