Why should I join the American Academy of Spine Physicians? Click here for 25 Reasons to Join.

Does being a member of the American Academy of Spine Physicians suggest that my practice is limited to spinecare? No. It simply acknowledges that you provide spinecare within your chosen scope of practice. You may have other areas of emphasis within your practice.

Is it beneficial to belong to other membership based spine organizations? Yes.

Should I join other national organizations such as the American Chiropractic Association (ACA) or the American Association of Neurological Surgeons (AANS)? Yes. The goals of these organizations are not limited to spinecare and they have a lot to offer their membership.

What is the highest level of recognition for physician continuing education in spinecare provided by the American Academy of Spine Physicians? Fellow status with the American College of Spine Physicians (FACSP). 

Do you have to be a member of the American Academy of Spine Physicians to obtain Diplomate status with the American Academy of Spine Physicians? Yes

Do you have to be a member of the American Academy of Spine Physicians to obtain Fellow status with the American College of Spine Physicians? Yes

Do you have to have a separate membership with the American College of Spine Physicians to obtain Fellow status with the American College of Spine Physicians? No, you must be a member of the American Academy of Spine Physicians (AASP). The American College of Spine Physicians is a division of the AASP.

Do I to need to apply for AASP membership (renew membership) online? No. Although we recommend that you complete the membership/renewal application process online to help ensure an accurate database. If you do not wish to apply online contact the AASP membership office at (847) 697-4660 and request that an application be sent or faxed to you. A faxback option will soon be available online. 

How will I receive notification of membership renewal? If the AASP has your email address on file you will receive notification of renewal by email. You may also receive notification by regular mail.

Do I have the option of setting up an automatic membership renewal? Yes. Go to the online membership/renewal application page and click on the area auto-renewal.

What is the benefit of setting up an auto membership renewal? It will help to ensure uninterrupted service and directory listing. It will help to ensure appropriate application of continuing education credits toward Diplomate or Fellow status.

Will the American Academy of Spine Physicians promote public awareness? Yes. The AASP is committed to enhancing public awareness about spinecare and about spine physicians at various levels. The AASP has a dedicated area on the website for the media. Members of the media can come to this location to obtain statistics, news about the advances in spinecare, information about cooperative spinecare and about the expertise and training  of the chiropractic physician and the neurosurgeon in the field of spinecare. 

Is the Diplomate status offered by the American Academy of Spine Physicians recognized by the chiropractic and medical professions? Organizations and individual physicians  who recognize the importance of continuing education and who become aware of the criteria required to obtain a credentialed status with the American Academy of Spine Physicians and the American College of Spine Physicians will recognize the achievements of the physicians who holds this status. The AASP is committed to enhancing the recognition of the credentialed status at all levels.

Will the AASP website continue to be developed and grow? Yes

Is the AASP committed to providing me with marketing and educational resources to help me enhance my recognition as a spine specialist within my community? Yes. The AASP will provide ongoing development of web resources, patient educational opportunities and news/press releases.

Will the AASP be developing strategic alliances with other organizations? Yes.

Can a physician from a country other than the United States of American join the American Academy of Spine Physicians? Yes.

What is a spine physician? This term refers to a doctor who provides spine and related care and specifically refers to chiropractic physicians and neurosurgeons, members of the AASP.

Is the AASP part of a College or University? No. The AASP is an independent organization with members from many different institutions. The AASP cooperates with and affiliates with various institutions in the development and provision of continuing educational opportunities for chiropractic physicians and neurosurgeons.

How can I find a doctor in my area who is an active member of the American Academy of Spine Physicians (AASP)?  To Locate a physican click here .

The doctor presently seeing me for back or neck problems does not appear to be an active member of the AASP; therefore, is he/she qualified to care for my spine? Your physician may be very qualified in providing spinecare. The AASP cannot guarantee the skills of any particular member or implicate the lack of skills in a non-member. The AASP is an organization, which provides a unique opportunity for chiropractic physicians and neurosurgeons to obtain continuing education and work together. Membership in the organization suggests the member is dedicated to providing conservative and cooperative spine care. The AASP attracts those who are leaders in spinecare.

Does the AASP screen prospective members prior to granting membership? Yes. The member must be a chiropractic physician or neurosurgeon with a spinecare practice and valid license to practice and must complete the application form and be approved by the AASP membership committee.

How can I help improve communication between my chiropractic physician and neurosurgeon? Let your physician know that you are aware of the AASP and request that they join for your benefit and the benefit of others. You can also contact the AASP membership office and request that information about the organization be sent to you or directly to the physicians of your choice. The AASP can forward information by fax, email or regular mail.

What is the benefit of seeing a physician who is an active member of the AASP? You are seeing a physician who prioritizes the well-being of the patient and is committed to conservative and cooperative spinecare.

Does the AASP recognize advanced training for spine physicians? Yes. The AASP provides opportunities for educational advancement for it members. The AASP provides the designations of Diplomate or Fellow to those active members who meet the academic requirements set forth. The level of advanced training achieved by members is posted on the member’s profile. High academic achievement is recognized by the doctor being named a Diplomate of the American Academy of Spine Physicians. The highest level of academic achievement recognized by the AASP is that of Fellow of the American College of Spine Physicians, through the AASP.

How do I find a member of the AASP who has pursued continuing education through the organization? Go to the online AASP member directory. Search for a member.

Do members of the AASP participate in managed care (PPO, HMO, etc). They might. You would have to contact the member’s office directly and confirm whether they participate in any particular insurance plan.

Does the AASP have a medical center or run a clinic? No.

Do physician members of the AASP provide second opinions? Most members are available to provide second opinions. You would have to contact the member of your choice and inquire about this.

Will the AASP schedule an appointment with a physician for me? No. You can obtain contact information from the AASP. You can schedule your own appointment.

What is the educational background of a neurosurgeon? Click here to view a Neurosurgeon’s training.

What is the educational background of a chiropractic physician? Click here to view a  Chiropractic Physician’s Training.

Can I go to a neurosurgeon and a chiropractic physician for spine care during the same time period? Yes.

Is it possible I might need surgery on one part of the spine and chiropractic care for another part of the spine? Yes.

What is conservative spine care? Conservative care refers to providing the least invasive therapeutic option, which provides the greatest potential benefit, and least exposure to risks.

When should I tell acquaintances about the AASP? If they have acute or persistent spinal and related complaints including back and neck pain and pain radiating down the arm or leg.  If they have been told they may require surgery and wish to seek a second opinion.

I thought medical doctors and chiropractic physicians did not get along, so how did the AASP develop? It developed as the result of a group of neurosurgeons and chiropractic physicians who put any bias aside, educated each other on their role in spine care and decided to work together for the benefit of patients with spinal disorders. AASP Hisory

How can I obtain more information about spinal disorders? Go to the AASP location spinaldisorders.info and search for your condition.

How can I obtain additional information about my spinal diagnosis through the AASP? Go to spinaldisorders.info and search by entering in your spinal diagnosis.

How can I obtain information about diagnostic approaches to spinal conditions? Go to spinaldisorders.info and click on the category of your choice.

Have there been press releases about the AASP? Yes, some of which are posted on the website for review.

Who provides direction to the AASP? The Academy Council,  Academy Scientific Consultants, Academy Education Committee and the Academy Scientific Committee provide direction to the AASP.

Who is on the Academy Council? The Academy Council is comprised of pre-eminent Chiropractic Physicians and Neurosurgeons dedicated to improving the quality of spine care through the mission and goals of the AASP. AASP Academy Council

What do the neurosurgeons and chiropractic physicians have in common? Both physicians emphasize conservative care of the spine. They both have extensive training in biomechanics, neurology and disorders of the spine.

Do I have a right to be informed by my attending physician of reasonable therapeutic options for my spinal condition? Yes.

What are some of signs and symptoms of spinal disorders? Back pain, back discomfort, or back stiffness. Neck pain, neck discomfort, or neck stiffness. Pain, numbness, tingling and/or weakness in arm(s) or leg(s). Can also include difficulty holding or passing urine or difficulty controlling the bowels.

What are some of the categories of treatment available to those of us with spinal disorders? Go to spinaldisorders.info and search under therapeutic options.

Would my primary care physician be aware of the AASP? Probably not, especially, if their practice does not emphasize care of the spine and related disorders.

Do you need to be certified by any other organization to apply for credentialing with the American Academy of Spine Physicians?

No. you do not need to be certified by any other organization to apply for credentialing with the American Academy of Spine Physicians.

Is a special credentialing examination required to obtain a Diplomate or Fellow status with the AASP?

No, however, in order to obtain the level of continuing education credits required to receive a Diplomate or Fellow status testing after each of the courses requires a passing score of 80% or greater.

Approximately how much money will I have to invest to obtain a Diplomate Status?

The average cost per online educational credit has been held to is $10. For example, to obtain 300 continuing education credits to meet the criteria for Diplomate status the cost would be approximately $3,000.

Do I have to buy the reference books used for the textbook review courses?

No. You may obtain the reference book from a library or borrow it from a colleague. If you wish to obtain a textbook, it may be available to members at a discount in the AASP store.

Do I have to pay a subscription rate for the AASP online Journal?

No. Active members of the AASP have direct access to the online Journal at no additional cost. Select Journal articles can be used to obtain continuing education credits with the AASP. The Journal is available online at www.spinephyscians.org.

Where do I obtain a list of books used for the Textbook Review Courses?

The list is available on the AASP website.

How were the textbooks chosen for the Textbook Review Courses?

The AASP Educational Committee reviewed numerous titles and chose those books which together represent a comprehensive study of spine disorders and spine care.

How long will it take for me to complete the academic requirements for Diplomate or Fellow status with the AASP?

The requirements for credentialing with the AASP can be obtained at your own pace.

1. AASP COMMITMENT TO EXCELLENCE THROUGH EDUCATION

The American Academy of Spine Physicians is committed to education. The AASP is dedicated to providing unique and affordable continuing educational opportunities for doctors who care for the spine. Special opportunities are also provided for chiropractic students and neurosurgical residents who are candidate members of the AASP. Emphasis is placed upon providing economical home or office study options, which allows for broad and efficient dissemination of relevant information. Greater educational exposure will reach more physicians thus better serving the public. The Academy’s continuing educational programs include the implementation of online opportunities and an array of written and multimedia resources. The AASP supports the concept of jointly sponsoring activities with organizations and educational facilities whose goals are compatible with the goals of the Academy.

Through education of its members and the public, the AASP can help improve the quality of comprehensive spinecare. The AASP is dedicated to using all available methods and technologies to inform its members and the public about trends in spinecare while emphasizing the benefits of conservative and cooperative spinecare.

The AASP continuing educational programs emphasize the anatomy, biomechanics, pathogenesis, diagnosis and care of the full spectrum of spinal disorders, the benefits of cooperative care, methods of early detection of spinal disorders and expanding therapeutic options available through the alliance of chiropractic physicians and neurosurgeons. These educational opportunities will also promote clinical interaction between chiropractic physicians and neurosurgeons which contributes to improved continuity and quality of spine care. The continuing medical education opportunities also encourage personal growth and professional development of chiropractic physicians and neurosurgeons.

The AASP will record the number of continuing medical education credits obtained through the Academy for members. The AASP will award Diplomate status and Fellow status to those AASP members who meet the designated level of educational criteria. The provision of Diplomate or Fellow status with the AASP serves to inform health care professionals and the public of the higher level of education a physician has received through the organization.

The AASP is one of the only organizations of its kind to offer interdisciplinary post-doctoral designations of educational achievement to its members who meet the continuing educational criteria. The highest level of educational distinction offered by the AASP is Fellow status. The neurosurgeon or chiropractic physician who achieves this level of academic achievement will be designated as Fellow of the American College of Spine Physicians.

2. BENEFITS OF OBTAINING CONTINUING EDUCATION THROUGH THE AASP

      1.  Affordable education.

2.    Flexible self study options

3.     Reduce time away from the office

4.     Choice of specific topics on which to focus. 

5.     Obtain continuing education in an interdisciplinary forum.

6.     Credits obtained through the AASP may be applied towards obtaining Diplomate status with the American Academy of Spine Physicians and Fellow status with the American College of Spine Physicians.

7.     Continuing education opportunities which can be applied to continuing education requirements for license renewal in various states

8.     Obtain relevant information for providing comprehensive spine care.

9.     Obtain information, which will help facilitate interdisciplinary dialoge and clinical interaction thus increasing the potential to serve more patients.

10. Expand your resume/curriculum vitae with significant continuing education topics in clinical and basic spine sciences.

3. CONTINUING EDUCATION PROGRAMS

Journal Review Courses:

Continuing medical education credits can be obtained through the American Academy of Spine Physicians’ Journal Review Courses (JRC). You can review articles published in JAASP, JOURNAL OF THE AMERICAN ACADEMY OF SPINE PHYSICIANS available online. After select journal articles there is a bank of test questions. Continuing educational credits are available for reading the articles and completing the assigned test bank with a minimum of 80% proficiency. The number of credits available is listed at the end of each eligible articles or section.

Textbook Review Courses:

The AASP’s Textbook Review Courses (TRC) are an outstanding practice resource and provides you with many of the advantages of a seminar in the convenience of your home or office. The TRC format is affordable, effective and precise. You are provided with a comprehensive list of spine related topics to choose from. The list includes the names of textbook and chapter source for the material.

You can now choose topic specific educational coursework based upon your practice needs. The information is carefully chosen by the interdisciplinary educational committee of the AASP. The chosen authoritative texts provide the insight and wisdom of world renowned experts on the spine. The selected combination of materials provides comprehensive coverage of subjects of interest to both chiropractic physicians and neurosurgeons and provides an overview of the spectrum of spinal disorders.

The TRC format also provides you with a unique opportunity to stay ahead in your field and gain a better understanding of the role of health care providers in other spine care related field. You can choose your area of focus and textbook of your choice.

Case Study Review Courses:

The case study review courses (CSRC) refers to an archive of case studies which is posted on the AASP website. Cases can be chosen by topic. Each case study protocol will include the case, an authoritative review (grand rounds) and a bank of test questions. Continuing educational credits can be obtained by successful completion of each case study format.

Symposia:

The American Academy of Spine Physicians may offer periodic symposia. This forum will provide an opportunity to bring together international experts in spine care from the neurosurgical and chiropractic disciplines to present a comprehensive review of spine care These meetings will provide an opportunity for the AASP members and non-member to update their skills and knowledge and earn continuing medical education credits in spine care. Symposia will be posted on the AASP website as spinephysicians.org.

4. SPECIAL APPLICATIONS FOR CONTINUING EDUCATION CREDITS

License Renewal: Many states require that practicing physicians obtain a specific number of continuing education credits. The American Academy of Spine Physicians provides Category I and Category II Continuing Educational opportunities online. Home study courses are available with at home testing as well as online testing. The continuing educational requirements for physicians differs from state to state, the AASP member must confirm with their respective state organization the eligibility of the AASP online programs.

Credentialing:  The AASP credentialing process provides recognition to individual spine physicians for achieving a high level of continuing education and demonstrating an ongoing interest in improving their capacities to provide or coordinate comprehensive spine care. Becoming a credentialed spine physician requires that individuals fulfill the eligibility criteria, achieve the minimum level of continuing education credits required and receive a passing score on examination. The AASP provides credentialing opportunities as a Diplomate and as a Fellow.

Recognition (Achievement) Awards: The AASP will offer recognition awards for academic achievement for contributing to the AASP educational development or completing a special designated educational opportunity. Such awards will be available to educational institutions that have been supportive to the AASP mission and to AASP members and candidate members.

Candidate Member Recognition (Achievement) Award: Candidate members of the AASP are eligible to obtain Candidate Continuing Education (CCE) credits through online programs. These credits will not apply to Diplomate or Fellow credentialing with the Academy. This program provides a unique opportunity for the candidate to obtain unique clinical insights and develop his or her resume with listing of levels of recognition received through the Academy. This program can be accessed on line by typing SPINE.TV. Some college, university and medical center locations will have a dedicated computer resource station within their library or resource center for student or resident access to the American Academy of Spine Physicians online educational programs.

5. CREDENTIALING WITH THE AASP

The AASP provides acknowledgement of the level of continuing education achieved through the Academy by the designation of Diplomate or Fellow to the member who has met the necessary criteria. Application for credentialing from the American Academy of Spine Physicians is voluntary on the part of physicians who engage in care of the spine and related disorders. The American Academy of Spine Physicians credentialing process requires the following steps:

•  Helps to implement an interdisciplinary Code of Ethics and the AASP Patient Bill of Rights
• Promotes professional accountability, visibility and leadership.
• Identifies those professionals who have chosen to advance their knowledge and raise their professional accomplishments in the spinecare field.  
• Advances interdisciplinary cooperation between chiropractic physicians and neurosurgeons.
• Encourages continued professional growth and development.

Levels of Credentialing

The American Academy of Spine Physicians offers two levels of credentialing. The level of credentialing awarded is based upon meeting the designated professional and continuing educational criteria.

