Auto Collision Related Spine Injuries 2012 Part I

Hi everyone~ I went to a seminar about Auto Collision Related Spine Injuries 2012 by Dr. Dan Dock, DC on Thursday, Feb 9, 2012. Here I will share some of the information that I learned from the seminar. As far as record keeping is concerned. Dr. Dock recommends hand writing notes. It has to be readable by other people as well. He also focused on incorporating an exercise program for patients to do in the office for their neck and/or back injuries.

There are ways to show the treatment is reasonable and necessary. Such as how patients activity of daily living have improved since getting care. Please be specific such as on the right or left, and which body part. And if their pain level have changed. You can use none, minimal, mild, moderate or severe to rate pain level besides using 0 to 10 scale. Mechanism of injury is the key to find out injury and to see clinical correlation. Where was the car hit? Where was the head turn? Was the foot on the break? Were arm on the steering wheel? If hit from behind, patient's body go backwards then forwards. If patient could not recall his position mostly he has light concussion, or short term amnesia. If the amnesia last for more than 2 to 4 hours, patient needs a CT scan. There might be intercranial bleeding.

If patient has gradual onset of pain following the accident. Most likely because the endorphin is slowly wearing out after the accident. If patient did not come for treatment, ask why. Is it because work, job, family or no health insurance? Look for muscle spasm and rate the level. Check for Active range of motion and passive range of motion once a month. Decreased cervical extension could be pedicle or facet fracture. Asymmetrical loss of motion could mean injury to the facet and disc. Look for sharp angulation, sharp reverse curve in cervical flexion and extension x-ray. This could mean damage to the capsule ligament, facet joint, interspinous ligament, and supraspinous ligament. If there is breakage in George's line there might be torn disc or fracture.

MRI for patient if there is distinct nerve root pattern, intense pain, something new and different, or patient is getting worse with treatment. Consider pre and post x-ray if the condition is unstable.

Care plan: update frequency of care, duration of care, exercise program, physical limitation and referrals for second opinion. Supportive care means patient's condition deteriorates without care. Maintenance care: no change in subjective and objective findings without care.

Active Spines Chiropractic Keeps Your Spine Active and Pain Free! You can contact Dr. Shao-Hao Cheng at 425-818-0086 or info@activespines.com