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THE ATTORNEY'S GUIDE FORSPINAL SOFT TISSUE INJURIESThe future of RESOLVING Spinal Injury Cases. Don't get left behind.

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INTRODUCTIONOur board-certified medicalradiologists at Spinal Kinetics performComputerized RadiographicMensuration Analysis™, which utilizesan FDA-cleared AI-assistedtechnology that enables the treatingdoctor to determine the severity andlocation of any non-disco ligamentousspinal ligament injury that causesspinal instability.Jeffrey Cronk, DC JDCEO of Spinal KineticsThis non-disc ligament injury has beenreferenced in countless national guidelines and iswidely accepted as serious trauma and can beresponsible for many more complicatedsymptoms than the simple disc injury.You can break down “spinal soft tissue injuries” into two types ofdamage: disc ligament injuries and non-disc ligament injuries.Today’s overwhelming concern for disc injuries and the neardisregard for non-disc ligament injuries leads to very seriousproblems:“30% of your personal injury caseshave surgical levels of non-discligament injuries. You won’t know it’sthere unless you test for it.”Patients still complaining of symptoms despite anegative MRI.Lack of objective documentation to justify necessarytreatment.Disc herniations being treated as pre-existing conditionsby insurers due to lack of supporting evidence toindicate otherwise. 3

Computerized Radiographic Mensuration Analysis(CRMA™ ) marks a significant advancement in spinalinjury diagnostics, employing FDA-cleared technology andconducted under the scrutiny of board-certified medicalradiologists. This third-party analysis ensures an objectiveand unbiased assessment, setting CRMA apart from in-house excessive motion testing commonly performed bychiropractic providers. In-house methods, while useful, often face skepticismfrom insurers due to the potential for perceived bias. Incontrast, CRMA's external, radiologist-reviewed approachprovides a robust foundation for legal cases, offeringunparalleled credibility. For attorneys, understanding the difference betweenCRMA and in-house diagnostics is crucial. CRMA'srigorous, unbiased process not only enhances thereliability of spinal injury claims but also strengthens thepursuit of justice for affected clients. CRMA represents a leap towards more accurate,dependable spinal injury assessments, positioning it as akey asset in spinal injury litigation.The Gold Standard in Spinal Injury Diagnosis4CRMA™

TO THE DISCCORRELATINGYou’re probably veryfamiliar with disc injuriesand their symptoms. Ifyour client does have adisc injury, you shouldknow that the non-discligament injuries canmake the disc injury a lotworse. It is imperative that this non-disc ligament injury befound and treated to prevent further degradation ofthe disc. When a disc injury is the only diagnosis, it can bewritten off as pre-existing condition by insurers dueto lack of supporting evidence of any new injury. 5

SYMPTOMSNON-DISC LIGAMENT INJURYDISC INJURY SYMPTOMSLocal Pain Radiating PainSPINAL LIGAMENT INJURY SYMPTOMS (NON-DISC)Autonomic Nerve SystemAxial (local) PainBalance DifficultyCervical RadiculopathyCerviocranial SyndromeDizzinessDrop AttacksDysregulationEar FullnessIncreased Intracranial PressureMeniere's DiseaseMigraine HeadachesParasthesias (Upper Extremities)Post-Concussion SyndromeRadicular (radiating) PainSwallowing DifficultyTinnitiusTMJ PainVagus Nerve CompressionVertebrobasilar Artery IschemiaVertigoVisual DisturbancesWhiplash-Associated Disorder Have you ever encountered a client withcontinuous symptoms after their injury, only to bedisappointed by a negative MRI report? The fact is,there are many more complicated symptomsassociated with the non-disco ligamentous injurythan the disc injury. Ref: https://emedicine.medscape.com/article/306176-clinical https://emedicine.medscape.com/article/306176-overview https://emedicine.medscape.com/article/95444-clinical6

What about measuring X-rays? Have we beenmeasuring X-rays for yearswith accuracy to diagnose andtreat patients? YES.A CRMA™ is an X-ray report. It is a specialized reportfocusing on the excessivemotion that indicatesdamage to the non-discspinal ligaments. Does a CRMA™ stand up tothe Daubert vs. Fryestandard? YES. Why? For the same reason thatan X-ray is a standard andaccepted test for diagnosis,courtroom evidence, ortreatment plans.STANDARDDAUBERT VS. FRYE7

ObjectivitySimplicityConsensusVALUEPRE-LIGITATIONThe report gives clear and measurable findingsof how many degrees or millimeters ofabnormality exists, removing much subjectiveinterpretation.Objective Report + Guidelines with Consensus = Very little room for refutability. The number of approved guidelines andreferences mentioning this injury are great innumber, some of which can be found later inthis booklet. The spinal ligament injury increases your pre-litigationvalue in the same way a disc herniation or a fractureprovides value to the case. It delivers objective proof ofinjury and medical necessity for the treatment or careprovided. 8

"No competent personal injury lawyer can do justice to theseserious ligamentous injuries by dismissing them as "run-of-the-mill" soft tissue injuries."Many are serious injuries that can be objectively provenwith Computerized Radiographic Mensuration Analysis whichcan turn a $20,000 case into a $1 million case." - Douglas E. Schmidt, Esq.Douglas E. Schmidt has over 40years of experience, in over 6,000cases, in bringing justice to thevictims of Personal Injury andWrongful Death.He is the recipient of the Award ofMerit of the American BarAssociation and has received theDistinguished Service Award of theMinnesota Trial LawyersAssociation.He has successfully tried over 500cases to a jury, judge or arbitratorin 4 states. He has been AV rated byMartindale Hubbell for 35 years.9