1.      Diplomate status is awarded to AASP members who have acquired a minimum of 300 continuing education credits through the AASP. The member may then use D.A.A.S.P. after his/her name indicating their status as Diplomate of the American Academy of Spine Physicians. 

2.      Fellow status with the American College of Spine Physicians is awarded to those physicians who have met the requirements of the Diplomate status and have acquired an additional 200 continuing education credits through the AASP. The member may then use F.A.C.S.P. after his/her name indicating their status as Diplomate of the American College of Spine Physicians. 

6. AMERICAN COLLEGE OF SPINE PHYSICIANS

The American College of Spine Physicians is a division of the American Academy of Spine Physicians. The College represents a select group of members of the AASP who have achieved the highest-level continuing education recognized by the AASP. Physicians inducted into the College as a Fellow have achieved a minimum of 500 continuing educational credits through the AASP. After being awarded a Fellow status with the College the physician may use the initials F.A.C.S.P. representing their status as a Fellow of the American College of Spine Physicians.

7. BECOMING CREDENTIAL ELIGIBLE

The first requirement for becoming a credentialed spine physician with the AASP is to become credential eligible. The application to become credential eligible requires completion of the following steps:

1.      Meet AASP membership criteria.

2.      Be a member of the American Academy of Spine Physicians in good standing.

3.      Complete and submit the Credentialing Application Form

4.      Submit a copy of state license

5.      Submit a non-refundable $100 credentialing application fee made payable to the American

       Academy of Spine Physicians

Upon completion of these steps, the application will be forwarded to and reviewed by the Academy’s Continuing Education Committee. The Academy reserves the right to request any additional information or clarification required for the completion of the application process. You will be notified by mail regarding the decision of the Continuing Education Committee. Completion of the peer review process may take 2-4 weeks after all of the required application materials have been received by the Academy.

Individuals who have satisfactorily completed the steps necessary for becoming Credential Eligible may begin acquiring continuing educational credits through the Academy.

8. MAINTAINING CREDENTIAL ELIGIBLE STATUS

You may remain Credential Eligible with the AASP for no more than 4 years. During this period you may use the term “credential eligible spine physician.” To remain in good standing as Credential Eligible with the AASP you must:

1.      Must be a member in good standing of the American Academy of Spine Physicians.

2.      Practice in accordance with the American Academy of Spine Physicians Code of Ethics.

3.      Practice in accordance with the American Academy of Spine Physicians Patient Bill of Rights.

4.      Maintain a current license to practice, if applicable.

5.      Remain in good standing with state regulatory agencies and your profession.

6.      Meet the continuing education criteria for Diplomate status with 4 years of becoming credential

       eligible.

9. THE CREDENTIALING PROCESS

Obtaining Credentialed Status with the AASP

1.       The applicant must be a member in good standing of the American Academy of Spine

        Physicians.

2.      The applicant must have met all criteria and be credential eligible.

3.      To become a Diplomate of the American Academy of Spine Physicians, the applicant

        must successfully obtain a minimum of 300 continuing education credits through the AASP

        while maintaining a credential eligible status.

4.     To become a Fellow of the American College of Spine Physicians, the applicant must

        successfully complete the requirements for Diplomate status and acquire an additional 200

        hours of continuing education credits through the AASP. Fellow status represents the highest

        level of academic achievement which can be obtained through the AASP.

10. MAINTAINING AN ACTIVE CREDENTIALED SPINE PHYSICIAN STATUS

To maintain your Credentialed Spine Physician status with the American Academy of Spine Physicians, the following is required.

1.      Must be a member in good standing of the American Academy of Spine Physicians.

2.      Practice in accordance with the American Academy of Spine Physicians Code of Ethics and the Patient Bill of Rights.

3.      Maintain a current licensure to practice, if applicable

4.      Remain in good standing with state regulatory agencies and your profession.

5.    &

Spinal Imaging (Technology) Update

Spinal imaging update is available to AASP members for a quick overview of advances in the field of radiology and neuroimaging that may provide insight into the diagnostic assessment of a patient with a complex or challenging spinal disorder or injury. Wherever possible the information is categorized by the imaging technology allowing for rapid access. Please click on one of the following categories to obtain the relevant imaging information.

Magnetic Resonance Imaging

Spinal imaging update is available to AASP members for a quick overview of advances in the field of radiology and neuroimaging that may provide insight into the diagnostic assessment of a patient with a complex or challenging spinal disorder or injury. Wherever possible the information is categorized by the imaging technology allowing for rapid access. Please click on one of the following categories to obtain the relevant imaging information.

 

Nuclear Imaging

Spinal imaging update is available to AASP members for a quick overview of advances in the field of radiology and neuroimaging that may provide insight into the diagnostic assessment of a patient with a complex or challenging spinal disorder or injury. Wherever possible the information is categorized by the imaging technology allowing for rapid access. Please click on one of the following categories to obtain the relevant imaging information.

 

Plain Radiographic Studies

Spinal imaging update is available to AASP members for a quick overview of advances in the field of radiology and neuroimaging that may provide insight into the diagnostic assessment of a patient with a complex or challenging spinal disorder or injury. Wherever possible the information is categorized by the imaging technology allowing for rapid access. Please click on one of the following categories to obtain the relevant imaging information.

 

Computerized Tomography

Spinal imaging update is available to AASP members for a quick overview of advances in the field of radiology and neuroimaging that may provide insight into the diagnostic assessment of a patient with a complex or challenging spinal disorder or injury. Wherever possible the information is categorized by the imaging technology allowing for rapid access. Please click on one of the following categories to obtain the relevant imaging information.

Free 1 Month Trial of Customized Interactive AASP Website

First 50 Physicians Only

Sign up for Free Trial Ends in 5 Days (04/23/2004)

____________________________________________________________

2. Presesnt to your patients a professional, educational and interactive website
3. Keep previous and new patients informed via educational newsletters and articles
4. Present to your patients and other meidcal professionals your dedication to cooperative spinecare
5. Set yourself apart from physicians in your Area.
6. Present initial patient forms to patients before their first visit

____________________________________________________________

1. Test drive your new AASP website now.
2. Upgrade an old outdated website
3. Our programmers will build and deploy your site with in two days
4. Pictures and text can be uploaded through our user-friendly admin panel

________________________________________________________________________

Please fill out the form below to trial an Interactive AASP Website for 1 Month Free

First Name:

Last Name:

Title:

Work Phone:

Home Phone:

Alternate Contact Name or Office Manager:

Practice Name:

Best Time to Contact you:

Please Denote Time Zone:

Email:

____________________________________________________________________________

Submit

Medical doctor Web sites are the crucial catalyst to unlocking the $9 billion dollar market in health transactions by 2005, according to Jupiter Research.

http://www.clickz.com/stats/markets/healthcare/article.php/10101_594991

55% of Americans view the Internet as a trustworthy source of medical information, while only 30% find newspapers reliable and 28% find TV reliable.³

By 2005, it is projected that 88.5 million American adults will use the Internet to shop for medical products, conduct medical research about their health concerns, and communicate with their physicians and insurance companies.⁴

http://www.devicelink.com/mx/archive/01/03/0103mx086.html

Harris Interactive calculated that 111 million adults have looked for health information on the Internet, compared to 109 million in 2003 and 110 million in 2002.

http://www.clickz.com/stats/markets/healthcare/article.php/3339561

http://www.informatics-review.com/thoughts/future.html

http://www.clickz.com/stats/markets/healthcare/article.php/10101_594991 **

Dear Dr. _____________, Our Member AASP website program has now been fullly implemented. Several Physicians have their AASP web sites up and running. We are contacting all members that have expressed interest in the AASP website which works hand in hand with the National Spincare Public Awareness Inititative.

The AASP is implementing a National Marketing Campaign and several physicians will have their photo and comments about the Initiative and the website program.

The deadline to have activated the website have it customized and a photo to us is Tuesday 03/22/2004, if you would like to be included.

The web site is only part of the Spine Care Public Awareness initiative. Physicians that have opted to have their testimonies and photos will also have the customized brochures for their practice working also.

Thanks Kevin McCowan

Phone:706-221-1643

Email:[email protected]

The Holy Spirit
NTCCC Bible Institute

12/7/2003

I) The Holy Spirit is God

Matthew 28:19-20

Acts 5:1-4

A) God the Father ( Source of Creation) ( Gen 1:1)

B) God the Son ( Died for the Sins of the World) (Matthew 1:21-23)

C) God the Holy Spirit ( Empowers Men for Service to God)

(Matt 3:16-17)

II) The Holy Spirit is A Person

A) Mind (Intellect) (1 Cor 2:10-11)

B) Will ( 1 Cor 12:1-11)

C) Emotions ( Eph 4:30)(Is 63:10)

III) Functions of the God the Holy Spirit

A) Teacher ( John 14:23-26)

B) Comforter / Counselor ( John 14:23-26)

C) Guide ( John 16:13) (Acts 16:6-7)

D) Convicts Sin (John 16:8)

E) Shows Things to Come (John 16:13)

F) Imparts Gifts ( 1 Cor 12:1-11)

G) Calls men into service (Acts 13:2)

H) Leads people to Jesus (John 15:26)

I) Spirit of Prayer (Zach 10:12) (Gal 4:6) (Romans 8:15) (Jude 1:20)

J) Testifies of Jesus (John 15:26-27) (Acts 1:8)

Taming The Money Monster

NTCCC Bible Institute

( 10/19/2003)

Ages 12-14

Chapter 2

Causes of Debt

A) Lack of Contentment ( Hebrews 13:5, Phil 4:11-13)

B) Search for Security (Deut 31:8) Security is not in things but in God

C) Search for Significance ( Matt 6:25-33) –Get Rich Quick Schemes

D) Lack of Discipline ( Galatians 5) Temperance

Chapter 3

Advertising Illusions

A) You Can’t Live without it

B) Why should you deny yourself

C) Advertising is geared to serve the advertisers, not you

D) Needs vs. Wants

Chapter 4

Financial Deceptions

Deception – Lie (John 8:44, Proverbs 8) Devil means deceiver

A) History proves economic cycles

B) Paying Back with Cheaper Dollars

C) Lenders push as much of the risk to borrowers

D) The Tax Deductibility or Interest

E) It will cost more later

F) The Magic of Leverage

Chapter 5

A) Is it a sin to borrow (Romans 13:7-8)

B) Is it a sin to loan money

Does the borrower have a legitimate need?

Is this a desire of the borrower?

Can you afford to loan it.

C) All borrowing must be repaid

(Psalms 37:21) (Deut 28:12-15) (Proverbs 22:7)

(1 Timothy 5:8)

E) Surety – Guranteeing the loan of another.

(Proverbs 6:1-5) ( Proverbs 11:15) ( Proverbs 17:18)

( Proverbs 22:26-29)

D) Borrowing may deny God and opportunity

A) Phlippian 4:19

B) Hebrews 11:6

Chapter 6 – Page 73

Proverbs 13:11

Proverbs 10:2-3

Proberbs 20:21

Psalm 128

Proverbs 13:22

Page – 75

Phillippian 4:19

Psalm 23

Psalm 84:11-12

Psalm 112:5-9

Proverbs 11:24-25

Compounding Vs Interest

Chapter 7 - How to Get out of Debt

You get out of debt little by little over time, and the major requirement is discipline.

1) Determine where you are – Record all debts

1 John 1:9

1 Thess 5:18

2) Stop going into debt

3) Develop a repayment plan

Sell assets

Use savings accounts

Double payments

Keep payments constant

Reduce living expenses

Reduce Tax Withholdings

4) Establish accountability

5) Reward yourself.

Taming The Money Monster

NTCCC Bible Institute

( 10/19/2003)

Ages 12-14

Chapter 2

Causes of Debt

A) Lack of Contentment ( Hebrews 13:5, Phil 4:11-13)

B) Search for Security (Deut 31:8) Security is not in things but in God

C) Search for Significance ( Matt 6:25-33) –Get Rich Quick Schemes

D) Lack of Discipline ( Galatians 5) Temperance

Chapter 3

Advertising Illusions

A) You Can’t Live without it

B) Why should you deny yourself

C) Advertising is geared to serve the advertisers, not you

D) Needs vs. Wants

Chapter 4

Financial Deceptions

Deception – Lie (John 8:44, Proverbs 8) Devil means deceiver

A) History proves economic cycles

B) Paying Back with Cheaper Dollars

C) Lenders push as much of the risk to borrowers

D) The Tax Deductibility or Interest

E) It will cost more later

F) The Magic of Leverage

Chapter 5

A) Is it a sin to borrow (Romans 13:7-8)

B) Is it a sin to loan money

Does the borrower have a legitimate need?

Is this a desire of the borrower?

Can you afford to loan it.

C) All borrowing must be repaid

(Psalms 37:21) (Deut 28:12-15) (Proverbs 22:7)

(1 Timothy 5:8)

E) Surety – Guranteeing the loan of another.

(Proverbs 6:1-5) ( Proverbs 11:15) ( Proverbs 17:18)

( Proverbs 22:26-29)

D) Borrowing may deny God and opportunity

A) Phlippian 4:19

B) Hebrews 11:6

Chapter 6 – Page 73

Proverbs 13:11

Proverbs 10:2-3

Proberbs 20:21

Psalm 128

Proverbs 13:22

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SUBMISSION CRITERIA FOR

JAASP

JOURNAL OF THE AMERICAN ACADEMY OF SPINE PHYSICIANS

The mission of the JOURNAL OF THE AMERICAN ACADEMY OF SPINEPHYSICIANS (JAASP) is to disseminate peer-reviewed scientific literature and topics pertaining to conservative and cooperative spinecare. The Journal is devoted to improving the quality of spinecare by serving the chiropractic and neurosurgical professions. The public, the scientific and academic communities will also benefit from its contents. This interdisciplinary online Journal has international distribution thus providing an unprecedented opportunity for chiropractic physicians and neurosurgeons to collaborate on relevant spinecare topics.

1. Purpose
   The Journal of the American Academy of Spine Physicians (JAASP) welcomes submissions from outside authors and member physicians. Manuscripts accepted for publication will be those that best fulfill the mission and educational objectives of JAASP and more specifically:

Inform spine physicians about the latest developments affecting their practices, their profession, and their role as leaders in spine care and relative to national health care issues.

Provide timely and useful information on spinecare education, clinical topics, research, and technological advances.

Provide timely, useful information on a variety of topic

CHIROPRACTIC ORGANIZATIONS

American Chiropractic Association
1701 Clarendon Blvd • Arlington, VA 22209 USA
Phone: 800-986-4636
Fax: 703-243-2593
E-mail:
Website: http://www.acatoday.com/

American Public Health Association

Chiropractic Health Care Section
741 Brady Street • Davenport, IA 52803 USA
Phone: 563-884-5854
Website: http://www.c3r.org/chirohealth/
 
Association for the History of Chiropractic
1000 Brady St. • Davenport, IA 52803 USA
Phone: 563-884-5404
Website: http://www.chiroweb.com/ahc/

The Canadian Chiropractic Association
1396 Eglinton Ave. West • Toronto, ON M6C-2E4 Canada
Phone: 416-781-5656
Fax: 416-781-7344
E-mail:
Website: http://www.ccachiro.org/

The Canadian Cochrane Network and Centre
1200 Main Street West, Room 3H7 • Hamilton ON L8N 3Z5
Phone: 905 525-9140, ext. 22487
Fax: 905 546-0401
E-mail:
Website:  http://www.cocsa.org/
 
World Federation of Chiropractic
3080 Yonge St., Suite 5065 • Toronto, ON M4N-3N1 Canada
Phone: 416-484-9978
Fax: 416-484-9665
E-Mail:
Website: http://www.wfc.org/
 
Congress of State Chiropractic Associations
P.O. Box 2054 • Lexington, SC  29071 USA
Phone: 803-356-6809
Fax: 803-356-6826
E-mail:
Website: http://www.cocsa.org/

Foundation for Chiropractic Education and Research
Website: http://www.fcer.org

International Chiropractors Association
110 N. Glebe Road, Suite 1000
Arlington, Virginia  22201
Phone: (800) 423-4690
Phone: (703) 528-5000
Fax: (703) 528-5023
Website: http://www.chiropractic.org

NEUROSURGICAL ORGANIZATIONS

American Association of Neurological Surgeons (AANS)
5550 Meadowbrook Drive
Rolling Meadows, Illinois  60008-3845
Phone: (847) 378-0500
Fax: (847) 378-0600
Email:
Website: http://www.aans.org

SPINE ORGANIZATIONS AND ASSOCIATIONS

North American Spine Society (NASS)
22 Calender Court, 2nd Floor
Lagrange, Illinois  USA  60525
Phone: (877) 774-6337
Email:
Website: http://www.spine.org
 
SPINAL CORD INJURY AND REHABILITATION INFORMATION

Arachnoiditis Sufferers Action and Monitoring Society (ASAMS) New Zealand
Website: http://www.aboutarachnoiditis.org/.

Barnes-Jewish Hospital, Washington University School of Medicine
Website: http://www.neuro.wustl.edu/sci.

