PostureRay®:

Joseph Ferrantelli, DC

Private Practice New Port Richey, FL

CTO & Instructor CBP^® Seminars

CEO PostureCo.

INTRODUCTION

In many Chiropractic Techniques as in Chiropractic BioPhysics, standard of care requires the clinician to “hand draw” on x-rays and to measure spinal subluxations using a protractor or templates such as the CBP® OXI and Elliptical Normal Templates. Even when doctors upgrade to digital x-ray solutions, they are left with very limited analysis tools built in to their PACs, which unfortunately take considerable time to utilize - leaving less time for patient care.

As you know, X-ray line drawing is not only a tedious task, but also is very time consuming – thus why many in our profession fail to identify crucial spinal subluxations. For most doctors, they must analyze films themselves, which places a burden on the doctor, taking time away from adjusting patients. This leaves most to resort to simply using only the briefest of lines (like only using the CBP® normal templates for patient education). How do I know? Quite simply, because not only do most of you tell me this at seminars, but I too did this early in my career!

Sometimes, the doctor will fall victim of “believing” that they are good enough to treat patients without a thorough segmental and global analysis. However, if you have treated patients long enough, you soon realize, that many of the patients who failed to “respond” to care may have been because you, as a clinician, failed to recognize the significant yet subtle segmental vertebral hyper-extension or hyper-flexion buckling (2nd and 3rd harmonics) of the sagittal curves on lateral views. If you didn’t identify the displacement, how likely would you be to correct it?

PostureRay® to the Rescue!

PostureRay® was developed by PostureCo, Inc. for Chiropractic Techniques that use x-ray analysis and is today’s premiere X-ray Mensuration EMR Solution. This system allows you to quickly analyze your plain or digital films using lines of mensuration quickly, easily, and painlessly! No longer will you have to stay after hours or come in on the weekends to analyze your films. With PostureRay®, you simply have your office staff obtain digital pictures of your films (using an ordinary digital camera), obtain DICOM x-ray files from your digital x-ray system, or even obtain from an outside radiological facility on CDs. Regardless of how you obtain the x-ray digital images, they can be quickly analyzed and documented by the PostureRay® EMR system (see Figure 1). 

Provide your patients the evidence

Often chiropractors are reluctant on giving care plans or explanations as to why it will take time to alleviate symptoms, correct the underlying problem, and maintain wellness. As you decide about giving patients care recommendations, remind yourself as well as them that when conditions are diagnosed, traditionally there have been validated courses of care for that condition. The same is true with spinal subluxations and now you can provide them evidence as to what the scientific research demonstrates in cases such as theirs. This allows them to make a more informed decision about engaging in your/their care. The fact of the matter is patients need to understand WHY they need corrective care. We need to provide them with legitimacy about their condition along with information on how we can help them. The PostureRay® Report of Findings document is your tool to pass this crucial information on to them. This report synthesizes the information in a simple to understand X-ray ROF personalized for the patients (see Figure 2) and is a take home piece that everyone can understand. This provides them with the information they need to initiate and continue their care based upon your initial recommendations.

Figure 2. In the above examples, excerpts from PostureRay® ROF are shown. In the PostureRay® ROF, the patient’s spine vs. normal are displayed, along with text descriptions which are completely customizable by the doctor.  Tools such as PostureRay® allow a chiropractic clinic to “stand out of the crowd” as unique in their city or town, all through better patient education.

The Best Marketing - Stimulate Internal Patient Referrals

By using PostureRay®, your office will benefit from not only a clinical standpoint - but a practice management standpoint as well. Your patients will get a detailed ROF on their x-ray findings, to go along with their PostureScreen Mobile or PosturePrint® findings. Using these to custom patient reports, your patient will be able to go home and show their family and friends their structural problem(s) in a clear and concise manner.

So what can PostureRay do that the “other” systems cannot?

