Advances in the Evaluation and Treatment of Cervical Spine Disorders

Course Outline

This seminar is designed to help clinicians achieve superior outcomes when treating patients with cervical spine disorders. Current best evidence is incorporated throughout the course to help participants diagnose and manage cervical spine disorders with greater confidence and cutting-edge proficiency. Cervical spine functional anatomy, mechanics, and pathomechanics are reviewed as a foundation for evidence-based practice. Considerable time is devoted to refining and improving the clinician’s ability to examine vascular, articular, and peripheral nerve integrity; segmental motion and pain provocation, and muscle performance. Disorders affecting the connective, muscular, and nervous tissues of the cervical spine are reviewed. Differential diagnoses discussed include cervicogenic headache, derangement, hypomobility, hypermobility, postural syndrome, and sprain/strain. Consideration is also given to the role of the lumbopelvic and thoracic spine in cervical spine disorders. Current classification schemes and a novel algorithm are presented to help guide intervention planning.

The second day of instruction is devoted to intervention strategies, with an emphasis on evidence-based therapeutic exercise strategies and manual therapy techniques. Numerous treatment approaches and recent advances in cervical spine research are integrated to provide the clinician with a diverse array of options to help optimize biomechanical function and functional ability. Special rehabilitation considerations pertaining to cervicogenic headaches, acceleration injuries, and cervical spine orthopedic operative procedures are discussed. This course is intended to facilitate immediate and confident clinical application and hands-on lab time is liberally incorporated during the course to promote deep learning.


Course Objectives

• Describe the functional anatomy, mechanics, and pathomechanics of the upper cervical spine region, lower cervical spine region, and the upper thoracic spine.
• Explain the etiology of common cervical spine disorders.
• Identify signs and symptoms that warrant immediate referral to another healthcare provider.
• Recognize behaviors that are associated with an increased risk of long-term disability.
• Select appropriate tests and measures based on the patient interview.
• Perform a thorough and systematic examination of the cervical spine region.
• Assess for occipito-atlantal and atlanto-axial instability and vertebral-basilar artery insufficiency.
• Classify cervical spine disorders, based on examination findings, for purposes of care planning and intervention decision-making.
• Integrate evidence from literature on the cervical spine with clinical experience.
• Formulate a safe and efficacious postoperative rehabilitation program.
• Competently utilize therapeutic exercise and manual therapy techniques to treat cervical spine disorders.
• Choose and incorporate appropriate physical agents into the treatment of patients with disorders of the cervical spine region.
• Effectively manage patients with cervicogenic headaches and acceleration injuries.

Schedule of instruction

  Day One   Day Two
7:30 8:00 Registration 8:00 8:30 Updates on Post-Operative Management of Cervical Spine Disorders
8:00 10:00 Functional Anatomy, Mechanics and Pathomechanics of the Cervical Spine Region   • Overview of common orthopedic surgical procedures for the
cervical spine
  • Review of salient anatomy of the upper and lower cervical spine   • Vertebral disc arthropathies
  • Normal cervical spine mechanics   • Post-operative rehabilitation highlights
  • Selected cervical spine and first rib pathomechanics 8:30 10:30 Developing Comprehensive and Efficacious Therapeutic Exercise Programs
(Lecture/Lab)
10:00 10:15 Break   • Exercises to improve strength and endurance
10:15 10:45 Beyond Red Flags: Critical Elements of the Cervical Spine Subjective Examination   • Exercises to improve mobility
  • Symptoms suggestive of vertebral- basilar artery insufficiency   • Exercise to improve proprioception
  • Symptoms suggestive of cervical spine instability 10:30 10:45 Options in Manual Therapy (Lecture/Lab)
  • Yellow Flags-identifying patients at risk for long term disability   • Techniques for OA , AA and the lower cervical spine
10:45 12:00 Evaluation: Critical Tests and Measures (Lecture/Lab)   • Upper thoracic spine and first rib mobilization techniques
  • Testing for vertebral-basilar artery insufficiency 12:00 1:00 Lunch (on your own)
  • Occipito-atlantal stability testing 1:00 1:45 Manual Therapy Lab (continued)
  • Atlanto-axial stability testing   • Positional release: indirect treatment for the irritable patient
12:00 1:00 Lunch (on your own) 1:45 2:00 Adjunctive Aids: Selecting Physical Agents
1:00 3:00 Evaluation: Critical Tests and Measures (Lecture/Lab)   • Traction
  • Derangements/obstructions vs. hypomobilities   • Pillows/support rolls
  • Special testing for passive motion and pain provocation of the cervical spine, upper thoracic spine and first rib   • Postural slings and taping
• Ergonomic aids
  • Special testing for cervical myelopathy 2:00 2:15 Break
3:00 3:15 Break Special Considerations: 2:15 3:00 Special Considerations: Evidence-Based Management of Cervicogenic Headaches
3:15 5:15 Evaluation: Critical Tests and Measures (Lecture/Lab)   • Differential diagnosis of headaches
  • Assessing nervous tissue mechanosensitivity   • Therapeutic exercise recommendations
  • Torso muscle performance testing: why and how   • Manual therapy recommendations
  • Assessing performance of the cervical extensors and deep flexors 3:00 3:45 Special Considerations: Acceleration (Whiplash) Injuries
5:15 5:45 Using Cervical Spine
Classification Systems to Guide Care Planning		   • Factors to consider when formulating a prognosis
  • Overview of current classification schemes   • Intervention strategies
  • A novel classification system for cervical spine disorders 3:45 4:00 Final Review/Questions and Answers
  • Algorithm-based differential diagnosis of cervical disorders    
5:45 6:00 Questions and Answers    

Downloads

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Course Brochure for Advances in the Evaluation and Treatment of Cervical Spine Disorders

Scheduled Dates and Locations

 

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Course Instructor
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Dr.Chris Durall is the director of the Student Health Center Physical Therapy Department and a graduate faculty member at the University of Wisconsin-LaCrosse, where he teaches in several physical therapy courses including Spine Orthopedics. Prior to assuming the directorship at UW-LaCrosse, Dr. Durall was an assistant professor in the physical therapy department at Creighton University. During his appointment at Creighton, Dr. Durall received three consecutive “Educator of the Year” awards.

A practicing outpatient orthopedic/ sports clinician since 1993, Dr. Durall earned baccalaureate and advanced masters degrees in physical therapy from UW-LaCrosse, and a Doctorate in physical therapy from Creighton University. He is a graduate of the year-long Gundersen-Lutheran Sports Physical Therapy Residency program, a board-certified sports physical therapist, a licensed athletic trainer, and has been a certified strength and conditioning specialist since 1997. Dr. Durall has authored and co-authored numerous textbook chapters and published articles in PT Magazine, Physiotherapy, the Journal of Manual and Manipulative Therapy, the Journal of Back and Musculoskeletal Rehabilitation, Isokinetics and Exercise Science, the Journal of Sport Rehabilitation, and the Strength and Conditioning Journal.
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