Florida SCI Resource Center
Website: http://www.fscirc.com/

National Rehabilitation Information Center
Website: http://www.naric.comNational

Spinal Cord Injury Association (NSCIA) Resource Center
Website: http://www.spinalcord.org/

Spinal Cord Injury Information Network
Website: http://www.spinalcord.uab.edu/

SPINAL CORD INJURY FOUNDATIONS AND FUNDING ORGANIZATIONS

Alan T Brown Foundation to Cure Paralysis
Website: http://www.atbf.org

Christopher Reeve Paralysis Foundation
Website: http://www.christopherreeve.org

Daniel Heumann Fund for Spinal Cord Research
Website: http://www.heumannfund.org/

International Campaign for Cures for SCI Paralysis
Website: http://www.campaignforcure.org/

International Spinal Research Trust
Website: http://www.spinal-research.org/

Kent Waldrep National Paralysis Foundation
Website: http://spinalvictory.org/

Mike Utley Foundation
The Mike Utley Foundation is dedicated to finding a cure for spinal cord injuries. It is committed to providing financial support of selected research, rehabilitation and education programs on spinal cord injuries. The Miami Project is grateful for past support from the Mike Utley Foundation.
Website: http://www.mikeutley.org/index.html

The Myelin Project
Website: http://www.myelin.org
The Myelin Project funds research for restoring myelin, a fundamental part of the nervous system, often involved with spinal cord injury.

Paralysis Project of America
Website: http://www.paralysisproject.org/

Rick Hansen Institute
Website: http://www.rickhansen.com/

Spinal Cord Society
Website: http://members.aol.com/scsweb/index.htm

The Spinal Research Fund of Australia
Website: http://www.srfa.com.au

SPINE RELATED RESEARCH INFORMATION

Miami Project to Cure Paralysis: Research at the Miami Project Index
Website: http://www.miamiproject.miami.edu/miami-project/RESINFO.HTM

CORD: Collaboration On Repair Discoveries; University of British Columbia
Website: http://cord.ubc.ca

Kentucky Spinal Cord Injury Research Center (KSCIRC)
Website: http://www.kscirc.org

National Institutes of Health
Website: http://www.nih.gov/

PVA-EPVA Center for Neuroscience and Regeneration Research:
Yale University
Website: http://www.pva.org/

 30 Tips to Spine Health

 AASP Acceptance Ebook

 AASP General Ebook

 AASP Screen Saver One

1) Click Free download and Download Screen Saver to a file

2) Press Open Folder

3) Right click your mouse on the file aasps2.scr  and press install.

4) Screen saver should activate with default time limit setting.

 ACA Feb 2003 Article

 ACA Feb. 2003 Article with George J. Dohrmann and David H. Durrant 

Conservative Management or Surgery (The Team Approach)

Abnormal Curvature of the Spine
Poor posture, a congenital abnormality, injury, infection, and other diseases, such as cerebral palsy, can cause abnormal curvature of the spine. The most common kinds of abnormal curvature are lordosis, flat back, kyphosis and scoliosis.

All these disorders can be treated with therapy, exercise, and, in some cases, surgery.

 
Normal Spine Lordosis Flat back Kyphosis Scoliosis
Lordosis, the inward curvature of the spine, is normal to a slight degree in the neck and lower back, but it can become exaggerated by poor posture or by kyphosis. Excessive lordosis in the lower back often occurs in someone who is overweight and has weak abdominal muscles. Once excessive lordosis has developed, it can become a permanent condition and may contribute to the development of osteoarthritis of the spine.

Flat back, the absence of normal spinal curves, is the result of abnormal development in infancy or injury.

Kyphosis, the outward curvature of the spine, is normal to a slight degree. Increased kyphosis of the upper back, the most common form of kyphosis, occurs frequently in post-menopausal women who suffer from osteoporosis. Increased kyphosis may result from other diseases such as osteoarthritis, from poor posture, a congenital deformity, or other disorder.

Scoliosis, a sideways curvature of the spine, can cause the vertebrae and ribs to move out of proper alignment. This problem may worsen with time and cause recurrent chest infections and shortness of breath.

Back Strain
This non-radiating back pain occurs as a result of stress placed on the lower spine. Back strain may be related to strain on the muscles or ligaments caused by either a specific traumatic episode (such as a car accident) or poor body mechanics.

Degenerative Disc Disease
Discs are fibrous pads of cartilage which separate vertebrae. The discs allow for flexibility in your spine, assist the muscles as shock absorbers, and provide cushioning between the vertebrae. As a disc ages, it can dry out, flatten, and lose its elastic, springy quality. As a result, the vertebrae above and below the disc move closer together and can pinch the nerves of the spinal cord. Also, vertebra ends can thicken and form bony growths, or spurs, called osteophytes, which can further irritate the nerves.

Disc Injury
Disc injury is among the most common spine problems, and usually results from repetitive and excessive stress on the annulus fibrosus (tough rings of tissue that protect the nucleus pulposus, the center of the disc). Disc injury can also be caused by a loss of normal movement in other areas of the spine and in the extremities, and by any sudden movement.

A disc injury may be referred to as a bulging, herniated, or extruded disc, terms which indicate the extent to which the disk is damaged. Each term is defined below.

Bulging Disc As a disc ages, it dries out and begins to shrink and lose its original height. This loss of disc height produces a bulging of the outer portion of the disc, either on the entire periphery of the disc or on one side of it. A bulging disc produces increased tension on surrounding soft tissue structures, such as ligaments and nerves, and can cause pain, stiffness, or a muscle spasm.

Herniated Disc When some of the annulus fibrosus tears, portions of the nucleus pulposus can herniate, or squeeze, through the defect. When the herniated part of the nucleus stays in contact with the annulus fibrosus, the condition is called a herniated disc. If the herniation is large, it can irritate or compress the spinal nerves.

A herniated disc may cause pain, stiffness, tingling, numbness, and weakness in the upper or lower extremities. In rare cases, the herniation can exert pressure on the spinal cord itself, causing weakness or paralysis of the arms or legs, or both. These are symptoms of a type of spine condition called myelopathy.

Extruded Disc When the herniated portion of the nucleus (see above definition) is no longer in contact with the annulus fibrosus, the condition is known as an extruded disc. The extruded nuclear pulposes material may be referred to as a fragment. When the disc fragment moves above or below the disc from which it came, the condition is referred to as a sequestrated disc. Extruded and sequestrated discs cause the same symptoms as herniated discs.

Ligament Strain
Ligament strain is caused by a partial tear in the ligament. The initial symptom is pain felt immediately after injuring the ligament, followed by stiffness and limited mobility without pain. A backache may develop when a person with an injured ligament practices poor body mechanics; attempts to lift or support heavy objects; or stands for a prolonged period of time, especially when wearing high-heeled shoes.

Mechanical Back Pain
This type of back pain usually occurs as a cumulative effect of poor body mechanics, which place tremendous stress on the spinal structures. Mechanical back pain can occur as a result of lifting, bending, or twisting, remaining in the same position for an extended period of time, or a combination of these activities.

Osteoarthritis
Osteoarthritis, sometimes called spondylosis, is a disease that causes the breakdown of joint tissue, leading to joint pain and stiffness. It affects

Like skin, bone steadily gets rid of its old cells and replaces them with new ones. As people reach their mid- to late 30s, however, more cells are removed than are replaced, causing bones to deteriorate. Osteoporosis, a sometimes crippling bone condition, occurs when the bones deteriorate so much that they become brittle and more susceptible to fractures. Osteoporosis commonly occurs
 in post-menopausal women and can affect the bones of the spine, rib cage, and extremities.

Sciatica
Sciatica is pain that radiates along the sciatic nerve. The pain sometimes extends from the buttock down the back of the leg to the foot. Symptoms can include numbness, weakness in the legs and ankles, and a prickly sensation. The most common cause of sciatica is a disc injury, although any kind of pressure on the sciatic nerve or disorder that involves nerves can produce this condition.

Spinal Stenosis
There are two forms of spinal stenosis (the word stenosis means narrowing). One form, central spinal stenosis, occurs when bony growths in the spinal canal reduce the diameter of the spinal canal, squeezing the spinal cord, which is inside. Central spinal stenosis may cause pain, weakness, numbness, and shock-like sensations in one or more of the extremities.

The second form of spinal stenosis, foraminal spinal stenosis, is caused by the narrowing of the intervertebral foramina, the spaces within the vertebral column through which the spinal nerves pass. In this case, the nerve roots may be pinched. Foraminal stenosis may cause numbness, tingling, and pain in the arms or legs. Spondylosis See osteoarthritis entry.

Spondylolisthesis/Spondylolysis
Spondylolisthesis is the forward slipping of one vertebrae over another. It most commonly occurs in the lumbar (lower) spine but may also occur in the cervical (upper) spine. Spondylolisthesis may be caused by recurrent microfractures, congenital abnormalities of the spine, or osteoarthritis.

Spondylolysis is the term used when a fracture occurs in a specific area of the back (arch) of the vertebrae. These two conditions do not necessarily occur together; patients may experience one or both. Symptoms, which are not always evident, may include back pain and, less commonly, leg pain.
 
 

Diagnostic Tests

Blood testing

• If you are scheduled for blood tests at Mercy, they will typically be performed at the Mercy Lab near the Patient Entrance, located across the parking lot from the NeuroScience Institute.

MRI scans

• Magnetic resonance imaging (MRI) scans are important in assessing your condition.

• If you live within 50 miles of Oklahoma City, your MRI and other diagnostic tests will usually be scheduled 2 to 3 days before your clinic appointment to make sure all results are available for your clinic visit.

• If you are not able to keep an appointment for a scan, please call 405-752-3608 to free the time for another patient and to reschedule your test.

Neuropsychological evaluation

• For some patients a neuropsychological evaluation gives your doctor information on how the brain tumor is affecting your daily life.

• It consists of standard tests for attention span, memory, speech, visual perception, reasoning and mood, all of which can be affected by a brain tumor.

• Test results can be used to help you compensate for a reduced function, such as memory loss, and as a guide for counseling and rehabilitation.

Additional test procedures available include

• Electroencephalogram (EEG) records electrical activity in the brain, useful in monitoring seizures

• Electromyelogram (EMG)

• Visual fields

• Nerve conduction studies

• Intraoperative cortical mapping allows the surgeon to avoid damage to critical areas when removing a brain tumor

Basic Spine Anatomy

(1) Vertebrae "Bones of the neck and back;" provides structural support for the spine, protects and encases the spinal cord.

(2) Discs Fibrous pads of cartilage which separate the vertebrae. The discs allow for flexibility in your spine, assist the muscles as shock absorbers, and provide cushioning between the vertebrae. The center of the disc is called the nucleus pulposus, it is a jelly-like substance. The nucleus is surrounded by tough rings of tissue called the annulus, which is similar to a ligament.

(3) Spinal Nerves There are 30 pairs of spinal nerve roots, which branch off the spinal cord and exit through the intervertebral foramina (see number seven below) between each vertebra. They transmit sensory and motor impulses to and from parts of your body so that you can feel sensations and move your body.

(4) Facet Joint The joints which connect one vertebra to the vertebra above or below it. They are paired joints, which means that there is a left and right joint. They are located on to the sides and behind the discs. Facet joints control the amount and direction of spinal movement.

(5) Spinal Cord A bundle of nerve fibers that act as the "main cable," carrying both sensory and motor information between the body and the brain.

(6) Ligaments Tough, non-elastic bands that hold the vertebrae together and help limit the amount of movement of a joint. They may become too lax, causing joint hypermobility (too much movement of a joint) and therefore pain.

(7) Intervertebral Foramina Spaces created by the vertebrae through which the spinal nerves pass.

(8) Muscles Elastic tissue that contracts to allow the body to move. Muscle groups may become weak or tight, causing a "muscle imbalance." This can directly affect full movement of the spine and extremities.

(9) Tendons Fibrous tissue that connects muscle to bone.

(10) Spinal Curves The vertebrae are stacked on top of each other to form four continuous curves. They are as follows: cervical, thoracic, lumbar, and sacral curves. These curves allow for flexibility.

Spinal Curves

In its proper position, the spine follows natural curves, which allow for increased flexibility. These curves include:

(1) Cervical (neck)

(2) Thoracic (middle spine)

(3) Lumbar (lower spine)

(4) Sacral (base of the spine)

SUBMISSION CRITERIA

JOURNAL OF THE AMERICAN ACADEMY OF SPINE PHYSICIANS

The purpose of the JOURNAL OF THE AMERICAN ACADEMY OF SPINE PHYSICIANS (JAASP) is to disseminate peer-reviewed scientific literature and topics pertaining to spine science and spine care with special emphasis placed upon cooperative spine care. The Journal is devoted to improving the quality of spine care by serving the chiropractic and neurosurgical professions. The public, the scientific and academic communities will also benefit from its contents. This unique interdisciplinary online Journal has online international distribution thus providing an unprecedented opportunity for chiropractic physicians and neurosurgeons to publish singly or in collaboration on relevant spine topics.

1. Purpose
   The Journal of the American Academy of Spine Physicians (JAASP) welcomes submissions from outside authors and AASP member physicians. Manuscripts accepted for publication will be those that best fulfill the mission and educational objectives of JAASP and more specifically:

Inform spine physicians about the latest developments affecting their practices, their profession, and their role as leaders in spine care and relative to national health care issues.

Provide timely and useful information on spinecare education, clinical topics, research, and technological advances.

Provide timely, useful information on a variety of topics of interest to chiropractic physicians and neurosurgeons and students of each specialty.

While the Journal welcomes articles that express the author's opinions on significant issues, please note that such articles should provide useful information to AASP members and help advance the cause of chiropractic, neurosurgery and spinecare in general. The submissions should be positive in nature, offering solutions to clearly identified problems and insight into potential challenges.

Categories of Articles Suitable for JAASP

Brief Reports consisting of shorter articles (approximately 1,000-word maximum), highlighting one aspect of clinical practice, a novel clinical concept, or pilot study. This format includes case studies, which focus on clinical presentations that have unusual or rarely published features.

Review Articles with detailed and critical summations of the current research and opinions in a specific clinical area or basic science area relative to the spine and spinecare.

Special Communications would also cover the topic of practice management within the range of topics included in this category is somewhat broad, reflecting the complexity of elements involved in operating a successful practice. Areas of coverage may include but not be limited to computer and digital applications, record keeping, patient education strategies and financial management. 

3. How to Submit Articles to JAASP

Please check with the Editorial Committee of JAASP on the suitability of a given topic before beginning the writing process. If the article is already written, please contact the Editorial Committee before mailing the manuscript to the JAASP to discuss the topic and its treatment.

4. Evaluation and Disposition of Manuscripts

Manuscripts will be selected for publication based on their suitability to the expressed mission of the AASP and purposes of JAASP. Members of the Editorial Committee of the AASP will evaluate submissions for overall importance, technical accuracy and literary competency.

5. Editing of Manuscripts
All articles accepted for publication will be subject to copy editing by the JAASP for elements such as correctness of grammar and syntax, adherence to Journal style, clarity, readability, and space constraints-elements which do not alter the sense of the article itself. If the article undergoes substantial editing, it will be returned to the author for review. The author must respond within 15 business days to accept changes, make changes or deny recommendations and withdraw the document(s) from submission.

6. Opinion Articles
On occasion, JAASP receives manuscripts that would be interesting and educational for our readership, however, they may also to reflect, to a large degree, the author's opinion, versus-or in addition to-the opinions and ideas of other referenced authors. Such articles may be presented under the title, "Opinion." The decision to label a given article in this manner will be made by the AASP Editorial Committee.

7. Order of Publication
In general, manuscripts will be published in the order in which they are accepted for publication. However, the Editorial Committee of the AASP reserves the right to expedite publication of those articles deemed particularly significant and/or timely.

Letters to the Editorial Committee

The Journal Editorial Committee invites brief letters (250 words or less) of general interest, commenting on work published within previous publications of the JAASP.  A limited number of letters to the editor will be selected for publication. The authors of the original work will be invited to respond to any letters commenting on their manuscript, and both the original letter and the author's response will be published together.

Brief Reviews

The Journal of The American Academy of Spine Physicians publishes invited brief reviews (up to four journal pages in length). Brief reviews will cover leading edge spine science and spine care topics, providing a balanced view of current research that can be understood by researchers outside of spine specialties. Authors interested in publication of a brief review may submit a proposal, which should include an outline of the proposed review, by letter or e-mail to the Academy Educational Committee. 

SUBMISSION OF MANUSCRIPTS

Manuscripts should be submitted to:

AMERICAN ACADEMY OF SPINE PHYSICIANS

JAASP
1795 Grandstand Place

Elgin, Illinois  60123

There is no processing fee is required for submission of manuscripts.

Manuscripts and figures are not returned to authors.

