Re: [OregonDCs] Referrals for Lordex Spinal System

[Guest guest]

Thanks Doctors !!

I appreciate the protocols you have published. I will certainly refer to you before the MD's on these types of difficult casses.

Regards

Danno

[OregonDCs] Referrals for Lordex Spinal System

Doctors often ask us which patients should be referred for consideration of the Lordex spinal protocol.

Basically, patients who have been under care for a period of time and have not responded to traditional chiropractic protocols in a satisfactory manner and continue to be symptom expressive in the lower back and/or lower extremities. Especially those patients being considered for orthopedic or neurosurgical referrals are potential candidates for the Lordex protocol.

Indications

low back pain, unilateral or bilateral sciatica; leg and or foot pain; paresthesia post surgical; failed back

Typical candidates include low back and leg pain related to disc injury, facet syndrome and failed back syndrome. We see patients with diagnoses including disc lesions, internal disc derangement, spinal stenosis, facet syndrome, DJD, and post-surgical failed back syndrome.

It is equally important to consider which patients are definitely NOT potential candidates for the Lordex protocol.

Contraindications

cauda equina syndrome open growth centers spinal tumors vertebral fractures spondylolisthesis grade II above Advanced Osteoporosis (dexa scan required) severe medical conditions pregnancy Ankylosing spondylitis spinal fusion with retained hardware spinal infections

Another frequent question is to provide our protocol for new patient intake when a referral is made by another physician.

The patient is provided a consult that includes an introductory video and a discussion of their history to determine if they are a potential candidate for the procedure. This is followed by a focused physical exam including orthopedic and neurologic testing, and a review of available imaging studies, preferably including an MRI within the previous 6 month period.

A report of findings and recommendations are made on the second visit with a narrative report provided to the referring physician. Sample reports are available.

We invite you to visit the clinic at your convenience. We are happy to provide in-services for you and your staff upon request.

Please don’t hesitate to contact us with any questions you may have.

K. Tunick, D.C.

J. Tomaino, D.C.

[Guest guest]

Dr. T, Should a patient who is in severe acute low back pain with radiculopathy be 'decompressed' or should the acute period abate somewhat first ? And I mean acute severe.

sharron fuchs dc

From: [mailto: ] On Behalf Of D Beebe, D.C.Sent: Thursday, January 11, 2007 11:26 AMJEFF TUNICK; Subject: Re: [OregonDCs] Referrals for Lordex Spinal System

Thanks Doctors !!

I appreciate the protocols you have published. I will certainly refer to you before the MD's on these types of difficult casses.

Regards

Danno

[OregonDCs] Referrals for Lordex Spinal System

Doctors often ask us which patients should be referred for consideration of the Lordex spinal protocol.

Basically, patients who have been under care for a period of time and have not responded to traditional chiropractic protocols in a satisfactory manner and continue to be symptom expressive in the lower back and/or lower extremities. Especially those patients being considered for orthopedic or neurosurgical referrals are potential candidates for the Lordex protocol.

Indications

low back pain, unilateral or bilateral sciatica; leg and or foot pain; paresthesia post surgical; failed back

Typical candidates include low back and leg pain related to disc injury, facet syndrome and failed back syndrome. We see patients with diagnoses including disc lesions, internal disc derangement, spinal stenosis, facet syndrome, DJD, and post-surgical failed back syndrome.

It is equally important to consider which patients are definitely NOT potential candidates for the Lordex protocol.

Contraindications

cauda equina syndrome open growth centers spinal tumors vertebral fractures spondylolisthesis grade II above Advanced Osteoporosis (dexa scan required) severe medical conditions pregnancy Ankylosing spondylitis spinal fusion with retained hardware spinal infections

Another frequent question is to provide our protocol for new patient intake when a referral is made by another physician.

The patient is provided a consult that includes an introductory video and a discussion of their history to determine if they are a potential candidate for the procedure. This is followed by a focused physical exam including orthopedic and neurologic testing, and a review of available imaging studies, preferably including an MRI within the previous 6 month period.

A report of findings and recommendations are made on the second visit with a narrative report provided to the referring physician. Sample reports are available.

We invite you to visit the clinic at your convenience. We are happy to provide in-services for you and your staff upon request.

Please don’t hesitate to contact us with any questions you may have.

