Online Continuing Education Courses

Cervical Spinal Manipulative Therapy (CSMT) and Vertebrobasilar Ischemia (VBI)

• Outline methods used and estimations as to the incidence of cervical spinal manipulative therapy and subsequent vertebrobasilar ischemia.
• Review and describe cerebrovascular anatomy and hemodynamics.
• Discuss proposed patho-physiological mechanisms believed responsible for subsequent vertebrobasilar ischemia.
• Review and discuss past and present scientific literature to explore the evolution of what we think we know about the process of cervical spinal manipulative therapy and subsequent vertebrobasilar ischemia.
• Identify radiographic signs of a vertebral artery dissection.
• List and discuss the uses, pros and cons of current examination tools as they apply to vertebral artery dissection.
• Explore issues and examination procedures related to patient assessment as well as vertebrobasilar ischemia recognition and proper diagnosis.
• Define and contrast currently suggested procedures and develop a vertebrobasilar ischemia plan of action.
• Explore various perspectives and reveal bias in both public media and biomedical journals.
• Identify and define new theoretical concepts and prophylactic therapies.
• Give multiple examples of anti-chiropractic bias in the biomedical literature
• List and describe the most common red flags for a patient “at risk” for suffering Vertebrobasilar Ischemia following cervical manipulation.
• Recite list of scientific studies relating to laboratory testing of plasma Homocystine levels and its relationship to Vertebrobasilar Ischemia from vertebral artery dissection.
• List examples of bias against chiropractic cited in both the popular media as well as in biomedical journals.
• Critically review landmark articles regarding the issue of cervical manipulation and vertebrobasilar distribution ischemia.
• List studies suggesting that a high plasma homocystine level may be associated with vertebrobasilar dissection.
• Cite studies suggesting that increasing folic acid intake can reduce plasma Homocystine levels.
• Identify laboratory tests that may be useful in helping calculate an individual’s risk of suffering vertebrobasilar stroke following cervical manipulation.