taught by  James M Cox, D.C., D.A.C.B.R.

Saturday — 6 hours — Focus: FAILED BACK SURGICAL SYNDROME & COX® TECHNIC

8am – Failed Back Surgical Syndrome Defined

8:30 am – Costs & Management Options

·           Comparison of spinal manipulation to surgical outcomes for treatment of spinal stenosis and herniated disc patients

·           How much does chiropractic cost?

·           Epidural steroid injection factoring into the surgical and non surgical care of post surgical cases and its value to the chiropractic physician

9:30 am (1 hr technique) – Cox® Technic Research Support

Chiropractic flexion distraction and decompression biomechanics and clinical outcomes comparing chiropractic and medical care - data from Health Resources and Services Administration of the Department of Health and Human Services federally funded research studies:

·           Neuropraxia to neurotmesis decision making in treating failed back surgical cases

·           synaptic relays of sensory and motor information in flexion distraction manipulation

·           long term follow up outcomes comparing medical and chiropractic manipulation of chronic low back pain

·           the five effects on the triple joint complex under flexion distraction manipulation.

Effect of distraction on disc degeneration in laboratory studies

 10:30 am (1/2 hour technique): Considerations

·           Changing face of chiropractic spinal manipulation in the growing incidence of spinal stenosis in our aging populous

·           Disc prosthesis - pros and cons

·           Lipson principle of post surgical metaplastic proliferative fibrocartilage as a recurrent disc herniation - 2 cases reported

·           Pre and post MRI studies of herniated disc and stenosis patients under conservative care - and do they mean anything?

·           Precautions and tolerance testing in treating post surgical patients with flexion distraction and decompression manipulation based on the study of Panjabi, Willen, Wildermuth, Schonstrom, Cox

11 am  - Noon (1 hour technique) — Cases: Chiropractic flexion distraction & decompression spinal manipulation for the FBSS case (or those not receiving perceived expectations from surgery)

Noon-1pm LUNCH ON OWN

1pm – 3pm (2 hours technique): Cases Continued…

·           Post surgical bolt and plate persistent and/or recurrent pain

·           Vertebroplasty persistent pain following the procedure

·           Degenerative spondylolisthesis: incidence, presentation of four cases with adjacent level fusion stenosis due to ligamentum flavum hypertrophy, disc herniation, and developed degenerative spondylolisthesis

·           Ligamentum flavum hypertrophy stenosis case. How much relief represents a successful clinical outcome?

·           Herniated disc adjacent to level of a disc prosthesis in a 20 y/o female

·           Pre and post MRI study of an L4-L5 and L5-S1 herniated disc protrusion following endoscopic surgery - an interdisciplinary surgical and flexion distraction approach to treatment

·           Three level decompressive laminectomy for spinal stenosis treated post surgically for continued pain

·           47 year old female with low back and right first sacral nerve root sciatic pain following L5-S1 laminectomy

·           Surgical fusion for L4 degenerative spondylolisthesis and hip arthroplasty in an 80 year old man with left lower extremity sciatica. The 50% rule importance in such a case.

·           Extraforaminal L5-S1 sequestered disc surgically removed with facetectomy and its post surgical care

·           Discogram positive L4-L5 herniated nucleus pulposus in a 41 year old female successfully treated for right sciatic pain following epidural steroid and physical therapy care failed to relieve the pain and surgery is recommended

·           Demonstration of flexion distraction and decompression chiropractic procedures in the treatment of the above mentioned failed back surgical cases.
more as available...

Sunday — 6 hours  — Focus: CERVICAL SPINE PAIN CONDITIONS & COX® TECHNIC 

8 am  Cervical Spine Biomechanics & Diagnosis Considerations

Literature Review of

·           Healing percentage of neck injury

·           Objective signs determining outcome

Specific Diagnostic Findings and Mechanism of Pathology  

Structural and Neuroanatomy of the Cervical Spine

Dorsal Root Ganglion Anatomy & Physiology

Spinal Stenosis – Pavlov Diagnosis & Clinical Findings

Vertebrobasilar Artery Disease

Whiplash Injury

Scleratogenous versus dermatogenous cervical spine and extremity pain

Herrniated Disc Patholgy and Clinical Presentation

10 am  Published Literature: Cox® Treatment of Cervical & Thoracic Conditions, Herniated Nucleus Pulposus & Stenosis

10:30 am  Patient Clinical Rounds & Management

·           Filmed presentation of actual patients from Dr. Cox’s practice & their care/outcome

·           Patient Management: algorithms of decision making; report of findings; re-examination; nutrition

11:30 am    Hands-on Demonstration to include Tolerance Testing

Noon-2 pm Hands-On Practice by attendees of cervical and thoracic spine protocols & FBSS protocols

2 pm Adjournment