K. Tunick, D.C.

J. Tomaino, D.C.

[Guest guest]

What about for sacroiliac problems that won't get better? Ann Goldeen

[OregonDCs] Referrals for Lordex Spinal System

Doctors often ask us which patients should be referred for consideration of the Lordex spinal protocol.

Basically, patients who have been under care for a period of time and have not responded to traditional chiropractic protocols in a satisfactory manner and continue to be symptom expressive in the lower back and/or lower extremities. Especially those patients being considered for orthopedic or neurosurgical referrals are potential candidates for the Lordex protocol.

Indications

low back pain, unilateral or bilateral sciatica; leg and or foot pain; paresthesia post surgical; failed back

Typical candidates include low back and leg pain related to disc injury, facet syndrome and failed back syndrome. We see patients with diagnoses including disc lesions, internal disc derangement, spinal stenosis, facet syndrome, DJD, and post-surgical failed back syndrome.

It is equally important to consider which patients are definitely NOT potential candidates for the Lordex protocol.

Contraindications

cauda equina syndrome open growth centers spinal tumors vertebral fractures spondylolisthesis grade II above Advanced Osteoporosis (dexa scan required) severe medical conditions pregnancy Ankylosing spondylitis spinal fusion with retained hardware spinal infections

Another frequent question is to provide our protocol for new patient intake when a referral is made by another physician.

The patient is provided a consult that includes an introductory video and a discussion of their history to determine if they are a potential candidate for the procedure. This is followed by a focused physical exam including orthopedic and neurologic testing, and a review of available imaging studies, preferably including an MRI within the previous 6 month period.

A report of findings and recommendations are made on the second visit with a narrative report provided to the referring physician. Sample reports are available.

We invite you to visit the clinic at your convenience. We are happy to provide in-services for you and your staff upon request.

Please don’t hesitate to contact us with any questions you may have.

K. Tunick, D.C.

J. Tomaino, D.C.

[Guest guest]

Ann,

Excellent question.....one of the issues that often presents itself with

refractive SI involvement is ruling out whether there are compressive

lesions contributory to the problem.

If an SI problem has not responded to care, it would be appropriate to order

an MRI to assess whether there are additional contributing factors that need

to be addressed. Should additional involvement be identified, treating with

decompression at those areas may be helpful in resolving the stubborn SI

lesion.

SI involvement usually responds quite well to traditional chiropractic

intervention as we all know. Therefore, we would recommend considering that

there may be other factors involved, some of which may be responsive to

decompression protocols.

We hope that provides some help, and would be happy to consult on a case by

case basis for particular presentations.

Best regards,

K. Tunick, D.C.

J. Tomaino, D.C.

Lordex Spine Institute

>From: " anngoldeeen " <anngoldeen@...>

>< >, " Sharron Fuchs " <sharronf@...>

>Subject: Re: [OregonDCs] Referrals for Lordex Spinal System

>Date: Thu, 11 Jan 2007 12:01:48 -0800

>

>What about for sacroiliac problems that won't get better? Ann Goldeen

> [OregonDCs] Referrals for Lordex Spinal System

>

>

>

> Doctors often ask us which patients should be referred for

>consideration of the Lordex spinal protocol.

>

>

> Basically, patients who have been under care for a period of time and

>have not responded to traditional chiropractic protocols in a satisfactory

>manner and continue to be symptom expressive in the lower back and/or lower

>extremities. Especially those patients being considered for orthopedic or

>neurosurgical referrals are potential candidates for the Lordex protocol.

>

>

> Indications

>

>

> 1.. low back pain, unilateral or bilateral

> 2.. sciatica; leg and or foot pain; paresthesia

> 3.. post surgical; failed back

>

> Typical candidates include low back and leg pain related to disc

>injury, facet syndrome and failed back syndrome. We see patients with

>diagnoses including disc lesions, internal disc derangement, spinal

>stenosis, facet syndrome, DJD, and post-surgical failed back syndrome.

>

>

> It is equally important to consider which patients are definitely NOT

>potential candidates for the Lordex protocol.

>

>

> Contraindications

>

>

>

>

> 1.. cauda equina syndrome

> 2.. open growth centers

> 3.. spinal tumors

> 4.. vertebral fractures

> 5.. spondylolisthesis grade II above

> 6.. Advanced Osteoporosis (dexa scan required)

> 7.. severe medical conditions

> 8.. pregnancy

> 9.. Ankylosing spondylitis

> 10.. spinal fusion with retained hardware

> 11.. spinal infections

>

>

>

> Another frequent question is to provide our protocol for new patient

>intake when a referral is made by another physician.