OBJECTIVITYPRE-LITIGATION VALUEThe findings are clearly objective and based on an FDA-Cleared AI-assisted program to determine measurements.The resulting report is based on measured facts rather thanopinion that is left open to be debated. 10

Mr. James Mathis has extensive professionalexperience in the Insurance Industry having heldmanagement positions with Allstate and FarmersInsurance and continues ongoing review ofinsurance procedures, processes, literature andclaim files in his capacity as a consultant. Mr. Mathis has dedicated the last 25 years topersonally training doctors and attorneys how toexpertly manage PI cases to maximize settlementwhenever possible."If you process your claims through Spinal Kinetics to get thatobjective identification, the settlements should go up unlessthe attorney just doesn't have the skills to get it into that highrange. If the settlements are higher, then you're absolutelygoing to see fewer reductions, fewer requests for you to cutyour bills back." - Mr. James MathisJames Mathis is an expert witness in all 50 states and consultant fortrial defenses and discovery preparation with extensive experiencein discovery process’ for bad faith, extra-contractual, breach ofcontract and consumer violation lawsuits.11

Up until recently, only the discs and bones were beingexamined for injury - however, the discs only make up forapproximately 10% of the spinal ligaments and thereforesignificant injuries were consistently being overlooked.SIMPLICITYPRE-LITIGATION VALUE The simplicity is that thereare only two components tothe spine*:BoneLigaments (discs and non-disc ligaments)*Parts such as the spinal cord, nerves, and muscles are adjacent to the spine,and not the spine itself. Since this injury hasalready been researchedand referenced inguidelines such as the AMAGuides for the Evaluation ofPermanent Impairment andmore, it can be a simpleprocess for the adjusters toreview this report andeffectively determine a higher value for the case due to better documentation ofthe injury. 12

"And we have been able to use these Spinal Kinetics report[s] tomake a big immediate difference in an offer. Where insituations, we have an offer, and we were sort of at a standstill,then all we did differently was give a Spinal Kinetics report andthen that ultimately led to a big breakthrough in thenegotiations."So we definitely have seen the benefits of the reports, bothwhen we do them early on in the stages, and also when we usethem to salvage an impasse."13

CONSENSUSPRE-LITIGATION VALUE14National guidelines & medical studies refer to spinalligamentous injuries as serious injuries. Case value isgreatly determined by well-documented, establishedinjuries.

"By learning about a ligament injury and how todocument them for impairment it was just going offthe charts in terms of value." - Mark Blane, Esq.Mark Blane is solo-practicingattorney and a two-time bestselling legal author who specializesin personal injury law indowntown San Diego. His book, “Wolf in Sheep's Clothing”,on the day of its release, hit theBest Sellers List in two categorieson Amazon reaching #1 in theInsurance category and #42 in thePersonal Finance category. He wasalso inducted into the NationalAcademy of Best-Selling Authors.His other book, "Protect & Defend"also hit the Best Sellers List onAmazon in two differentcategories. He is the author of 10injury consumer guides.15

Let's start with what your doctor’s current full workuptypically looks like:Patient ConsultationPhysical ExamSpinal X-rays and/or MRI X-rays are a long-standing and necessary component ofthe diagnostic work included in your client's case. Thisimaging helps identify fractures, disc degeneration, andother abnormalities. When paired with the CRMA™ report,it can also show significant non-disco ligamentous injuries,which, if present, can greatly worsen a disc injury orotherwise lead to a myriad of symptoms not linked to discinjuries. This provides required documentation for extended care,therefore higher settlements and less early-care cut-offs.HOW THE CRMA® FITS INTO ASTANDARD DOCTOR WORKUP16

Standard WorkupPatientConsultationPhysicalExamX-ray / MRICRMA™ reportis based on the X-ray study.17

REFERENCESGUIDELINES &Translational Damage Angulation DamageThe guidelines dictating the care and justified treatmentfor these injuries refer to the injury in terms oftranslational and angulation damage as depicted below.Up to 1 mm of translation is normal, anything above isabnormal. If there is 3.5 mm or more motion it is severeand could require surgery if not stabilized withconservative care.Up to 7° of angular difference is normal, anything above7° is abnormal. Anything 11° or more can be surgical ifnot stabilized with care.On the following page are excerpts of several of theseguidelines and where they mention this injury.18

CROFT CARE GUIDELINESAMA GUIDES FOR THE EVALUATIONOF PERMANENT IMPAIRMENTFor more guidelines andresources, visit ourResource Center online:EVICORE SURGICAL GUIDELINES19

For more information on this injury, visit ourwebsite at www.thespinalkinetics.com. Why Choose Spinal Kinetics?Established in early 2008, we possess an unmatchedlevel of experience with this procedure amongmedical radiology services, setting a benchmark forexcellence and expertise in the field.Undiagnosed injuries don’t get better with time, theylead to chronic pain and unresolved symptoms, that'swhy our mission to leave no spinal ligament injury undetected. IS FDA-CLEAREDWITHSTANDS LEGAL ANDINSURANCE CARRIER SCRUTINYIS FULLY ALIGNED WITH AMA ANDSURGICAL GUIDELINESREMOVES SUSPICION OF TREATMENT PROVIDER BIAS