Manuscripts, articles, tables and graphics published in JAASP become the sole property of, and with all rights in copyright reserved to the American Academy of Spine Physicians. A copyright assignment form is to be signed by the corresponding author on behalf of all authors. Authors of articles written as part of their official duties as employees of the U.S. Government are exempt from this requirement for assignment transfer of copyright. Any previously copyrighted material reproduced in the manuscript, including modified figures and tables, must be accompanied by written permission from the copyright holder.

After a manuscript has been submitted, information on the status of the manuscript can be obtained by e-mail at [email protected].

INSTRUCTIONS FOR MANUSCRIPT PREPARATION

Submission forms are located at submission forms online. Authors must complete the information on the online form, print the form out, sign it, and include the signed copy with the submission package mailed to JAASP. The completed submission form should also be submitted by email. Authors may also use the Full-Length form or the online form appearing in the first issue of each printed volume of JAASP.

In addition to the signed copy of the submission form, five copies of the manuscript, with graphics (separate or within document). If figures are photographs, all copies should be publication quality. The entire manuscript must be typed double-spaced on one side of good quality paper. A 12-point serif font, preferably Times New Roman, is required. Compressed type format should not be used.

Manuscripts and figures are not returned to authors.

The average length of full-length articles is four to eight printed pages. Instructions for estimating the printed length of a manuscript are included below. Each of the following components should begin on a separate page:

1. The Title Page must include the full title; a running title (not to exceed 60 characters); the author's full name (first name, middle initial, surname); the affiliations of all authors and their institutions, departments or organizations (use the following symbols in this order: *, †, ‡, §, ¶, ||, #, **, ††, ‡‡, §§, ¶¶, || ||, ##); and three to five keywords, that describe the topic of the manuscript. Please note that the list of keywords does not represent an exhaustive view of what the JAASP considers to be important topics, but it has been found to be useful for assignment purposes.)
2. The Abstract must be 250 words or less. References should not be included in the abstract.
3. Acknowledgments must appear immediately after the text and before references. Grant support must not be included in the Acknowledgments but should be cited as a footnote to the title.
4. References must be numbered as they appear in the text. All authors must be listed for each reference. If citations are included in tables or in figure legends, they must be numbered according to the position of the citation of the table or figure in the text. Only published papers and papers "in press" may be included in the references. Five copies of all "in press" manuscripts cited must accompany the submission. Citations of "manuscripts in preparation," "unpublished observations," and "personal communications" must appear parenthetically in the text. Manuscripts "submitted for publication" are cited as footnotes to the text. Written approval by the person(s) cited in personal communications must accompany the manuscript unless they are also an author of the manuscript submitted to JAASP.

Format for references:

Periodicals: Ono,,K., Ota, H., Tada, K., and Yamamoto, T. Cervical myelopathy secondary to multiple spondylotic protrusions: a clinicopathologic study, Spine, 2:109-125, 1977.

Books: DeJong, R.N., Examination of the autonomic nervous system, in Dejong, R.N., Ed., The Neurological Examination, Philadelphia, PA: Lippincott, 1992: 519-520.

5. Footnotes should be used to designate the source of support, new or special abbreviations used, correspondence address, current address, manuscripts submitted for publication, etc. Footnotes are numbered consecutively in order of appearance in the text but are grouped together and placed on a separate page between the References and the Figure Legends.
6. Abbreviations may be used without definition as ling as they are standard and widely used. Abbreviations and their definitions must be consistent throughout the text.
7. Figure Legends must be numbered with Arabic numerals in order of appearance in the text and should include a short title after the figure number. Where possible, symbols and patterns used to distinguish data must be defined in a key placed within the graphic rather than in the figure legend.
8. Tables  should be created in a word processor or database program. Tables must be numbered in order of appearance in the text. (table 1, table 2, etc.). Table legends or captions are labeled the same as the table number and should be included with the document file.
9. Figures should be submitted in digital form when possible such as JPEG or TIF files, saved at 300 DPI resolution or greater. Graphic files created with Corel Draw or Illustrator or other programs are acceptable, (contact the editor for additional options). Authors should submit all figures as digital art, which should be provided on a separate CD or disk. Figure quality is important; blurry, low resolution and over-detailed figures will be returned for correction. Figures may be printed in one of two formats: single column (width from 3.37 to 8.23 cm), and double column (width from 12.65 to 17.1 cm). The single column format is preferred. If it is necessary to submit figures that require reduction or enlargement, the image will be sized as necessary. Text in figures should be 8-10 point in size, except for single letter markers which may be 12 point. An easy to read font such as Helvetica should be used for all figure text (except for the use of symbols). Figures must be numbered as they appear in the text; figure 1, figure 2, etc. The figure caption should identically numbered and be placed numerically at the end of the document. Photos should be marked carefully on the reverse side with figure number, first author's name, and orientation (top). Figures may be adapted as necessary.

10. SUPPLEMENTAL DATA

All supplemental material accompanying an article should be submitted with the original paper for peer review and must be submitted on a separate disk and clearly labeled. All supplemental material must be accompanied by legends or short explanations of the material. Links to the material will appear in two places in the on-line journal: on the Table of Contents and in the information box associated with the first page of the full-text article. There will not be any links in the body of the article. In the printed paper supplemental material should be footnoted the first time mentioned: "The on-line version of this article contains supplemental material.

SUBMISSION OF REVISED MANUSCRIPTS

Follow carefully and fully the instructions provided in the "Checklist for Revision" provided by JAASP when submitting revised manuscripts. One unmarked copy of the revised manuscript should be submitted with the requested number of copies of the revised manuscript which are marked to indicate revisions. Each manuscript copy should include legible copies of the figures. In addition, authors should identify any figures that have been revised and include one set of publication-quality prints for any revised figure.

GUIDE FOR ESTIMATING THE LENGTH OF A PRINTED PAPER

Full-length manuscripts should not exceed eight pages in length. One printed page in The Journal of the American Academy of Spine Physicians contains approximately 8,000 characters, including spaces. Thus, an eight page full-length article would contain approximately 64,000 characters. Each line in a table occupies about 60 characters for a single-column table (120 characters for a double-column table). Figures occupy about 180 characters per centimeter height for single column figures (360 characters for double-column figures). Determine the total character count for the text of your manuscript and add the character-equivalents for the tables and figures. This will provide a reasonable estimate for the printed length of a manuscript.

ABBREVIATED TABLE OF CONTENTS

SECTION 1

MYELOPATHY, SPINAL CORD INJURY AND SELCTED CLINICAL SYNDROMES

Chapter 1

Relevent Spinal Cord Anatomy

1.1     Basic Spinal Cord Anatomy

1.2     Segmental Spinal Anatomy

1.3     Meninges and Compartments

1.4     Spinal Vascular Anatomy

1.5     Cytoarchitectural Organization of Spinal Gray Matter

1.6     Relevent Spinal Cord Pathways

1.7     Relevant Spinal Cord Nuclei

1.8     Anatomy of Spinal-Mediated Myotatic reflexes

Chapter 2

Pathophysiology in Myelopathy and Spinal Cord Injury

2.1 Introduction to Pathophysiologic Mechanisms

2.2 Cellular, Ionic, and Biomolecular Mechanisms of Spinal Cord Injury

2.3 Stages of Spinal Cord Injury

2.4 Spinal Shock

2.5 Spinal Cord Edema

2.6 Ischemic Myelopathy

2.7 Myelomalacia

2.8 Cavitation and Gliosis

2.9 Spinal Cord Atrophy

Chapter 3

3.1 Spinal Cord Pathomechanics

3.2 Types of Spinal Cord Trauma

3.3 Vertebral Fracture, Dislocation, and Instability

3.4 Spinal Hemorrhage

3.5 Myelopathy and Disk Herniation

Chapter 4

Conditions Associated with Myelopathy

4.1  Degeneration and Stenosis

4.2 Expansile Lesions

4.3 Arteriovenous Malformations

4.4 Noncompressive Myelopathy

4.5 Congenital Spinal Anomalies

4.6 Chiari malformations

4.7 Klippel-Feil Syndrome

4.8  Scoliosis and Myelopathy

Chapter 5

Assessment of Spinal Cord Injury and Myelopathy

5.1  Spasticity, Paresis, Clonus and Myelopathy

5.2 Superficial Reflexes and Reflexes of Spinal Automatisms

5.3 Sensory Abnormalities

5.4 Spinal Cord Injury Pain

5.5 Neurogenic Claudication

5.7 Autonomic and Other System Considerations

5.8 Myelopathy and Associated Musculoskeletal Conditions

5.9 Electrodiagnostic Assessment

5.10 Diagnostic Imaging

5.11 Neurosonography

5.12 Computed Tomography

5.13 Plain Film Radiography

5.14 Quantitative Considerations in Spinal Cord Imaging

5.15 Functional and Laboratory Assessment

Chapter 6

Spinal Cord Syndromes and Guide to Neurological Levels

6.1 Vascular Syndromes of the Spinal Cord

6.2 Complete Spinal Cord Transection (Transverse Myelopathy)

6.3 Central Cord Syndrome

6.4 Anterior Cord Syndrome

6.5 Posterior Cord Syndrome

6.6 Anterior Horn Syndrome (Progressive Muscular Atrophy)

6.7 Multifocal Cord Syndrome

6.8 Cervical Medullary Syndrome

6.9 Hemisection Syndrome (Brown-Sequard Syndrome)

6.10 Cervical Medullary Syndrome

6.11 Guide to Neurological Levels

SECTION 2

RADCIULOPATHY

Chapter 7

Pathomechanisms for Radiculopathy

7.1 Spinal Nerve Root Anatomy and Regional Characteristics

7.2 Biomechnically Induced Radiculopathy

7.3 Spinal Degeneration and Radiculopathy

7.4 Fibrosis and Radiculopathy

7.5 Acquired Lateral Recess Stenosis ands Vascular Stasis

7.6 Failed Back Surgery Syndrome

7.7 Trauma and Radiculopathy

7.8 Intervertebral Disc Herniation and Radiculopathy

7.9 Nerve Root Compromise: Expansile Lesions

7.10 Vertebral Osteomyelitis and Discitis

7.11 Spondylolithesis and Radiculopathy

7.12 Noncompressive Radicloneuropathy

Chapter 8

Classic Sings and Symptoms of Radiculopathy

8.1 Sensory Abnormalities

8.2 Nerve Root Irritability Sings

8.3 Refelx Abnormalities

8.4 Paresis

8.5 Muscular Dystrophy

8.6 Dysautonomia and Trophic Changes

8.7 Combined Pain Syndromes: Radicular and Vertebrogenic Pain

8.8 Assessment of Radiculopathy

8.9 Cervical Monoradiculopathy Syndromes

8.10 Thoracic Monoradiculopsathy Syndromes

8.12 Cauda Equina Syndrome

SECTION 3

PERIPHERAL NERVE ENTRAPMENT AND COMPRESSION NEUROPATHY

Chapter 9

Relevant Anatomy, Pathophysiology, and Predisposing Factors for Peripheral Nerve Injury

9.1 General Organization of Peripheral Nerve Distribution

9.2 Cervical Plexus

9.3 Brachial Plexus

9.4 Lumbar Plexus

9.5 Lumbosacral Plexus

9.6  Autonomic Nervous System

9.7 Relevant Anatomy of the Peripheral Nerve

9.8 Peripheral Nerve Vascularity

9.10 Classification of Nerve Injuries

9.11 Peripheral nerve Response to Injury

9.12 Nerve Compression and Related Pathomechanisms

9.13 Myotendinous, Myofascial, and Related Contribution to Entrapment

9.14 Common Predisposing Disorders Associated with Entrapment Neuropathy

Chapter 10

Characteristic Signs and Symptoms of Entrapment

10.1 Assessment of Entrapment Syndromes

10.2 Proximal Upper Extremity Entrapment

10.3 Median Nerve Entrapment Nerve Syndromes

10.4 Posterior Upper Extremity Syndromes

10.5 Ulnar Nerve Syndromes

10.6 Abdominal/Pelvic Entrapment Syndromes

10.8 Summary

Section 4

APPENDIX

Table 1: Clinical Considerations with Neurological Compromise below the Level of the Foramen Magnum

Table 2: Common Neuro-orthopedic Test and Signs

Table 3:A Upper Extremity Motor Innervation

Table3B: Lower Extremity Motor Innervation

Terry Yochum, D.C. During June of 2003, Dr. Terry Yochum, chiropractic radiologist and member of the AASP Academy Council was awarded Radiology Teacher of the Year by residents of the University of Colorado, School of Medicine, Department of Radiology. Each year graduating residents have the opportunity to honor the instructor who has provided the highest level of academic and clinical instruction. This is the seventh time Dr. Yochum has received this distinquished recognition.  No other radiologist has achieved this acclamation more than twice.

Scott Haldemann, D.C., M.D., Ph.D., The Foundation of Chiropractic Research and Education (FCER) named Dr. Haldemann 2002 Researcher of the year. Dr. Haldemann has been one of most influential physicians and researchers in the advancement and acceptance of chiropractic research. The award will be presented to Dr. Haldemann on May 3, 2003 at the World Federation of Chiropractic's Congress in Orlando, Florida.

George P. McClelland, D.C. During March of 2003 George P. McClelland, D.C. provided testimony to the Chiropractic Advisory Committee of the Department of Veterans Affairs, Also in Washington. His testimony cited support for benchmarks with which to judge the effectiveness of chiropractic care.

David Durrant, D.C. and George Dohrmann, M.D., Ph.D., were recently interviewed for a feature (Focus) article titled Surgery Versus Conservative Care to be published in the Journal of the American Chiropractic Association (JACA) in February of 2003

Edward Benzel, M.D., is serving as the Chairman of the Council of Spine Societies.

George Dohrmann, M.D., PhD., a previous recipient of the Bucy Award, presented the 2003 Bucy Award to Madjid Samii, M.D., President of the International Neuroscience Institute, Hannover, Germany. The award honors the late Dr. Paul Bucy, a national and internationally renowned neurosurgeon. The award is given annually to a person who has made outstanding contributions to neurosurgical education.

David Durrant, D.C. and Jerome True, D.C., board certified chiropractic neurologists, recently received the highest peer review rating available "10 out of 10" for their benchmark neurology textbook titled Myelopathy, Radiculopathy and Peripheral Entrapment Syndromes. The book summary and rating was recently published in Dynamic Chiropractic and book remains on their preferred reading list. The textbook represents one of the most concise treatises on the evaluation of myelopathy and radiculopathy. It also represents one of the first neuroscience textbooks authored by chiropractic physicians.

Barth Green, M.D., continues to direct the multimillion-dollar Miami Project to Cure Paralysis. Significant information about spinal cord injury and repair of such injury has gained international recognition and has been presented around the world. Dr. Green is a member of the Academy Council of the AASP.

George Dohrmann, M.D., Ph.D., is serving as quest editor of the journal, Neurological Research, and is working on a special issue devoted to spine/spinal cord injury as well as head/brain injury.

George McClelland, D.C., former President of the American Association of Spine Physicians and current member is presently serving as the Board Liaison to the Editorial Review Committee of the Journal of the American Chiropractic Association (JACCA).

John Triano D.C., Ph.D.

The Council on Chiropractic Guidelines and Practice Parameters (CCGPP) announced the appointment of John Triano, D.C., Ph.D. as the new chairmen of its research commission. The CCGPP was formed in 1995 by the Congress of Chiropractic State Association (COCSA) member organizations. Dr. Triano is a graduate of Logan College of Chiropractic and is presently an instructor and clinician at the renowned Texas Back Institute (TBI). Also to Dr. Triano’s credit he recently co-sponsored the North American Spine Societies conference on spinal manipulation along with fellow research Scott Haldemann, D.C., Ph.D., M.D. who is an AASP member and a Scientific Consultant to the AASP.

Glossary of Spinal Diagnostic Tests

Algometry:

Algometry refers to the quantitative measurement of pressure thresholds and pressure tolerances perceived and reported by the patient. The Algometer is a device, which has a pressure measurement tip which can be applied over a body region. The Algometer records the amount of pressure applied, which is correlated to the patient’s perception of pressure or reported level of discomfort or pain.  This technique is usually repeated over time and the information compared to determine if sensitivity and pain are diminishing, resolved or worsening.

Autonomic Testing:

Your doctor may wish to determine whether your autonomic nervous system is functioning normally. The nervous system consists of motor, sensory and autonomic components. The autonomic portion of the nervous system controls and regulates internal functions such as blood pressure, blood flow, sweating, and bowel and bladder function.  Certain disorders and diseases can compromise the autonomic nervous system in isolation, or as part of more widespread illness. In the second case, many functions of the nervous system, including autonomic, sensory and motor systems, may be affected, and autonomic testing can be used as a "marker" to diagnose such a disease. In all of these cases, the autonomic nervous system will be functioning poorly or not at all. With more isolated involvement, chronic pain restricted to one part of the body may be associated with increased sympathetic (autonomic) function thereby magnifying the pain syndrome, as in a disorder known as RSDS (Reflex Sympathetic Dystrophy Syndrome).