>

>

> The patient is provided a consult that includes an introductory video

>and a discussion of their history to determine if they are a potential

>candidate for the procedure. This is followed by a focused physical exam

>including orthopedic and neurologic testing, and a review of available

>imaging studies, preferably including an MRI within the previous 6 month

>period.

>

>

> A report of findings and recommendations are made on the second visit

>with a narrative report provided to the referring physician. Sample reports

>are available.

>

>

> We invite you to visit the clinic at your convenience. We are happy to

>provide in-services for you and your staff upon request.

>

>

> Please don't hesitate to contact us with any questions you may have.

>

>

>

> K. Tunick, D.C.

>

> J. Tomaino, D.C.

>

>

>

>

>

[Guest guest]

Dr. Oliver,

What kind of distraction unit do you have, and what protocols do you use???

Dr. Don WHite

[Guest guest]

Sharon,

Patients that are in acute distress with significant radiculopathy are

provided a protocol where the strength restoration component is decreased so

that the resistance is consistent with their functional capacity. If

necessary, the strength restoration component is deferred until such time

that their pain levels and functional capacity are capable of participating

in the procedure.

With regards to the decompression component, if they are able to get on the

table and tolerate the harness, we will provide decompression at an

appropriate level. This may be preceded by icing or IFC if deemed necessary.

As always, the dictum is to 'do no harm', so protocols must be determined on

a case by case basis. If the patient is too acute to tolerate any

intervention, then of course it needs to be deferred until a degree of

stability has been attained.

Typically, most referrals are made to us after the acute phase has subsided,

but we accept severe acute cases as well.

We are available to consult on a case by case basis and welcome your

questions!

Best regards,

K. Tunick, D.C.

J. Tomaino, D.C.

Lordex Spine Institute

>From: " Sharron Fuchs " <sharronf@...>

>< >

>Subject: RE: [OregonDCs] Referrals for Lordex Spinal System

>Date: Thu, 11 Jan 2007 11:34:07 -0800

>

>Dr. T, Should a patient who is in severe acute low back pain with

>radiculopathy be 'decompressed' or should the acute period abate

>somewhat first ? And I mean acute severe.

>

>sharron fuchs dc

>

>________________________________

>

>From: [mailto: ] On

>Behalf Of D Beebe, D.C.

>Sent: Thursday, January 11, 2007 11:26 AM

>JEFF TUNICK;

>Subject: Re: [OregonDCs] Referrals for Lordex Spinal System

>

>

>

>Thanks Doctors !!

>

>I appreciate the protocols you have published. I will certainly refer

>to you before the MD's on these types of difficult casses.

>

>Regards

>

>Danno

>

> [OregonDCs] Referrals for Lordex Spinal System

>

>

>

>

> Doctors often ask us which patients should be referred for

>consideration of the Lordex spinal protocol.

>

>

>

> Basically, patients who have been under care for a period of

>time and have not responded to traditional chiropractic protocols in a

>satisfactory manner and continue to be symptom expressive in the lower

>back and/or lower extremities. Especially those patients being

>considered for orthopedic or neurosurgical referrals are potential

>candidates for the Lordex protocol.

>

>

>

> Indications

>

>

>

> 1. low back pain, unilateral or bilateral

> 2. sciatica; leg and or foot pain; paresthesia

> 3. post surgical; failed back

>

>

>

> Typical candidates include low back and leg pain related to disc

>injury, facet syndrome and failed back syndrome. We see patients with

>diagnoses including disc lesions, internal disc derangement, spinal

>stenosis, facet syndrome, DJD, and post-surgical failed back syndrome.

>

>

>

> It is equally important to consider which patients are

>definitely NOT potential candidates for the Lordex protocol.

>

>

>

> Contraindications

>

>

>

>

>

>

> 1. cauda equina syndrome

> 2. open growth centers

> 3. spinal tumors

> 4. vertebral fractures

> 5. spondylolisthesis grade II above

> 6. Advanced Osteoporosis (dexa scan required)

> 7. severe medical conditions

> 8. pregnancy

> 9. Ankylosing spondylitis

> 10. spinal fusion with retained hardware

> 11. spinal infections

>

>

>

>

>

>

> Another frequent question is to provide our protocol for new

>patient intake when a referral is made by another physician.