1. Compares your patient’s spine to normal from digital x-ray images of AP and lateral cervical, thoracic, and lumbar films, AP nasiums, AP or PA Ferguson sacral base views (obtaining true anatomical leg length inequality), lateral fullspine and flexion/extension stress views.
2. PostureRay® allows a patient’s x-rays to be available in a simple and easy to use patient database and Digital ViewBox screen with all pertinent results – all with telestrator functionality!
3. PostureRay® compares their subluxations at each level to normal and the percentage loss or gain from normal calculated automatically measuring all segmental relative rotational angles and the global absolute rotational angles in degrees along with all translational distances in millimeters.
4. PostureRay® superimposes The Harrison Ideal Elliptical curves (using any color) and highlights George’s line (patient’s spinal position) on their digital x-rays. In addition, you can export these images to 3rd party practice management software. Furthermore, this is the ONLY system which can legally and correctly apply and overlay the copyrighted Harrison Spinal Model on digital images.
5. PostureRay® compares patients pre-post care films with percentage improvement at each level of their spine, or conversely their worsening if they had a traumatic event such as a motor vehicle crash.
6. PostureRay® objectively measures spinal instability crucial for calculating impairment ratings.

SUMMARY

So with that being said, the question soon becomes, “How long can your practice survive without PostureRay®?” If you would like to learn on how the PostureRay radiographic analysis EMR solution can benefit your practice, please call 866.577.7297, email sales@postureco.com or visit www.postureco.com

Think Zinc and D3 for the Cold and Flu

The cold and flu ‘season’ is coming to an end—nearly over so to speak—as spring is here. Of course, there is really no season for these virus strains as most recent research shows that the spikes found in wintertime incidence and prevalence of these two illnesses is largely dependent on shorter days with reduced sunlight hours and colder weather; both of which impact the amount of direct skin to sunlight exposure time of human populations. Problematically, the common cold and flu are two of the most widespread illnesses our societal populations face today and are among the leading causes of visits to physicians and loss time from work and school.

During this ‘seasonal’ time of year, the pro-flu-shot-vaccination campaign increases in its aggressiveness and intensity. Some of the recent strategies can be found popping up on bill boards across the US where the marketing campaigns target human social and emotional behaviors. The taglines read:

• ·      The flu ruins date night…
• ·      The flu ruins birthdays…
• ·      Etc…
• Lack of good Evidence for Vaccination

Of interest, in 2010, a Cochrane¹ analysis was published assessing the available literature evaluating the effectiveness of the flu vaccine for influenza in adults. They included 50 studies, with 40 clinical trials assessing over 70,000 subjects. The results were enlightening:

• The flu vaccine was found to be a poor match (approx. 1%) to the actual viral strain(s) affecting the population during that specific year.
• The flu vaccine had only a modest effect on reducing time off work in adults and had no effect on hospitalization or actual complication rates (pneumonia, transmission to others, etc.).
• Importantly, the inactivated vaccines caused ‘local harms and an estimated 1.6 additional cases of Guillain-Barre Syndrome’ per million vaccinations’.¹

• Natural alternatives for Innate Immunity

In addition to providing Chiropractic adjustments and spinal rehabilitation interventions, conservative care (health/wellness) based Chiropractors have generally advised their patient populations on nutra-ceuticals to enhance innate immunity for protection against the cold and flu viruses. Here’s a brief review of recent research on two of the main nutritional supplements Chiropractors should and do recommend for enhanced immunity.

• ·      Zinc-

A recent, 2011 systematic review by Singh et al², presented information based on the available randomized, double-blind, placebo-controlled trials using zinc for at least five consecutive days to treat, or for at least five months to prevent the common cold. They identified 15 studies that met their inclusion criteria: 13 therapeutic trials (with a total of 966 total subjects) and 2 preventive trials (with 394 total subjects). This review identified that intake of zinc was associated with a statistically significant reduction in the duration (p = 0.001) and the severity of the common cold symptoms (p =0.04). Additionally it was revealed that:

• ·      There was a significant difference between the zinc and control group
  for the proportion of participants symptomatic after seven days of treatment;
• ·     
• ·     
• ·     

Note that the adverse events from zinc supplementation seem a heck of allot better than the ones from vaccination! Also, not all zinc is the same, some studies show conflicting evidence due to a reduced bioavailability of zinc from specific formulations.