Autonomic testing is usually non-invasive and generally well-tolerated. The tests and specific protocols used depend upon the patient’s presentation and suspected condition. Testing procedures may involve blood pressure testing under different postural, breathing and exertional conditions. The ability to sweat on different areas of the body may be assessed. Skin temperature along with digit blood flow may be monitored during a variety of provocative procedures.  Electrocardiography (EKG) testing may be used to evaluate heart rate variability during different procedures. Ambulatory electrocardiography (EKG) may be performed to address heart rate variability (R-R intervals) over the long term, a means of determining a more subtle disorder.

The sweat glands, heart rate, blood pressure, and blood flow in the limbs are all controlled by the autonomic nervous system. When we measure these functions, we can tell whether your autonomic nervous system is working normally, or if some of the symptoms you have could be related to under or over function of the autonomic nervous system.

Bone Scan:

A bone scan refers to a detailed imaging survey of bone to help identify a region of increased vascular activity or compromise. The bone scan is capable of covering a large area in contrast to a regional X-ray study. The bone scan may be performed to rule out an active inflammatory process within or involving bone such as a tumor, infection or fracture. A radioactive chemical marker is introduced through an intravenous (IV) line during the bone scan procedure.  Within approximately three hours after the administration of the radioactive chemical, the patient is placed in a special scanner that is capable of detecting the radioactive marker wherever there is increased concentration.  

The bone scan is particularly sensitive at detecting disorders, which are associated with a region of altered or increased bone metabolism. The study can help ascertain whether a bone fracture is new (active) or old (chronic). More recent fractures are generally associated with a region of increased signal on the bone scan due to greater concentration of the radioactive marker at the site of high bone turnover. Bone scans are not capable of differentiating what a lesion is comprised of, in other words, a bone scan has a high sensitivity but a lower specificity. The bone scan is relatively good at identifying the region of involvement but not in discriminating the type of bone involvement such as a specific tumor process. A positive bone scan typically requires that additional imaging of the area be perfomed such as an MRI or CT scan to further characterize the problem area. The later imaging studies help characterize the nature of lesion for the purpose of implementing a more efficient plan of diagnostic or therapeutic intervention. 

Computerized Tomography:

Computed Tomography, also referred to as CAT scanning or CT scanning (Computerized Axial Tomography), is an advanced and special form of X-ray imaging. The CT machine looks like a large square or donut with a whole in the middle.  To perform the imaging procedure the patient is placed onto a table, which slides into the hole within the imaging unit. CT scanning provides detailed two-dimensional cross sectional images of the body.  CT scanning is fast, painless and simple involving limited radiation exposure. The CT scan usually takes from between 15 to 30 minutes.

The CT scan provides excellent bone detail and is therefore is particularly advantageous for evaluating bony spinal stenosis, a congenital or acquired narrowing of the spinal canal diameter. The CT scan also provides for viewing of tissues at angles that can help identify soft tissue pathology and mass lesions including tumors. It is helpful in the assessment of degenerative bone or joint conditions and in characterizing a fracture such as in spinal trauma cases. A contrast agent may be administered by I.V. prior to the study to enhance the sensitivity of the evaluation process; the contrast can help in determining the size, shape, and borders of tumors, fractures and stenotic lesions. 

Like an X-ray a CT scan also works by sending an X-ray beam through the body. The information is captured, processed and is formatted in a computer with sophisticated software.  The computer can depict and reformat the tissue images at different angles. In some cases the information may be reconstructed in three dimensions and rotated to help with surgical planning, and fracture and tumor characterization.  CT scans, like routine X-rays, studies do not provide detailed views of soft tissues such as muscles, spinal nerve roots, the spinal cord, ligaments and intervertebral discs. Specialized types of CT imaging are listed below:

Post-Myelogram CT Scan (Computerized Tomography with  Myelography):

This procedure is somewhat similar to a myelogram (see Myelography below). The CT imaging study is performed after the administration of a contrast agent (radio-opaque dye) into the subarachnoid space (spinal sac). When the contrast agent is applied as part of CT scan it provides a detailed view of the integrity and morphology of the spinal canal and nerve root sleeves. The patient can be moved or positioned so that the flow of contrast is directed to particular areas of interest, such as to the head or neck, to one side, or towards the lumbar spine.  This dynamic option provides a unique view of the areas surrounding the spinal cord and nerve roots.  The administration of contrast myelogram consists of injecting a dye (radiographically opaque) into the sac, which surrounds the nerve roots.  The dye provides contrast around the spinal cord and nerve roots and therefore helps assess whether there is any physical compression or deviation of the cord or nerve roots. The corresponding CT scan helps assess whether there is any bony compromise from bony degeneration or trauma, which may be contributing to the spinal cord or nerve root compression.

3D-CT scan: Computerized X-ray which provides detailed information about

           bones and tissue in a three dimensional format. A 3D-CT is a longer test than a

           routine CT scan because more X-ray images are acquired in smaller sections at

           many different angles. At the completion of the study the technician uses a

           computer to remove select tissues signals in order to render and recreate bones in a

three dimensional format. This form of imaging can be particularly helpful for

           therapeutic planning, especially surgery.

Cerebrospinal Fluid Study (Spinal Tap):

The diagnostic cerebrospinal fluid study is often referred to as a lumbar puncture. The procedure may be performed to assess the pressure around the brain and spinal cord, to inject dye for a radiographic diagnostic test, to give spinal anesthesia or to inject medications. The study is also used to test the cerebrospinal fluid (CSF). Testing the CSF can help reveal the presence of disorders of the central nervous system, which may involve the brain or the spinal cord. The evaluation of cerebrospinal fluid (CSF) includes the testing of the number and type of white blood cells, the level of glucose (sugar), the types and levels of proteins, the presence of infectious organisms and the presence of biochemical tumor markers.

Ceretec:

CERETEC is another radionuclear pharmaceutical imaging agent that is labeled with technetium 99m.  It is used in nuclear medicine studies.  This agent has special properties and thus different indications. One is for visualization of cerebral blood flow and upper central nervous system vascular flow in stroke patients and the other is for labeling of white blood cells to localize intra-abdominal infection and inflammatory bowel disease.  It has been used in determining spinal infections and the extent of the metastasis (spread) of spinal infections to other adjacent regions and seeding of distal organ systems.
A thorough knowledge of the normal distribution of intravenously administered technetium Tc 99m exametazime injection is essential in order to interpret pathologic studies accurately. Caution should be exercised in making the final diagnosis. As in the Indium studies, results can be affected by the presence of a myriad of other problems including but not limited to: tumor, infarction, peritonitis, or nongastrointestinal or bony sites of inflammatory cell collections.

Current Perceptual Threshold Evaluation (CPT):

Current Perceptual Threshold (CPT) testing refers to the application of superficial conducting electrodes to a designated skin region that corresponds to the area innervated by the nerve to be tested by the select application of a given current through the electrodes. The CPT study is performed to help quantify the threshold of sensation carried by a select peripheral nerve. CPT studies can be a helpful tool in the screening and monitoring of polyneuropathy, peripheral nerve injury and peripheral nerve entrapment syndromes. It tends to be less helpful in the evaluion of radiculopathy.

Dual Energy X-ray Absorptiometry (Dexa scan):

A dexa scan is used specifically to assess a patient’s risk of fracture by detecting osteoporosis of the vertebral bodies. A dexa scan takes between 10 and 30 minutes and is associated with a minimal radiation exposure. Low energy x-rays are targeted through the bones of the lower lumbar spine and hips to measure the mineral content of the bones.

Discography:

Discography is a provocative test used to help identify whether a specific intervertebral disc is contributing to spine or back pain. The intervertebral discs are soft cushion-like pads which are located between the hard bony vertebral bodies of the spine.

Standard diagnostic imaging tests such as plain X-rays, CT, MRI and myelography are not always helpful at localizing the primary source of back pain. In fact, these scans are limited to demonstrating tissue structure (anatomy) and be used to help confirm the definitive source of spine pain. Pain primarily arising from an intervertebral disc is referred to as discogenic pain. Discogenic pain may refer to the neck, mid-back, low back, chest, abdomen or extremities. Discogenic pain is often associated with disc degeneration and herniation.  Discography is sometimes perfomed to address whether a patient is a candidate for an interventional procedure or surgical fusion at the site of the involved disc. A negative discogram may help prevent a surgical procedure which would not likely help reduce pain. Because of the invasive nature of discography it is typically performed if an invasive procedure such as IDET or surgery is being considered.

During the discogram procedure, an IV is used to administer antibiotics and medication to help the patient relax. The attending physician numbs the skin and then carefully inserts a needle into the back guided by X-ray (fluoroscopy), specifically into the center of the suspected or control disc.  After the needle is properly positioned, a small amount of contrast (radiographically opaque dye) is then administered into the center of the disc. This contributes to elevated pressure within the disc. If the injected dye reproduces the patients primary complaints it is felt that the discography findings are concordant (correlates with) the patient’s pain and thus the symptomatic disc has been identified. If the pain is not like the patients primary complaints the reproduced pain is considered discordant (not related) to the primary painful complaints.  These provocative discograms are typically done at several disc levels to ensure the level of involvement is well defined.

The discogram is not performed to treat pain. Often after a discogram is performed, a thin slice CT scan is ordered to evaluated the morphology or structural integrity on the intervertebral disc. The radio-opaque dye that was injected helps to define the anatomical borders within the center of the disc since many of these symptomatic discs are internally deranged (they have internal discontinuities, which may or may not, extend to the outer borders of the disc and result in a frank herniation). There are many risks associated with a discogram, which include but are not limited to infection, nerve damage and chronic pain.

Doppler Ultrasound:

Doppler ultrasound uses reflected sound waves (sonar) to help evaluate the velocity and quality of blood flow through an artery or vein. The patient reclines on a table. The technician or physician applies a hand held transducer over the blood vessels to be evaluated. The transducer emits sound waves, which are reflected from the vessel and moving blood flow.

Extra-Cranial Cerebrovascular Duplex Scan: Carotid arterial assessment using non-invasive real time ultrasound scanning, combined with Doppler color and spectral analysis is fast becoming the test of choice in determining hemodynamic occlusive disease in the neck. Typically, evaluation of the neck involves assessment of the right and left carotid and vertebral arteries.

Carotid duplex scanning is a cost effective and very accurate screening test and gives the attending physician(s) valuable information on the degree of artery narrowing (stenosis) and the type of plaque present in the artery. The vertebral arterial circulation may also be assessed before or after exercise in order to demonstrate Subclavian Steal syndrome. This study may be ordered if your physician hears an abnormal sound over an artery (bruit) or if he or she suspects arterial insufficiency.

Ankle Brachial Index (ABI): The ankle brachial index is a simple non-invasive screening test utilizing doppler ultrasound to help detect reduced arterial blood flow to an extremity.  The ankle/arm pressure index also known as the ankle/brachial index, abbreviated ABI is a test used to compare the systolic blood pressure at the distal leg (ankle) to that of the arm (brachial). The ABI provides an objective baseline to follow the progression of the disease process and evaluate the effectiveness of the treatment plan.

With increasing degrees of arterial narrowing, there is a corresponding fall of the systolic blood pressure below the site or sites (if multiple sites of occlusion exists within the limb(s) or pelvis) of intra-arterial obstruction or narrowing. The extent to which the systolic pressure falls is dependent upon the extent of involvement. With the use of sensors, such as continuous wave doppler ultrasound, it is possible to measure the systolic pressures at all levels of the limbs.

To perform the study a pneumatic blood pressure cuff is applied to the limb to be tested and the sensing unit is placed over a designated artery below the level of the cuff. The cuff is rapidly inflated above systolic pressures, subsequently obliterating the flow to the part under study. As the pressure in the cuff is gradually deflated, the point at which flow is resumed is recorded as the opening or the systolic pressure.

The ABI findings are usually correlated with corresponding doppler or pulse volume waveform analysis. A significant drop in arterial systolic pressure in one limb indicates reduced blood flow secondary to obstruction of the blood vessels. The presence of more subtle arterial obstructive disease can be detected by increasing blood flow and pressure, either by exercise testing or by inducing reactive hyperemia with an occlusive cuff.

Patients, such as diabetics, with calcified vessels may show falsely elevated ankle pressures. In this case, pressure measurements can be made on the foot or toes using Photo Plethysmography (PPG) for more accurate results. Diagnostic information is obtained both from the waveform of the arterial flow when displayed on a chart recorder and from using the PPG sensor to determine the blood pressure in the digit.

To detect pressures a Doppler or PPG sensor is used. Waveform analysis is evaluated along with the blood pressures. A drop in blood pressure in one limb or in one vessel suggests the possibility of atherosclerotic disease (arterial blockage). The assessment of ABI helps to establish the diagnosis and also serves as a baseline measure for follow up purposes.

Electromyography (EMG):

Needle electromyography (EMG) is used to assess the health and integrity of the motor nerve fibers of the spinal cord, the spinal nerve root, the plexus and the peripheral nerves. Electromyography is used to measure tiny electrical discharges produced within a muscle. A physician may recommend the EMG test when a patient reports muscle weakness and the physical examination confirms a reduction of muscle strength. The study is used to help diagnose muscle and nerve disorders. The needle EMG study can be used to localize the site of nerve compromise and to assess the degree and duration of nerve injury.

The needle electromyographic study is a common procedure used to assess the health and integrity of muscle in the presence of muscle atrophy and/or weakness.  Muscles receive a constant supply of electrical signals, which travel along nerve pathways. Muscles also produce their own electrical signals during contraction. The EMG study of muscle requires the careful placement of a small sterile recording needle into muscles, which receive their nerve supply from the spine. There may be some local discomfort associated with the testing and there may be occasional focal bruising at the site of needle placement/insertion. This thin recording electrode is used to detect the pattern of electrical activity within the muscle. The electrode is interfaced to sophisticated testing equipment, which has software, which records and analyzes the patterns of electrical activity when the muscle is at rest and during voluntary contraction of the muscle. The size, duration and frequency of the muscle signals help determine whether there is compromise of the muscle or the nerves, which innervate the muscle. A comprehensive needle EMG study with nerve conduction studies takes approximately one hour to complete.

After two to three weeks of nerve compromise needle EMG assessment of the muscles innervated by the damaged nerve region may reveal abnormal wave forms secondary to a loss of nerve supply to the muscle. The needle EMG study can be particularly helpful in distinguishing peripheral nerve damage from compromise of a spinal nerve root. The results of EMG tests are often correlated with the results from nerve conduction studies perfomed during the same testing session.

Needle electromyography, together with nerve conduction studies, is essential in the evaluation of suspected radicular and peripheral nerve disorders.

Specialized forms of EMG include:

Quantitative Electromyography (QEMG): Quantitative electromyography is reserved for those patients with unusual or complicated neurologic or muscular disease. It may also be used to evaluate whether there is significant muscle reinnervation after a course of care. It is a more time-consuming study than routine needle electromyography. Select muscles are assessed in greater detail than would be done during a routine EMG study. QEEG requires very specialized training, sophisticated equipment and detailed protocols. 

There are a variety of tests, which fall under this heading. Categories of QEMG assessment include: triggered Single Fiber EMG, Stimulated Single Fiber EMG, Macro EMG, Template Matching, Parametric matching, Manual Interference Pattern Analysis, On-line Interference Pattern Analysis, Myofrequency Assessment and Recruitment analysis.

The types of parameters, which are quantifiably measured, include assessment of the individual muscle fiber (Single Fiber EMG), which may reflect widespread involvement within a muscle, and the assessment of electrical activity arising from an entire motor unit which refers to all those muscle fibers attached to a single nerve fiber.  A Template Match Motor Unit analysis provides quantitative characterization of individual nerve and muscle fiber relationships. QEEG can provide a detailed look at the pattern of muscle fiber recruitment during muscle contraction, the quantity of muscle fibers, the firing speed, waveform appearance and the collective pattern of muscle fiber firing in detail.

Epiduroscopy:

Epiduroscopy is a relatively new method for directly visualizing the inside of the spinal column. This process is achieved by inserting a small fiberoptic catheter through a small incision along the back. The spinal epidural space is assessed with a steerable or controllable flexible endoscope (similar to arthroscopic surgery used on knees, only a smaller device). The contents of the spinal column are visualized on a video monitor. This endoscopic procedure technique may be used for diagnostic and therapeutic intervention for carefully selected patients with chronic spinal pain syndromes. The scope allows for various spinal structures and abnormal states to be visualized including but not limited to scar tissue (adhesions), dura mater, connective tissues, blood vessels and nerve fibers. The study may reveal developmental abnormalities.

Fluoroscopy:

Fluoroscopy refers to taking X-rays with a fluoroscope, a device capable of aquiring and processing an X-ray and displaying it on a viewing screen, like a television. Fluoroscopy is routinely used for intra-operative localization of patient anatomy and surgical instrument position. By providing this information, it facilitates improved accuracy and reduced surgical exposure for a wide variety of procedures. The shape of the fluoroscopy unit is usually C-shaped (known as a C-arm) providing for flexible viewing of the area in question from any angle. Spine specialists often use this form of imaging to help guide needles and scopes to the precise location when performing interventional procedures such as discography or spinal injections. The C-arm can easily be positioned to take unique X-ray pictures of the patient. Digital videoflouroscopy (DVF) may occasionally be used to assess spinal biomechanics.