>

>

>

> The patient is provided a consult that includes an introductory

>video and a discussion of their history to determine if they are a

>potential candidate for the procedure. This is followed by a focused

>physical exam including orthopedic and neurologic testing, and a review

>of available imaging studies, preferably including an MRI within the

>previous 6 month period.

>

>

>

> A report of findings and recommendations are made on the second

>visit with a narrative report provided to the referring physician.

>Sample reports are available.

>

>

>

> We invite you to visit the clinic at your convenience. We are

>happy to provide in-services for you and your staff upon request.

>

>

>

> Please don't hesitate to contact us with any questions you may

>have.

>

>

>

> K. Tunick, D.C.

>

> J. Tomaino, D.C.

>

>

>

>

[Guest guest]

Danno,

Thanks for the vote of confidence!

We look forward to assisting you.

Best regards,

K. Tunick, D.C.

J. Tomaino, D.C.

Lordex Spine Institute

>From: " D Beebe, D.C. " <res0btan@...>

> " JEFF TUNICK " <jtunick46@...>, < >

>Subject: Re: [OregonDCs] Referrals for Lordex Spinal System

>Date: Thu, 11 Jan 2007 11:26:02 -0800

>

>Thanks Doctors !!

>

>I appreciate the protocols you have published. I will certainly refer to

>you before the MD's on these types of difficult casses.

>

>Regards

>

>Danno

> [OregonDCs] Referrals for Lordex Spinal System

>

>

>

> Doctors often ask us which patients should be referred for consideration

>of the Lordex spinal protocol.

>

>

>

> Basically, patients who have been under care for a period of time and

>have not responded to traditional chiropractic protocols in a satisfactory

>manner and continue to be symptom expressive in the lower back and/or lower

>extremities. Especially those patients being considered for orthopedic or

>neurosurgical referrals are potential candidates for the Lordex protocol.

>

>

>

> Indications

>

>

>

> 1.. low back pain, unilateral or bilateral

> 2.. sciatica; leg and or foot pain; paresthesia

> 3.. post surgical; failed back

>

>

> Typical candidates include low back and leg pain related to disc injury,

>facet syndrome and failed back syndrome. We see patients with diagnoses

>including disc lesions, internal disc derangement, spinal stenosis, facet

>syndrome, DJD, and post-surgical failed back syndrome.

>

>

>

> It is equally important to consider which patients are definitely NOT

>potential candidates for the Lordex protocol.

>

>

>

> Contraindications

>

>

>

>

>

> 1.. cauda equina syndrome

> 2.. open growth centers

> 3.. spinal tumors

> 4.. vertebral fractures

> 5.. spondylolisthesis grade II above

> 6.. Advanced Osteoporosis (dexa scan required)

> 7.. severe medical conditions

> 8.. pregnancy

> 9.. Ankylosing spondylitis

> 10.. spinal fusion with retained hardware

> 11.. spinal infections

>

>

>

>

> Another frequent question is to provide our protocol for new patient

>intake when a referral is made by another physician.

>

>

>

> The patient is provided a consult that includes an introductory video

>and a discussion of their history to determine if they are a potential

>candidate for the procedure. This is followed by a focused physical exam

>including orthopedic and neurologic testing, and a review of available

>imaging studies, preferably including an MRI within the previous 6 month

>period.

>

>

>

> A report of findings and recommendations are made on the second visit

>with a narrative report provided to the referring physician. Sample reports

>are available.

>

>

>

> We invite you to visit the clinic at your convenience. We are happy to

>provide in-services for you and your staff upon request.

>

>

>

> Please don't hesitate to contact us with any questions you may have.

>

>

>

> K. Tunick, D.C.

>

> J. Tomaino, D.C.

>

>

>

[Guest guest]

Thanks. I can understand working within the limits of the patient. I

guess what fried me about this particular case is that the patient was

not offered ,in a timely manner, upfront pain relief then spinal care.

Why did the patient have to suffer so very long - weeks ? I have no idea

if the 'inversion' care worked at all because so much time went by that

after weeks and weeks the acute episode may have resolved on its own.

For a 90 yo this was, in my mind, over the top.

sharron fuchs dc

Re: [OregonDCs] Referrals for Lordex Spinal System

>

>

>

>Thanks Doctors !!

>

>I appreciate the protocols you have published. I will certainly refer

>to you before the MD's on these types of difficult casses.

