by facetal articulations.
These are the studies by guys like Michael Adams out of U.K. and they're published in Clinical Biomechanics or they're published in the Cervical Spine. The result is, if we're ever challenged on any of this, we can always support the back end of it. Anyway, because disc herniations are seen and when I'm asked to look at cases, a number of them are disc herniation cases, the result is I've decided to make sure there was a section on that in my informed consent that would, again, protect both patient and protect the chiropractor that's making the adjustments. What do you think, Stu? I think it's something that I want to look at to add to ours. We've been more simplistic in that one area, but I have to agree with you because one of the most common injury issue that we get to see is somebody came in with a neck issue, but it was a full spine practitioner, they did some side posture move, and the neck thing you know, that patient is at an orthopedic surgeon telling the patient that the chiropractic herniated their disc. I think that that's an important area to cover. Just this weekend I did whiplash class up in Cincinnati. I did the Ohio Chiropractic Association Convention and one of the studies we went over was a study in whiplash that was posed 9in the Journal of Whiplash-Related Spinal Disorders and it just flat out says that you can never get the best outcome on a whiplash if you do not treat full spine, including the S-Is and the lumbars and the thoracal lumbar spine. There's a wonderful quote by John Brand, B-R-A-N-D, in his book Disorders of the Cervical Spine, Brand ... Bland, B-L-A-N-D ... Bland is a rhumatologist from the University of Vermont College of Medicine. If you take a look at his book, Disorders of the Cervical Spine, on page 84, last paragraph, there is a wonderful blurb on how the spine is a single-functioning unit and will never get best outcome on any area of the spine unless you look at the spine as a single-functioning unit. They clearly go over how you can help necks by working on backs and vice versa, how you can help out backs by working on necks. I agree with you that it is extremely common for chiropractors to treat full spine like that. I think, consequently, I'm tighter, at least on my informed consent, on that, but I'm even more tight on the next section. The next section was primary upgrade of my informed consent. What I'm going to go over next, and it's because I've seen a couple cases on it and I'm thinking, "You know, this is really an important thing and it's cauda equina syndrome." Now, cauda equina syndrome and disc herniations, they're related, so I've actioned out in my informed consent have a specific section on cauda equina, it's one paragraph. It's pretty short. After that, it's pretty much simple, no-brainer, but this is the ones that I think are really important. Here's the section, "Cauda equina syndrome occurs when a low back disc problem puts pressure on the nerves that control bowel, bladder, and sexual function. Representative symptoms include, leaky bladder or leaky bowel, or loss of sensation or around the pelvis or sexual organs," then in parenthesis, "The saddle
Dr. Hoffman:
Dr. Murphy:
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