• Vitamin D

Vitamin D is fast becoming, if not already, the ‘Vitamin C’ of the current generation. It is a known fact that Vitamin D levels in the human body have an inverse trend to the cold and flu virus incidence and prevalence. It is currently accepted that vitamin D supplementation reduces the incidence of viral respiratory infections in children and adults.³ Recent evidence has been found that vitamin D has anti-viral and anti-microbial roles in the immune regulating system.⁴ One of the more compelling pieces of evidence for vitamin D’s role in protection against the flu comes from the 2010 randomized, double-blind, placebo-controlled trial by Urashima and colleagues.⁵ They⁵ found that vitamin D(3) supplementation during the winter months reduces the incidence of influenza A:

Summary

            Let’s face it, we’re all going to get run down, stressed out, and sick from time to time. Instead of running to the local cold and flu needle sticking shop, why not supplement with appropriate nutra-ceuticals to aid in the prevention of and lessening the severity/duration of the cold and flu. It appears to be just as effective, if not more, and safer to think zinc and vitamin D

References

PostureRay®: Better Software Based on the Best Structural Science!

This year we have released many exciting updates to our PostureRay® Radiographic EMR system.  In addition to its already exhaustive list of features geared to stimulate patient referrals and bullet proof your documentation, we have again added EVEN MORE requested features.  Here is a glimpse of the latest additions.

Pediatric Age-Related Segmental and Global Analysis:  Yes, you heard correct, we have released our modeling research findings in our software for inclusion of age-related specific normal for the pediatric/adolescent populations.  Earlier this year, Deed Harrison, DC, Tad Janik, PhD, and myself revisited our ideal and normal modeling studies to extrapolate age related normal using our published modeling for the Harrison Posterior Tangent Methods.  This again, is available nowhere else but in the PostureRay® CBP® module.

Updates Instability Analysis: We have included an optional upgrade to the Endplate (Cobb) analysis for instability pioneered originally by White and Panajbi – which was adopted by the AMA Guides.  In addition, we have also added Penning’s Analysis to better evaluate total instability within total range of motion.  This is crucial for doctors that work on patients involved in MVC’s and other injuries where cervical instability is to be assessed.

Lateral Full Spine Analysis:  Now available in PostureRay® you can digitize a lateral fullspine view and overlay the copyrighted CBP® elliptical fullspine model allowing much more accurate assessment of a patient’s true sagittal plane balance.  This has never been possible, and obviously is not available in any other software package on the market.

Phrase Builder – Since our system is geared as a Structural Based Radiographic Specific EMR, this unique addition will drastically reduce reporting by doctors to both educate patients as well as add impressions to a pathology report using our state of the art macro phrase builder/reporting system.

Nasium Analysis – New to PostureRay® is inclusion of the CBP® Nasium analysis, adding the completion of upper cervical analysis specific to CBP® Methods.

Support for 3^rd Party EMRs / PACs– We are currently partnering with all major vendors of documentation EMRs as well as 3^rd party PACs systems to allow tighter integration with patient demographic implementation and calling up of our QuickView Module.

Updated QuickView and Image Exporting: Doctors now have ability to display and export different variations of our analysis, especially for scoliosis cases.  This allows for adding overlay of annotated findings with impression report lines (such as Risser-Ferguson/Cobb Analysis/ or “patient  friendly” assessment lines 

Impression Report Updates with citations:  Since CBP® originally authored countless index medicus papers on x-ray reliability, validity, as well as the modeling studies, we have used this expertise, to generate specific reports and references to aid your documentation of your x-ray findings.  Again, this available no where else.

If you would like to learn on how the PostureRay® radiographic analysis EMR solution can benefit your practice, please call 866.577.7297, email sales@postureco.com or visit www.postureco.com