Despite its widespread acceptance and use fluoroscopy does have some disadvantages; the most  notable is occupational radiation exposure and the other being that only a single real–time planar view is usable at any given time. Consequently, for procedures requiring multiplanar fluoroscopic visualization, such as percutaneous transpedicular biopsy, the C–arm has to be positioned and repositioned many times during the procedure. This repositioning process is often tedious and time–consuming. In an ideal situation, the physician holds an instrument perfectly still in one plane while correcting its position in the other. The x–ray technologist then repositions the fluoroscope to obtain the perfect view in each desired plane

By combining current C–arm fluoroscopy with computer–aided technology, many benefits of fluoroscopy can be maximized, while minimizing or limiting its shortcomings. This combination of technologies has resulted in the development of Virtual Fluroscopy (see below).

Virtual Fluoroscopy (FluoroNav)

A virtual fluoroscopy system (FluoroNav) for spinal and musculoskeletal procedures offers several distinct advantages over conventional C–arm fluoroscopy. Radiation exposure is reduced, the need to obtain multiple images to update instrument position is eliminated by a real-time tracking of the instrument by the system, and bilateral localization at any given spinal level(s) can be performed using a single image thus reducing fluoroscopy time and radiation.  Virtual fluoroscopy eliminates the repetitive C–arm repositioning and improves the surgeon’s efficiency. Additionally, computational power of the system allows further enhancement of standard fluoroscopy by providing real–time quantitative information.

Despite these advantages, virtual fluoroscopy is still a two–dimensional navigational system; it does not provide the detailed multi-planar imaging generated by three-dimensional systems.  Errors in the clinical interpretation of 2–D images and the extrapolation of 2–D information to 3–D anatomy are still dependent on the expertise of  the technologist and surgeon.  Furthermore, inherent to the nature of fluoroscopy, other disadvantages remain. A virtual fluoroscopy system cannot compensate for causes of substandard image quality. Clinical misinterpretation of a low quality, poorly oriented image cannot be compensated for by any navigational system.

Functional Capacity Evaluation (FCE):

Functional capacity evaluation (FCE) refers to the evaluation of physical performance. The study may take on average from 30 minutes to three hours to perform. Protocol can be implemented to specifically evaluate spinal and related neuromusculoskeletal tasks. The FCE can be an invaluable way to determine the degree of physical impairment secondary to spinal cord or spinal nerve compromise. The findings can serve as the basis for designing a physical rehabilitation program and serve as an objective baseline of function from which to measure post-therapeutic recovery.

Gait Analysis:

Gait analysis refers to the evaluation of posture and movement patterns while walking or jogging. Gait analysis is used to evaluate the complex integration or coordination of neurological and musculoskeletal performance. It may be performed with variable grade and speed with the use of a treadmill and video capture unit. Gait analysis can provide valuable information about postural control of the trunk and/or limbs.  This information may give an insight into spinal cord function, peripheral nerve function, vision, balance function of the inner ear, brainstem and higher cortical (brain) centers. It can also be particular helpful in the assessment of muscle weakness and associated gait disorders secondary to nerve root compromise associated with spinal stenosis and lumbar disc herniation. It may also be useful in determining the gross functional derangement or progression of the neurologic disease.  The use of a variable speed treadmill can help detect gait abnormalities that would not be readily obvious while watching the patient walk a short distance at a slow pace.

Gallium Scan

Spinal osteomyelitis and accompanying soft tissue infection can often be diagnosed accurately with a single radionuclide procedure: SPECT Ga-67. This procedure can be used as a reliable alternative when MRI cannot be performed and as an adjunct in patients in whom the diagnosis is uncertain.

Indium Scan (Indium-Oxine Scan):

The Indium scan is a scanning procedure in which a patient's white blood cells (leukoctyes) are first labeled (the cells are marked or identified) with the radioactive pharmaceutical substance Indium (Indium-Oxine, In-111), and then the patient's body is scanned to track the migration pattern and locate white blood cells at the site of possible infection, inflammation or abscess. By labeling the leukocytes  radiologists or nuclear medicine specialists can then watch their migration towards infection.

The Indium study may be used to rule out an infection within the vertebral body, the spinal canal (an intradural or epidural abscess), the spinal (facet) joints and/or the intervertebral disc. There has recently been some concern about the utility of labeled leukocytes in musculoskeletal infection. The imaging of tagged leukocytes may occasionally miss an infection of the spine (osteomyelitis) for reasons that are not well understood.  One theory is that cell clumping can occur and produce local accumulations of radioactivity in tissues.  These areas may not “wash out” in 24 hours and thus be one of the reasons for false positive results.  Such problems can be reduced by imaging immediately after injection.  The presence of red blood cells or plasma can result in diminished leukocyte labeling efficiency because of competition for the Indium.   The study may be used to rule out infection, post-operative infection and inflammatory processes of the spine. 

To perform the “tagging” procedure a nuclear medicine technologist draws about 50 ml. of blood. White blood cells are collected and exposed to Indium, then re-injected through an IV back into the patient. The Indium scan is then scheduled roughly 24 hours after the leukocytes (WBC’s) have been labeled with the Indium. Occasionally scanning may be scheduled 48 hours after labeling.  The scan procedure requires that the patient lie on a special scanning table. Either a single camera will pass underneath the table or two cameras with one above the table and one underneath the table are used to perform the scan.

Isokinetic Testing:

The patient is positioned on specialized equipment so that the specific body and joint movements to be measured are isolated. The equipment is set at different speeds and the force applied is measured throughout the range of movement. The results are typically recorded at different speeds so that a speed/strength/power relationship can be seen. Comparative evaluation of muscle strength with side-to-side assessment and of agonists/antagonists relationships can be performed. Nearly any joint action can be tested by the adjustment of the Isokinetic equipment. The equipment is often large, bulky and expensive therefore these tests are often performed at large clinics and universities as part of research projects, or as part of injury rehabilitation services.

Isokinetic testing can be used to evaluate impairment of muscle function secondary to central or peripheral nerve compromise, including nerve root compromise. The Isokinetic testing may be performed as part of a battery of functional tests in the individual with neurological compromise. It provides an extensive array of quantitative data of which can be used to baseline physical performance. Isokinetic testing can be used to help assess both neurological and neuromuscular recovery. 

Magnetic Resonance Imaging (MRI):

Magnetic Resonance Imaging (MRI) has become one of the single most helpful ways to image the spine and nervous system. MRI does not utilize ionizing radiation like X-ray or CT scans. MRI is a safe non-invasive imaging technology that uses radiofrequency waves and the natural magnetic properties of tissues within an enhanced magnetic field to provide detailed images. The images are strongly influenced by the water concentration within the tissues.

MRI units come with different configurations. Some of the units have closed cylindrical magnets and there are more patient friendly units, which are more open reducing the risk for claustrophobia and movement related artifact. High field magnets often provide better image quality than lower field magnet strength. Typically an MRI scan of one region of the body or spine takes from between 15 to 45 minutes in the scanner. The MRI study acquires images of an area of the body by using a large magnetic field, which encircles the body. Through the use of the magnetic field and radio frequency waves energy emitted from hydrogen atoms providing the information used by the computer to process an image. MRI studies provide highly detailed images of the body and the spine from many perspectives.

The collected data can be used to create a composite, three-dimensional representation of the region visualized. Any two-dimensional image (slice) can be selected electronically from this representation and displayed on a screen as well as printed on special film for review.

The MRI study can be used to obtain detailed views of soft tissues of the spine including the intervertebral disc, spinal (thecal) sac, the spinal cord and the spinal nerve roots. By comparing variations in signal (T1 and T2 weighted images) tissue characteristics can be determined allowing a detailed look spinal tumors, spinal cysts, infectious abscesses within the spine and assessment of small metabolic shifts within spinal tissues.  MRI is used to identify and monitor spinal disorders. MR imaging is often a crucial step for planning therapeutic intervention including but not limited to manipulation of the spine, spinal rehabilitation, radiation therapy and surgery.

Specialized forms of MR imaging include:

            Diffusion Imaging: A strong magnetic field is used to detect areas of tissue

            ischemia and to help determine the location and severity central nervous system

injury. It is a valuable diagnostic method in the evaluion of stroke.  The study

           does not require the use of radiation. The study is painless and non-invasive.

            Functional Magnetic Resonance Imaging (fMRI): is a computerized method of

           evaluating areas of the brain which are responsible for specific functions, such as

           speaking, comprehension, motor(muscle) activities, hearing and vision. The

           procedure does not require radiation and is painless. Functional MRI may soon be

           applied to other bodily regions including the spine.

          MRI Guidance Imaging: is used to assist physicians during surgery to plan the

          approach and more precisely locate and remove the lesion. Prior to surgery the

          patient may undergo an MRI scan with special markers placed over a select

          region. The markers are used to register landmarks so that the MRI scan

          information can be entered into a computer in the operating room. The physican

          uses an instrument called a wand to touch the surgical area. This method is used

          to help identity the specific lesion. MRI guidance imaging is primarily used for

          tumors involving soft tissues of the brain, spine, blood vessels, and nerves.

         Magnetic Resonance Spectroscopy (MRS): is a relatively new technology, used

         on a limited basis for the biochemical evaluation of brain tumors, neurological

         diseases, certain inflammatory and ischemic diseases, disorders of metabolism and