>

>Regards

>

>Danno

>

> [OregonDCs] Referrals for Lordex Spinal System

>

>

>

>

> Doctors often ask us which patients should be referred for

>consideration of the Lordex spinal protocol.

>

>

>

> Basically, patients who have been under care for a period of

time and

>have not responded to traditional chiropractic protocols in a

>satisfactory manner and continue to be symptom expressive in the lower

>back and/or lower extremities. Especially those patients being

>considered for orthopedic or neurosurgical referrals are potential

>candidates for the Lordex protocol.

>

>

>

> Indications

>

>

>

> 1. low back pain, unilateral or bilateral

> 2. sciatica; leg and or foot pain; paresthesia

> 3. post surgical; failed back

>

>

>

> Typical candidates include low back and leg pain related to disc

>injury, facet syndrome and failed back syndrome. We see patients with

>diagnoses including disc lesions, internal disc derangement, spinal

>stenosis, facet syndrome, DJD, and post-surgical failed back syndrome.

>

>

>

> It is equally important to consider which patients are

definitely NOT

>potential candidates for the Lordex protocol.

>

>

>

> Contraindications

>

>

>

>

>

>

> 1. cauda equina syndrome

> 2. open growth centers

> 3. spinal tumors

> 4. vertebral fractures

> 5. spondylolisthesis grade II above

> 6. Advanced Osteoporosis (dexa scan required)

> 7. severe medical conditions

> 8. pregnancy

> 9. Ankylosing spondylitis

> 10. spinal fusion with retained hardware

> 11. spinal infections

>

>

>

>

>

>

> Another frequent question is to provide our protocol for new

patient

>intake when a referral is made by another physician.

>

>

>

> The patient is provided a consult that includes an introductory

video

>and a discussion of their history to determine if they are a potential

>candidate for the procedure. This is followed by a focused physical

>exam including orthopedic and neurologic testing, and a review of

>available imaging studies, preferably including an MRI within the

>previous 6 month period.

>

>

>

> A report of findings and recommendations are made on the second

visit

>with a narrative report provided to the referring physician.

>Sample reports are available.

>

>

>

> We invite you to visit the clinic at your convenience. We are

happy to

>provide in-services for you and your staff upon request.

>

>

>

> Please don't hesitate to contact us with any questions you may

have.

>

>

>

> K. Tunick, D.C.

>

> J. Tomaino, D.C.

>

>

>

>

[Guest guest]

Hi all:

When I was in severe distress a few months ago, Dr. Tunick and Dr. Tomaino went out of their way to help me figure out what was wrong. I toured their clinic and was very impressed with what I saw. If I wasn't an hour and a half away from them, I would definitely give the Lordex protocol a try.....I still might!

Rod , DC

Tillamook, OR

[OregonDCs] Referrals for Lordex Spinal System

Doctors often ask us which patients should be referred for consideration of the Lordex spinal protocol.

Basically, patients who have been under care for a period of time and have not responded to traditional chiropractic protocols in a satisfactory manner and continue to be symptom expressive in the lower back and/or lower extremities. Especially those patients being considered for orthopedic or neurosurgical referrals are potential candidates for the Lordex protocol.

Indications

low back pain, unilateral or bilateral sciatica; leg and or foot pain; paresthesia post surgical; failed back

Typical candidates include low back and leg pain related to disc injury, facet syndrome and failed back syndrome. We see patients with diagnoses including disc lesions, internal disc derangement, spinal stenosis, facet syndrome, DJD, and post-surgical failed back syndrome.

It is equally important to consider which patients are definitely NOT potential candidates for the Lordex protocol.

Contraindications

cauda equina syndrome open growth centers spinal tumors vertebral fractures spondylolisthesis grade II above Advanced Osteoporosis (dexa scan required) severe medical conditions pregnancy Ankylosing spondylitis spinal fusion with retained hardware spinal infections

Another frequent question is to provide our protocol for new patient intake when a referral is made by another physician.

The patient is provided a consult that includes an introductory video and a discussion of their history to determine if they are a potential candidate for the procedure. This is followed by a focused physical exam including orthopedic and neurologic testing, and a review of available imaging studies, preferably including an MRI within the previous 6 month period.

A report of findings and recommendations are made on the second visit with a narrative report provided to the referring physician. Sample reports are available.

We invite you to visit the clinic at your convenience. We are happy to provide in-services for you and your staff upon request.

Please don’t hesitate to contact us with any questions you may have.

K. Tunick, D.C.

J. Tomaino, D.C.