1. Interact with Leaders in Spinecare Help shape the future of spinecare Expand your professional network Interact with experts and leaders in the field of spinecare. By being a member of the American Academy of Spine Physicians (AASP) you have an opportunity to help shape the future of spinecare and your practice. The AASP is an international organization comprised of neurosurgeons and chiropractic physicians dedicated to improving the quality of spinecare through conservative and cooperative efforts. The AASP membership includes some of the most nationally and internationally respected neurosurgeons and chiropractic physicians. The AASP Academy Council is comprised of preeminent neurosurgeons and chiropractic physicians in the United States. These spinecare experts and leaders provide valuable direction to the Academy and help set it apart from other organizations. The respected visibility of the Academy Council and the collaboration between Academy Council members and AASP committees strengthens the role and influence of the AASP and helps to promote the development and implementation of member services. 2. Participate in the AASP National Spinecare Awareness Initiative Educate your patients with Initiative resources Stimulate referrals by educating your patients Grow your practice by providing a public service The mission of the AASP National Initiative is to focus the attention of physicians, patients and the public on the spine, spine health, spine disorders and the physicians who have the expertise to care for the spine. The Initiative consists of the National Physician Awareness Program . The Initiative is provided by the American Academy of Spine Physicians (AASP), representing chiropractic physicians and neurosurgeons committed to conservative and cooperative spinecare, and by the International Spine Association (ISA), representing spine organizations on six continents. Members of the AASP receive numerous free educational and practice building resources. Some of the resources explain the role of the spine physician and the service they are able to offer to the public as well as other healthcare professionals. 3.Achieve Online Credentialing as a Spine Physician (Diplomate of the American Academy of Spine Physicians and Fellow of the American College of Spine Physicians) Enhance your Recognition as a Credentialed Spine Physician Obtain Diplomate status with the American Academy of Spine Physicians (DAASP) Obtain Fellow status with the American College of Spine Physicians (FACSP) The American Academy of Spine Physicians (AASP) offers advanced credentialing for members who achieve various levels of academic achievement through the Academy. A Diplomate status with the American Academy of Spine Physicians (D.A.A.S.P) is granted to those members of the AASP who achieve a total of 300 continuing education (CE) credits through the AASP. Members who achieve an additional 200 continuing education (CE) credits through the AASP are eligible for Fellow status with the American College of Spine Physicians (F.A.C.S.P.). Credentialing with the AASP demonstrates the member's commitment to excellence in spinecare and enhances their professional stature with patients, the public and other medical professionals. The continuing education programs provide an opportunity for participating AASP members to improve the quality of spinecare provided to their patients. 4. Be listed in the online NATIONAL DIRECTORY OF SPINE PHYSICIANS Increase practice visibility Make yourself available for referrals Distinguish yourself as a specialist online Members of the American Academy of Spine Physicians are listed in the highly visible online National Directory of Spine Physicians. The National Directory of Spine Physicians has four levels with the fourth level representing a unique patient/public informational resource available to the member at a considerable cost savings. The National Directory of Spine Physicians is posted on the World Wide Web and is listed with major search engines to increase Directory and AASP member visibility. The National Directory of Spine Physicians provides a search function so that consumers, patients and professionals can search for spine physicians by geographic location which will lead to the member's website (Level three) The AASP member is provided with level I and level II listing in the Directory at no additional charge as part of their membership. If the member has an existing website it can be linked to the second level of the directory at no additional charge. If a member does not have a personalized website for the third level of the Directory, a customized practice website can be provided through the AASP at a significant cost savings. AASP members are profiled with priority in the National Directory of Spine Physicians. AASP members are listed alphabetically and by geographic location. Click here to visit the National Directory of Spine Physicians WWW.SPINEPHYSICIANS.NET Directory Levels Level I -The first level of the directory is the general registry which includes the members name and basic contact information for the member's practice. Non-members and members are posted here. Level II - The second level of the Directory is a full-page profile of the member that is linked to first level of the National Directory of Spine Physicians. Level II provides additional contact and background information about the AASP member, including the Diplomate/Fellow status held (if any) with the AASP/American College of Spine Physicians. Level III - The third level of the Directory is comprised of the physician's practice website which can be linked to the profile page (Level II of the Directory). Level IV - The fourth level of the Directory represents an online patient/public information area referred to as the AASP Public Information Center (PIC). The PIC is available to AASP members at a considerable cost savings and will provide invaluable educational resources on their personal website. The PIC can be embedded into an existing website or can be placed into a custom website developed for the AASP member. (please go to # 5: Patient Information Center for Your Office and Your Website) 5. Personalized Interactive AASP Website for Your Use Introduce yourself and your practice online Link your website to online directory listings Educate your patients online 24/7  As part of the National Spinecare Public Awareness Initiative, the AASP is offering a customized interactive website to its members. There is no charge for the development, setup and deployment of the website. The AASP website will convey to the public, patients and other physicians the unique background and training of the member. The professionalism and effectiveness of the customized AASP site is unsurpassed by others in the industry. The AASP website offered to each member is linked to the large informational database of the American Academy of Spine Physicians. This seamless pass through (link) provides each AASP member with a continually updated body of need-to-know information for their patients as well as an expanding library of resources. The website also contains the unique resources of the AASP National Spinecare Awareness Initiative resources including personalized brochures and press releases. The AASP Website for each member comes with a variety of ready to go functions including the Public Information Center (PIC) which includes need-to-know information about the spine, spine disorders, diagnostic tests, spinecare and spine physicians: Additional Features of the Customized website include: 1) Refer a Patient Function 2) Online Practice Newsletter Builder 3) Online Article Builder 4) AASP Member Certificate 5) Chiropractic Services Summaries 6) About the AASP 7) Member Press Release 8) Directions to your practice 9) Our Team Page 10) Our Services Page 11) The Doctor(s) Page 12) The Academy Page 13) Informative Links 14) Academy News 15) And much more 6. Use the PUBLIC INFORMATION CENTER (PIC) in your Office and on your Website Add the equivalent of a full time medical writer to your staff Present state-of-the art medical graphics Make the report of findings process more efficient The AASP offers its members one of the most unique educational tools available: the Public Information Center (PIC). The PIC utilizes unique technology developed by the AASP, which displays a user-friendly interface for accessing educational modules referred to as plug-ins. The PIC is designed to be embedded into an existing website. The PIC database is accessed online through the Internet (World Wide Web). The PIC displays educational information in an unprecedented multimedia format including text, video clips, line drawings and graphic animations. The PIC also contains downloadable patient educational resources such as fact sheets and brochures. The PIC can be accessed in the member's office as part of a patient educational station or center. Individuals can also be directed to access the PIC though the members website or via the AASP website. Patients can be motivated to refer friends, family and other contacts to the PIC for concise and peer-reviewed information about the spine, spine disorders and spinecare. The PIC can be displayed on a standard computer monitor, flat plasma screen, or HDTV monitor in the member's office to educate the patient about their condition. 7. Display a Personalized Certificate of Membership Display your commitment to cooperative spinecare Acknowledge your dedication to conservative spinecare Distinguish yourself as a leader in spinecare AASP members receive a prestigious personalized membership certificate suitable for framing and placing in their office. This eye-catching certificate acknowledges their commitment to conservative and cooperative spinecare. The certificate of membership is a distinctive and effective communication tool. Special certificates are also provided for members who have achieved Diplomate status with the AASP and Fellow status with the American College of Spine Physicians (ACSP). Custom framing for the personalized certificates of membership and academic achievement is available for AASP members. 8. Achieve Diplomate Status with the American Academy of Spine Physicians (D.A.A.S.P.) Gain the respect of your medical colleagues Obtain interdisciplinary training Enhance your recognition as a spine physician   The American Academy of Spine Physicians is committed to recognizing academic achievement and continuing education by awarding Diplomate status to those chiropractic physicians and neurosurgeons who meet the academic criteria through the AASP. The AASP is committed to acknowledging the Diplomate status in the AASP Member Directory and in the National Directory of Spine Physicians emphasizing those members who are committed to continuing education and who are steadfast in their approach to improving the quality of spinecare. Personalized AASP resources will also reflect the member's status as a Diplomate. 9. Achieve FELLOW STATUS: with the AMERICAN COLLEGE OF SPINE PHYSICIANS (F.A.C.S.P.) Obtain the highest level of academic achievement in the field of cooperative spinecare Show your commitment to continuing education by obtaining Fellow status The AASP is the only organization of its kind to offer interdisciplinary post-doctoral credentialing to its members who meet the continuing education criteria. The highest level of academic distinction offered to AASP members is Fellow status with the American College of Spine Physicians (FACSP). The neurosurgeon or chiropractic physician who achieves this level of academic achievement will be designated as Fellow of the American College of Spine Physicians and will be listed as such in the AASP Member Directory and the National Directory of Spine Physicians. Personalized AASP resources will also reflect the member's status as a Fellow. 10. Receive the ACADEMY NEWS Display current breakthroughs in spinecare in your waiting room Develop press releases with the Academy News Keep your referring physicians informed with Academy News The AASP is committed to keeping members informed about trends in spinecare, member contributions to the field of spinecare and the activities of the Academy. (Click here to go to AASP Newsletter Archive) Members, who provide the AASP with their email address, will receive regular email delivery of the Academy Newsletter at no charge as part of their membership benefits. This unique method of delivery allows for efficient communication of new membership services and strategic links to additional information. Newsletter topics are archived and indexed allowing for efficient search and review. 11. Enhance Community Recognition with the Member Public Relations Kit Personalized press release acknowledging acceptance as an AASP member Participate in the online build a press release program Enhance public awareness of your practice A personalized public relations kit is provided to members. The kit includes a personalized press release acknowledging the spine specialists acceptance as an active member of the AASP and there chosen designation as a spine physician. The Press release kit also provides pertinent information about the Academy. The Public Relations Kit provides an effective method acknowledging the professional advancement of the member to their community. The AASP member has access to an online pressroom that provides access to a growing list of available press releases developed by the AASP staff. The online pressroom also contains a library of archived articles, which have been published about the AASP, all of which can be downloaded and forwarded to local media. Disseminating time sensitive news can be one of the most effective and efficient methods of education and marketing. Archived press releases can be downloaded and submitted to local media promoting the mission of the AASP and increasing member visibility. 12. Save Money through AASP Buying Advantages Discount on promotional and practice building resources Purchase practice building resources at a considerable savings Buy Equiptment and Supplies for your practice at a considerable price savings. Many companies offer members of the AASP a preferred discount on equipment, educational resources, promotional items, practice supplies and products. AASP member have preferred access to these discounted prices on the International Directory of Backcare Products and Services. Many products in the AASP online store are also offered at a discount to members. The AASP store contains items such clothing, web resources, AASP branded educational items, and fine art for the clinical setting. Many of the items in the AASP store display the AASP logo such as shirts, caps, etc. Customized AASP promotional products are available to physicians to help them inform the public of their commitment to conservative and cooperative spinecare. 13. Preferred Access to the International Directory of Backcare Products and Services Obtain significant discounts on backcare products and services Efficient search for new products The AASP has developed cooperative relationships with various businesses and service providers who have committed to providing discounts to members of the AASP. This is made available through the online AASP Buying Advantage Program a service provided exclusively for members. The AASP exposes its membership to discounted leading-edge products and resources. The potential cost savings is significant. This interactive addition to the AASP website allows vendors to access the website and post discounts in designated categories. The format provides vendors an opportunity to compete for the best price categories and expose their products and resources to AASP membership. This unique program gives AASP members an opportunity to price compare in an extremely efficient manner. (www.backproducts.net) 14. Use the INFORM A COLLEAGUE Service Build your spinecare referral network Forward information to colleagues quickly Expand and educate your spinecare network through the online AASP Inform a Colleague Email resource. This high-tech resource represents an extraordinary method the AASP member can use to inform their colleagues about the American Academy of Spine Physicians (AASP), the American College of Spine Physicians (ACSP) and spinecare. The online link library offers a variety of unique educational tools and documents which can simply be attached to an email message. The Inform a Colleague Service resource provides an invaluable time saving service for expanding your spinecare network and for inviting colleagues to join the AASP. 15. Obtain Affordable and Convenient ON-LINE CONTINUING EDUCATION CREDITS for Licensure Renewal Obtain cost efficient continuing education Choose the educational subjects of your choice Continuing Education with Flexibility The AASP provides one of the most flexible and unique educational opportunities available to physicians. The AASP home study and online continuing education programs are designed to be affordable and practical. The continuing education credits achieved through the AASP may be used to meet mandatory state continuing education requirements and also can also be applied toward obtaining Diplomate status with the American Academy of Spine Physicians up to Fellow status with the American College of Spine Physicians. Click here for states that accept C.E. credits online 16. Reach your Community with AASP Slide Programs Ready to use presentations for patients and the public Slide programs which can posted on your website AASP members have the opportunity to access a library of educational slide sets at no cost which can be downloaded from the AASP website to the member's personal computer. Some of the slides can be personalized for member presentations. The educational slide programs provide effective visual resources to inform patients, the public and physicians about the benefits of conservative and cooperative spinecare, the member's specialized approach and the member's practice. Slides are provided which can be used to present the member's credentialed status with the AASP and the American College of Spine Physicians (ACSP). 17. Display Helpful Website Links Invaluable resource for the public and patients One stop location for research The AASP offers members quick online access to informative websites on the worldwide web. The website links provide members and their patient's with invaluable educational resources. It can take many hours or days of online research to find the variety of credible links that the AASP has to offer. The savings in online research time is immeasurable. 18. Refer Patients to the AASP Spine Disorders Database Direct your patients to accurate information on the spine Extend your report of findings with the AASP spine disorders database Provide your patients with resources they can access after the office visit The AASP is committed to growing it s existing online database of information about the spine, spine disorders and spinecare. The database can be accessed by members, patients and the public. This resource provides spine physicians with a reliable location to direct patients for peer reviewed need-to-know information. This resource will help the AASP member offer an expanded educating opportunity for their patient and will also help them save time that can be spent caring for other patients. 19. Provide Downloadable Publications to your Patients Save money on custom printing and ordering of pre-printed materials Empower your patients with information to stimulate referrals Expand your practice with downloadable online resources which are continuously updated The AASP publishes numerous clinical and educational resources, which help members promote their role in spinecare. AASP publications help members inform their patients about diagnostic procedures, spinal conditions and available therapeutic options. For example, the Why COOPERATIVE SPINE CARE? brochure is an excellent tool, which can simplify the interdisciplinary referral process. 20. Affiliation with the INTERNATIONAL SPINE ASSOCIATION (ISA) Become part of an International Educational Initiative Help increase International respect for spine specialists  WWW.SPINEASSOCIATION.ORG The American Academy of Spine Physicians (AASP) has a strategic alliance with the International Spine Association (ISA) to develop information about the spine and spinecare for the public. The ISA is an international organization comprised of numerous divisions (spine societies) representing many countries. This significant alliance will result in the development of many educational categories, which will include the ongoing development of a large educational database on basic spinal anatomy, information about spinal disorders, available therapeutic options, information about spinal diagnostic procedures and advances in technology. This unique international alliance will increase public exposure to AASP members through the AASP Member Directory and the National Spine Physicians Directory. The AASP member will also have direct and timely access to educational materials developed by the AASP and ISA. 21. Grow with Leadership Direction Take the lead in your practice and community Stay at the leading edge of spinecare The online leadership articles are designed to assist members in personal and professional development. The AASP recognizes that spine physicians require leadership skills to excel in their field and their practice. The acquisition of leadership skills also contributes to improved patient care. 22. Candidate Membership Build relationships with practicing physicians before graduation Refine your skills as a spine specialist Develop a practice building plan Neurosurgical residents and chiropractic students are eligible to apply for candidate membership in the AASP. Members of the AASP (neurosurgeons and chiropractic physicians) are offered the opportunity to participate in programs to help candidate members, as they will be our spinecare colleagues of tomorrow. 23. Increase Patient Referrals through the Spine Physician Referral Network Expand your interdisciplinary relationships Build the Ultimate Spinecare Network The American Academy of Spine Physicians (AASP) has implemented online technology that can be used to help members develop spinecare referral networks within their geographic locations. Member chiropractic physicians and neurosurgeons have an opportunity to develop a working relationship with the other by using AASP search functions as well as AASP introductory and educational resources. The AASP provides an interdisciplinary "matchmaking" service FREE to its members. 24. Access the Online Build a Press Release Program Educate the public Grow your practice with news The American Academy of Spine Physicians (AASP) is dedicated to providing its members with time and cost efficient methods of educating their patients and informing the public about trends and developments in spinecare. The AASP offers its members a public relations program which includes the opportunity to build a press release online from the extensive archive of news published in the online ACADEMY NEWS. This unique opportunity provides the AASP member with the occasion to disseminate up-to-date information about the spine, spine disorders and trends in cooperative spinecare to the public with a minimum of effort. 25. Display Your Personalized Certificate of Participation in the National Spinecare Awareness Initiative Members of the American Academy of Spine Physicians have an opportunity to participate in the AASP National Spinecare Awareness Initiative. The member can download one or more personalized certificates of participation which can be framed and placed in a highly visible area such a wall in the waiting room.Certificates of participation can also be placed in examination or treatment rooms. The professionally designed certificate is a valuable resource which will serve to inform patients that their physician (AASP member) is committed to education and public health. It will also serve to stimulate requests for Initiative educational resources resulting in increased patient satisfaction, increased patient referrals and practice growth. 26. Stay at the Leading Edge of Technology and Product Development Each AASP member will receive a Spinecare Product e-catalog one time per month. The service is made available through the contributions of AASP corporate and educational sponsors. The e-catalog incorporates state of the art internet and database programming technology to help the AASP bring timely information to its membership. The catalog will feature advances in technology, new products and leading-edge services available to spine physicians. The catalog also features search function to help a member locate a company, locate a product, identify products or services endorsed by the Academy and to obtain special pricing. Members will also receive information about leading edge technology in spinecare thorugh the monthly Academy News.   27. Patient Newsletter Program (New Benefit) Each member of the American Academy of Spine Physicians (AASP) has an opportunity to grow their practice by educating their patients and members of the community with a monthly eNewsletter. The AASP eNewsletter program was designed to help members inform their patients and the public about the spine and spinecare. The AASP currently provides a eNewsletter to its members each month which can in turn be forwarded to their patients. The AASP eNewsletter program will help AASP members enhance recognition in their community through a consistent and professional educational commitment. The eNewsletters are easily obtained by members on the AASP website or on their personalized AASP member website. The member's websites are programmed with an online patient signup option. The newsletters can be forwarded to patients: 1) by email directly from the members website or 2) they can be printed and sent by direct mail. Each member website is designed with an automated eNewsletter program and a print function. After publication each eNewsletter is archived by date and topic. The content of the eNewsletter can not be altered, however each eNewsletter is automatically personalized with the member's information. The eNewsletters are automatically send to the members patients monthly via email. ( Read More...... ) 28. Access to Ongoing Technological and Resource Development (New Benefit) Each member of the American Academy of Spine Physicians (AASP) will benefit by ongoing developments throughout their membership year. The list of member benefits included in the annual membership fee keeps expanding. For example, new technology and interactive features will be added to the AASP website as well as to the personalized AASP member websites. The AASP will also continue to increase its multimedia database of information used for the online Patient/Public Information Center (PIC). The AASP will continue to enlarge the inventory of available practice building and patient educational resources throughout the membership year. The real benefit is that the AASP member essentially buys into a dynamic process of resource design and development for their practice. 29. Access to Free Online Continuing Education Credits (CE) (New Benefit) The American Academy of Spine Physicians (AASP) is committed to providing affordable and flexible continuing educational opportunities to its members. The AASP currently provides online continuing education programs thorugh a variety of multimedia formats including Textbook Review Courses, Journal Review Courses and Case Study Review Courses. Tests are taken on line and are auto graded. Physicians who join or renew membership with the AASP after December 15, 2004 are eligible to obtain 20 CE credits per membership year at no charge as part of a growing list of membership benefits. In many states CE obtained through the AASP can be applied for license renewal requirements. The credits can also be applied toward obtaining Diplomate Status with the American Academy of Spine Physicians (DAASP) and Fellow Status with the American College of Spine Physicians (FACSP). News.   30. Obtain an Officer Manager's Guide to Implementing AASP Practice Development Resources (New Benefit) Each AASP member can obtain an office managers guide to implementing practice development resources. The implementation guide provides simple step by step methods which the office manager can use to facilitate use of the unique member benefits. The guide can be retrieved on the part of the AASP website that is available to members and the guide can be printed at any time. The AASP will continue to develop the implementation guide throughout the membership year. New and improved practice development resources will continue to be added for use by the AASP members.

CLICK TO JOIN

THE

AMERICAN ACADEMY OF SPINE PHYSICIANS

1. Interact with Experts and Leaders in the Field of Spinecare
Connect with experts and leaders in the field of spinecare. By being a member of the American Academy of Spine Physicians (AASP) you have an opportunity to help shape the future of spinecare. The AASP is an international organization comprised of neurosurgeons and chiropractic physicians dedicated to improving the quality of spinecare through conservative and cooperative efforts. The AASP membership includes some of the most nationally and internationally respected neurosurgeons and chiropractic physicians.

2. Credentialing as a Spine Physician
The American Academy of Spine Physicians (AASP) offers advanced credentialing for members who achieve various levels of academic achievement through the Academy. A Diplomate status with the American Academy of Spine Physicians (D.A.A.S.P) is granted to those members of the AASP who achieve a total of 300 continuing education credits through the AASP. Members who achieve an additional 200 continuing education credits through the AASP are eligible for Fellow status with the American College of Spine Physicians (F.A.C.S.P.).

Credentialing with the AASP demonstrates the member’s commitment to excellence in spinecare and enhances their professional stature with their patients, the public and other medical professionals. The continuing education programs provide additional knowledge that will help members improve the delivery of spinecare to their patients. 

  3. Be listed in the online NATIONAL DIRECTORY OF SPINE PHYSICIANS

Members of the American Academy of Spine Physicians will be listed in an online National Directory of Spine Physicians. The National Directory of Spine Physicians has four levels with the fourth level representing a unique patient informational resource available to the member at considerable cost savings.

The AASP member will be listed at two levels of the directory at no additional charge as part of their membership.   If the member has an existing website it can be linked to the second level of the directory at no additional charge. If a member does not have a personalized website for the third level of the Directory, this can be provided through the AASP at a significant cost savings. 

Level I -The First Level of the directory is the general registry where basic contact information about spine physicians within a geographic location is posted along with a listing of their membership status with the AASP.

Level II - The Second Level of the Directory is a full-page profile of the member that is linked to first level of the National Directory of Spine Physicians. This level provides additional contact and background information about the AASP member, including the Diplomate/Fellow status held (if any) with the AASP/American College of Spine Physicians.

Level III - The Third Level of the Directory is the physician’s website which can be linked to the profile page (Level two of the Directory). The National Directory of Spine Physicians will be posted on the World Wide Web and will be listed with the major search engines to increase Directory and AASP member visibility. The National Directory of Spine Physicians provides a search function so that consumers, patients and professionals can search for spine physicians by geographic location which will lead to the members website (Level three)

Level IV - The Fourth Level of the Directory represents an online patient and public information area referred to as the AASP Patient Information Center (PIC). The PIC is available to AASP members at a considerable cost savings and will provide invaluable educational resources on their personal website.  The PIC can be embedded into an existing website or can be placed into a custom website developed for the AASP member.

The AASP has invested a great deal of research and development in order to offer  AASP members a custom interactive website emphasizing the member’s professional qualifications and the healthcare services offered by the member or by the member’s facility. The internet continues to evolve as a widely used research tool for patients and the public; therefore, a professional and  interactive website is a must for the spine physician who wants be on the leading-edge of patient service or education. Through the AASP the member can obtain an interactive educational website at a considerable cost savings. The educational services can be enhanced with the addition of the AASP’s PIC also available to AASP members at a considerable cost savings. The following list represents  a few of the features  of our interactive websites.

Custom Interactive Website Features Include

Practice News
Map to the Office
eNewsletter Signups
Office Calendar/Schedule
Ability to Send eNewsletters
Site contains 15 Pages
Informative Articles
Refer A Patient Feature
Ability to link to the AASP Patient Information Center (PIC)
The AASP has gone to great lengths to keep the costs minimal.

5. PATIENT INFORMATION CENTER (PIC) for your Office and your Website 
The AASP offers its members one of the most unique educational tools availabl: the Patient Information Center (PIC). The PIC is a software program developed by the AASP, which displays a user-friendly interface for accessing multimedia educational modules referred to as plug-ins. The PIC is designed to be placed into a website and accessed through the Internet (World Wide Web). The PIC can house numerous educational plug-ins, which incorporate text, video clips, line drawings and graphic animations. The PIC also contains downloadable features  providing the user with printed materials and brochures; the brochures are excellent for patient information. 

The PIC can be used in the member’s office as an educational station or center. The PIC can also by a patient or the public by accessing the website from their home. Patients can be motivated to refer friends, family and other contacts to the PIC for concise and peer-reviewed information about the spine, spine disorders and spinecare. The PIC can be  displayed on a standard computer monitor, flat plasma screen, or HDTV monitor which can be used in the office to educate the patient about their condition.  

6. Personalized Wall Certificate with Special Framing Available

AASP members receive a prestigious personalized membership certificate suitable for framing and placing in their office. This eye-catching certificate acknowledges their commitment to conservative and cooperative spine care. This is a distinctive and effective communication tool. Special certificates are also provided for those who have achieved Diplomate status with the AASP and Fellow status with the American College of Spine Physicians (ACSP). Custom framing for the personalized certificates of membership and academic achievement is available for AASP members.

7. DIPLOMATE PROGRAM: Become a Diplomate of the American Academy of Spine Physicians (D.A.A.S.P.)
The American Academy of Spine Physicians is committed to recognizing academic achievement and continuing education by awarding Diplomate status to those chiropractic physicians and neurosurgeons who meet the academic criteria through the AASP.  The AASP is committed to acknowledging the Diplomate status in the AASP Member Directory and in the National Directory of Spine Physicians emphasizing those members who are committed to continuing education and who are steadfast in their approach to improving the quality of spinecare.

8. FELLOW STATUS: Opportunity to Qualify for the Elite AMERICAN COLLEGE OF SPINE PHYSICIANS (F.A.C.S.P.)
The AASP is one of the only organizations of its kind to offer interdisciplinary post-doctoral designations of educational achievement to its members who meet the continuing educational criteria. The highest level of educational distinction offered is to qualify for Fellow status with the American College of Spine Physicians. The neurosurgeon or chiropractic physician who achieves this level of academic achievement may be designated as Fellow of the American College of Spine Physicians and will be listed as such in the AASP Member Directory and the National Directory of Spine Physicians.

9. Networking: The AASP Membership Directory
Membership with the AASP makes you part one of the most prestigious and unique professional organizations of spinecare professionals in the world. The AASP provides members with invaluable resources they can use to network with the public, with other physicians and the media. The online AASP member directory is a valuable resource for the public to access spine physicians. It also provides members with the option to network with other healthcare professionals. AASP members are listed alphabetically and by geographic location. AASP members will also be profiled with priority in the National Directory of Spine Physicians. The AASP Membership Directory provides contact information, denotes the level of academic achievement the member has obtained through the AASP and provides a direct link to the member’s website if available.

10. Special Options through the Patient Information Center (PIC) for Customized Website
The AASP provides members the option to obtain a customized and personalized professional website at a considerable savings.  Members can have a seamless internet extension into the AASP spine disorders data base and other informative areas directly from their website. Members of the AASP can purchase this sophisticated interactive website which is easily personalized. Special Plug-ins are available to provide spine-related educational resources.   State of the art interactive features are made available to AASP through this opportunity. This invaluable educational website can be linked to level two of the AASP Membership Directory and to level two of the National Directory of Spine Physicians both which will increase member exposure to patients, the public, and healthcare professionals. (Go to #5: Patient Information Center for your Office and Your Website)

11. Newsletter: ACADEMY NEWS is Available to all Members via Email
The AASP is committed to keeping members informed about trends in spinecare, member contributions to the field of spinecare and activities of the Academy.  Members, who provide the AASP with their email address, will receive regular email delivery of the Academy Newsletter at no charge as part of their membership benefits. This unique method of delivery allows for efficient communication of new membership services and strategic links to additional information. Newsletter topics are indexed for easy search and find functions.  

12. Member Public Relations Kit
A personalized public relations kit is provided to members. The kit includes a personalized press release acknowledging the spine physician’s acceptance as an active member of the AASP and pertinent information about the organization. The Public Relations Kit provides an effective method of acknowledging professional advancement to members of the community. The AASP member has access to an online pressroom that offers the ongoing posting of a broad category of press releases developed by the AASP staff. The online pressroom also contains a library of archived articles, which have been published about the AASP, all of which can be downloaded and forwarded to local media. Disseminating time sensitive news can be one of the most effective and efficient methods of education and marketing. Archived press releases can be downloaded and submitted to local media promoting the mission of the AASP and increasing member visibility.

13. Academy Council
The AASP Academy Council is comprised of preeminent neurosurgeons and chiropractic physicians in the United States. These spinecare experts and leaders provide valuable direction to the Academy and help set it apart from other organizations.  The respected visibility of the Academy Council and the collaboration between Academy Council members and AASP committees strengthens the role and influence of the AASP and helps to promote the development and implementation of member services.   

14. Online Store
The AASP online store features promotional products, AASP clothing, web resources, educational items, and fine art for the clinical setting.  Some of the items in the AASP store have the AASP logo such as shirts, caps, etc. Customized AASP promotional products are available to physicians to help them inform the public of their commitment to conservative and cooperative spinecare. Made to order displays for AASP membership certificates as well as Diplomate and Fellow certificates are also available.

15. AASP Buying Advantage Program
The AASP has developed cooperative relationships with various businesses and service providers who have committed to providing discounts to members of the AASP. This is made available through the online AASP Buying Advantage Program a service provided exclusively for members.  The AASP exposes its membership to discounted leading-edge products and resources. The potential cost savings is significant. This interactive addition to the AASP website allows vendors to access the website and post discounts in designated categories. The format provides vendors an opportunity to compete for the best price categories and expose their products and resources to AASP membership. This unique program gives AASP members an opportunity to price compare in an extremely efficient manner.

16. INFORM A COLLEAGUE Service
Expand and educate your spinecare network through the AASP Inform a Colleague Email Service. This represents an extraordinary online web resource, which the physician can use to inform their colleagues about the AASP, the American College of Spine Physicians (ACSP) and spinecare. An online library of unique informational links is provided and this can be attached to email messages. This Inform a Colleague Service resource provides an invaluable time saving service for expanding your spinecare network and for inviting colleagues to join the AASP.

17. Affordable and Convenient ON-LINE CONTINUING EDUCATION OPPORTUNITIES
The AASP provides one of the most flexible and unique educational opportunities available to physicians. The AASP home study and online continuing education programs are designed to be affordable and practical. The continuing education credits achieved through the AASP may be used to meet mandatory state continuing education requirements and also can also be applied toward obtaining Diplomate status with the American Academy of Spine Physicians up to Fellow status with the American College of Spine Physicians. 

19. Helpful Website Links
The AASP offers members quick online access to informative websites on the worldwide web. The website links provide members with invaluable networking and academic resources. It can take many hours or days of online research to find the variety of relevant links that the AASP has to offer. The savings in online research time is immeasurable.

20. Spine Disorders Database
The AASP is committed to building an online database, which can be used to search for relevant descriptions and overviews of spinal disorders for the public and for patients. This resource provides spine physicians with a reliable location to direct patients for peer reviewed need-to-know information, which can help members save time that can be spent caring for other patients.

21. Publications and Information for your Patients
The AASP publishes numerous clinical and educational resources, which help members promote their role in spinecare.  AASP will help them inform their patients about diagnostic procedures and spinal conditions. For example, the Why COOPERATIVE SPINE CARE? brochure is an excellent tool, which can simplify the interdisciplinary referral process.

22. Affiliation with the INTERNATIONAL SPINE ASSOCIATION (ISA) with Divisions Representing most Countries Around the World

The American Academy of Spine Physicians (AASP) has a strategic alliance with the International Spine Association (ISA) to develop information about the spine and spinecare for the general public. The ISA is an international organization comprised of numerous divisions (spine societies) representing many countries.  This significant alliance will result in the development of many educational categories, which will include the ongoing development of a large educational database on basic spinal anatomy, information about spinal disorders, available therapeutic options, information about spinal diagnostic procedures and advances in technology. This unique international alliance will increase public exposure to AASP members through the AASP Member Directory and the National Spine Physicians Directory. The AASP member will also have direct and timely access to educational materials developed by the AASP and ISA. 

23. Practice Marketing 
AASP member information will be added to the AASP database and this is used to build the online member directory. The AASP directory will list member contact information which includes a direct link from the AASP website to the members personal or practice website. We are committed to informing the public about AASP member’s roles in spinecare. Consistent public relations efforts will be deployed to direct patients and the public to the AASP website.

24. Leadership Programs
The online leadership programs are designed to assist members in personal and professional development. The AASP recognizes that spine physicians require leadership skills to excel in their field and their practice. The continuing education and the leadership skills both contribute to improved patient care.

25. Candidate Membership
Neurosurgical residents and chiropractic students are eligible to apply for candidate membership in the AASP. Members of the AASP (neurosurgeons and chiropractic physicians) are offered the opportunity to participate in programs to serve these candidate members, as they will be our spinecare colleagues of tomorrow.

   Surgical Procedures 

ALLOGRAFT

A piece of bone taken from a dead person (cadaver).  These pieces of bone are treated in a way to make them clean and free of infection (bacteria and viruses).  They are then stored in plastic containers in a bone bank for use as needed in fusions (See FUSION; INTERBODY FUSION). 

ANTERIOR CERVICAL DISCECTOMY/MICRODISCECTOMY

The name of the procedure where the neurosurgeon operates in the front of the neck and holds the patient=s breathing tube (trachea) and swallowing tube (esophagus) to one side to expose the front (anterior) of the spine.  The disc (See DISC) is opened and the contents of the disc are removed using special instruments.  Any disc material pressing on the spinal cord and/or nerves coming off of the spinal cord (nerve roots) is removed.  If this is done using an operating microscope to improve visualization, the operation is referred to as an anterior cervical microdiscectomy. 

ANTERIOR LUMBAR DISCECTOMY/MICRODISCECTOMY

An operative procedure on the lumbar spine from the front (anterior).  (See ANTERIOR CERVICAL DISCECTOMY/MICRODISCECTOMY) 

ANTERIOR THORACIC DISCECTOMY/MICRODISCECTOMY

An operative procedure done on the thoracic spine from the front (anterior).  (See ANTERIOR CERVICAL DISCECTOMY/MICRODISCECTOMY) 

AUTOGRAFT

Bone used in fusing the spine (See FUSION) taken from the patient being operated upon.  A piece or pieces of bone can be taken from the large bone you can feel at the sides of your waist (iliac crest bone graft), from a bone of the lower leg (fibular graft) or pieces of bone removed while doing a laminectomy (See LAMINECTOMY).  (See FUSION; INTERBODY FUSION)

SPINAL STIMULATOR/SPINAL CORD STIMULATOR

This is an electrical device that a neurosurgeon may implant in a person to help control pain that has not been controlled by pain medicines (analgesics) and by TENS units (See TENS UNITS).  A stimulator box is attached to a wire with an electrode on the end.  The electrode is placed over the surface of the spinal cord.  To attempt to control the pain, the settings on the box are changed until the best result is obtained.    

360 DEGREE FUSION/ANTERIOR-POSTERIOR FUSION

This is an operative procedure to join two or more bones (vertebrae) of the spine together permanently by doing a procedure at the back of the spine (posterior fusion) as well as a procedure on the front of the spine (anterior fusion).  (See FUSION; INTERBODY FUSION; APLIF@).   The neurosurgeon may do both procedures under the same anesthesia or do the procedures on different days.

COMMON NEUROLOGICAL SIGNS & SYMPTOMS

There are many neurological signs and symptoms, which warrant neurological evaluation.Some of the more common neurological signs and symptoms are listed below. 

Aphasia
Inability to verbally express oneself either because of inability to coordinate speech or to select proper words. This may occur secondary to injury to select regions of the speech and auditory processing centers within the cerebral cortex of the brain. 

Apraxia
Disorders of voluntary movement, consisting of partial or complete incapacity to execute purposeful movement notwithstanding the preservation of muscle power, sensation and coordination. 

Atony
A lack of muscle tone.

Atrophy
Shrinkage or wasting away of an organ or tissue because of a reduction in the size or number of its cells. Tissue atrophy may occur secondary to death or resorption of cells, diminished cellular proliferation, pressure, ischemia,malnutrition, decreased activity or hormonal changes.  The most common plication of the term is muscle atrophy which may occur secondary to denervation, disuse or muscel disease. 

Aura
Symptoms which occur prior to a particular neurological event such as a seizure or migraine that serves as a warning that additional signs or symptoms
will follow. 

Bradykinesia
The slowing of motor movements due to dysfunction of a specialized group of cells in the brain called the basal ganglia. 

Cramping
A painful muscle spasm, which may involve one or more muscles.

Dementia
An acquired loss of cognitive function that may affect language, attention, memory, personality and abstract reasoning. 

Diploplia
Double vision. 

Imbalance
Lack of equality between muscle forces leading to difficulty performing a task such as walking.

Incoordination (ataxia)
Inability to efficiently contract muscles in a smooth firing pattern during the execution of a movement.
Muscle Fasiculations: Visible or palpable twitching of muscle fibers. This can occur with diseases involving the spinal cord, nerve root, peripheral nervous system and with muscle disease.  

Muscle Fatigue
A progressive loss of muscle performance associated with physical exertion. This may occur secondary to a loss of nerve supply to the muscle or with deconditioning of the  muscle due to disease.

Pain
An unpleasant sensation associated with actual or potential tissue damage, mediated by specific nerve fibers to the brain where its conscious appreciation may be modified by various factors.

Paresthesia:
Unusual sensory symptoms consisting of one or more of the following: tingling, numbness or other feelings or abnormal senosry experiences. 

Ptosis
Drooping of the eyelids due to weakness of the muscles responsible for keeping the eyelids open. 

Numbness
Diminished sensation with a feeling of dullness. 

Sleep Apnea
A disorder that results in apnea (cessation of breathing) during Sleep often secondary to obstruction of the airway.

Spasticity
stiffness or rigidity of muscles involving the limbs, which results from dysfunction or compromise of the corticospinal tracts (motor pathways). 

Tingling
A peculiar pricking thrill, caused by cold, by an emotional shock or nerve compromise.

Tinnitus
Subjective ringing or noise in the ears. 

Tremor
An involuntary trembling movement.

Vertigo
Dizziness or imbalance that is often associated with a spinning or rotational component. 

Weakness
A loss or reduction of physical strength

Spine Anatomy

(1) Vertebrae: The bones of the neck and back. These provide structural support for the spine. They encase the spinal cord and the nerve roots and serve to protect them.

(2) Intervertebral Foramina: The intervertebral foramina also referred to as neuroforamina are spaces created by adjacent vertebrae through which the nerves that go to various parts of the body (nerve roots) travel.

(3) Facet Joint: The facet joints connect one vertebra to the vertebra above or below it. They are paired joints located behind and to sides of the intervertebral discs. Facet joints control the amount and direction of spinal movement.

(4) Intervertebral Discs: Fibrous pads, which separate the bones of the spine (vertebrae). The intervertebral discs allow for flexibility in your spine, serve as shock absorbers, and provide cushioning between the vertebrae. The center of the intervertebral disc is referred to as the nucleus pulposus, which is a substance much like firm Jello. The nucleus is surrounded by tough rings of tissue referred to collectively as the annulus, which is similar to a ligament in consistency.

(5) Spinal Cord: A bundle of nerve fibers that act as the "main cable," carrying both sensory (sensation) information and motor (movement) information between the brain and the rest of the body. The spinal cord contains sensory, motor, autonomic and special interconnecting nerves. The spinal cord has many blood vessels.

(6) Spinal Nerves: There are 30 pairs of nerve roots, which branch off the spinal cord and exit through the holes (intervertebral foramina) between the bone (vertebra) above and the bone (vertebra) below. The spinal nerves (nerve roots) transmit sensation and movement information to and from parts of your body so that you can feel sensations and move your body.

(7) Ligaments: Ligaments are tough tissues that help hold the bones of the spine (vertebrae) together and help limit the amount of movement of a joint. Ligaments may become lax causing to much movement of a joint (joint hypermobility) and subsequent pain.

(8) Muscles: Muscles are comprised of special tissues, which contract to allow the body to move. Muscle groups may become weak or tight, causing a "muscle imbalance." This can directly affect full movement of the spine and extremities.

(9) Tendons: Tendons are comprised of fibrous tissue that connect muscle to bone. They are the muscle’s attachment to the bone.

(10) Spinal Curves: The vertebrae of the spine are stacked on top of one another Collectively they form four continuous curves. They are as follows: cervical, thoracic, lumbar, and sacral curves. These anterior to posterior curves allow for flexibility and postural support.