Revolutionizing Spinal Diagnostics: The Power of Vertebral Motion Analysis | Podcast Ep. 378

Foreign hello and welcome to the Evidence Based Chiropractor. I AM your host, Dr. Jeff Langmaid. On today's episode we're going to talk all about functional spinal imaging and specifically the VMA vertebral motion analysis technology that has been on the market for over a decade. Yet far too few of healthcare providers, including probably many people listening, maybe you listening right now, have no idea that this technology is available, that it's out there and the benefits it can offer when done at the right time. So we're gonna talk all about that and much more on today's episode. Before we get started, I'll say a few words about patient pilot by the smart chiropractor. If you are looking for a simple and elegant solution to teach and invite your patients and and generate consistent reactivations in your practice, patient pilot is where it's at. We have a 3x ROI guarantee. That is because we build the automations that power reactivations. We work with over 300 practices, we send over a million and a quarter emails each and every month. So we have really good data on exactly what works that it means better open rates, better click through rates, better click to call rates. All of that means more people on your schedule. If you want to learn more about that, you can head over to thesmartchiropractor.com and book a demo. Again, this is thesmartchiropractor.com, book a demo. We'd be happy to give you and offer you that 3xroi guarantee but you got to head over to themartchiropractor.com I'll drop that link down below but as I said at the top on today's episode, this is all around functional spinal imaging and specifically the VMA which is the vertebral motion analysis. I want to take a step back in time and give you a little bit of history upon how I came about this technology and also where it lies today before we dive into the clinical aspects related to your practice. So about eight or nine years ago I was in a multidisciplinary orthopedic group and I noticed they were performing a diagnostic test prior to surgery. What is this test? And it was the VMA vertebral motion analysis previous to having a laminectomy, a laminotomy, a foraminotomy, I'll loosely just call a decompression procedure versus a fusion based procedure with hardware. Everybody was going through and having the vertebral motion analysis done. Now why is that the case? Well the case and really the reason why this was being performed pre surgically was to help in the surgical decision making process. Because the VMA analyzes the spine weight bearing and in motion. So you're able to get really specific data on vertebral translation. Vertebrates, vertebral angulation and disc height. How specific? Down to a tenth of a millimeter. Specificity. Additionally being a tool for over a decade, I started diving in. What kind of peer reviewed research is out there regarding this? Over a decade of research showcasing the fact that it is ultra specific, it's reliable, it's repeatable, and it is all of those things you want to hear when you're running a diagnostic test. It is objective by definition. We'll talk about why that's the case in just a moment. But the surgeons were utilizing this tool because it helped in the clinical decision making, the surgical planning process. If you have a patient that lies down and they think they're gonna have a decompression procedure and they go under anesthesia and all of a sudden everything quote, unquote, falls apart, meaning there's a ton of translation. The joint is generally speaking unstable. That's gonna lead that surgeon to a fusion based procedure. And having somebody think they're gonna get one thing, having to wake them up, have a conversation. Now it's a more advanced surgery. You have to do that different day or all of that. That is time and money. That costs a lot of time. It costs a lot of money and it's an unpleasurable situation. Of course you can imagine for the patient. But if you can get that information before the surgery is scheduled, that can help in that decision making and that planning process. Very important piece of this. Now I came upon this, I said, how come this is only being used in the operating room? Come to find out there's only about 50 vertebral motion analysis units spread throughout the United States. So there's not a ton of these. So if you haven't heard of this, it's not surprising because not that many people have. Now I'll kind of fast forward here and give you a little bit of insight. I do own a VMA company called AOMZ Diagnostics. So if you want to see everything we're talking about on today's episode, I'll drop the link down below, but you can head over to AOMC Diagnostics. Because when I saw this tack, I was like, how come this is not being utilized outside of the operating rooms? So I made it a point, partnered with a great Friend of mine, and we have been operating VMAs in Florida, and we have a unit in Georgia and New Mexico and Texas and Ohio. We have this technology now spread in many chiropractic practices throughout the United States. Now let's talk about what this technology is and how it applies to practice. Now, full transparency. We've been focused in the personal injury realm because translation and angulation tie directly to impairment and disability ratings. So if you are in the PI space at all, this is a dramatic value add. When an adjuster is entering information, for example, into a colossus type system, into a demand letter type system. One of the things that opens up opportunity on the case, because it's important, is when there's alteration of motion segment integrity. Well, as you can imagine, that means excessive translation or angulation, which is exactly why we named our company AOMZ Diagnostics. So this is a very, very important thing to drive case value, as I like to say, not because you're trying to find things that aren't there, but because you're seeing things as they actually are. Now, the stat behind that that's really important to recognize and understand is, is you might say, well, I take flexion extension X rays. Those are great. Well, you might be shocked to hear over 30% of flexion extension X rays are false negatives, meaning over one in three patients where you take flexion extension X ray and everything does not look as if it is unstable or injured. Actually is. Now, that's number one scary. But it's also really important, especially in a patient care and especially in a PI or litigation setting, Being able to objectively and analyze the data and accurately diagnose what's going on is absolutely critical from a patient management perspective. So there's no tool or technology better than the vma. I'll talk about the tech in a moment, but I want to bring one more example of the exact patient type where we've seen a tremendous amount of success. And I think this will resonate with everybody listening. You have a patient that has radiculopathy, they have pain going down their arm or pain going down their leg. For this example, we'll use pain going down the arm, and you take an MRI and it comes back. You take an X ray and you have degenerative changes. You might see a little disc bulge, but things look pretty clean. You take a MRI and the MRI comes back pretty clean. And the patient's saying, when I'm up and moving at my desk, my arm is killing me. By the end of the Day. Now, it's been estimated that's about 20% of patients in a chiropractic practice, specifically those in the PI realm that have been involved in a traumatic injury, that have symptomatology of radiculopathy, yet have pretty clean X ray and mri. And normally that leaves everybody kind of arms up in the air. The patient's frustrated because they're saying, I just want to get well. The attorney's saying, we have a great case, but there's no objective findings. And the doc is sitting there saying, God, this puts me between a rock and a hard place. I'm trying to help this patient get well, but the findings are inconclusive at best. A lot of these challenges are there might not be a big disc pressing on the nerve, but there probably is a translational issue. So when. Why is it clean? Well, when the patient relaxes, number one, they might have the X ray done still. So they were still during that time. Okay, so minimal finding, and it's not in motion, so you're only getting a moment in time. Then they go and get the mri, they're lying down, and that enables all the tissue to relax, so to speak. You're not gonna have a translational thing pop up. It's not what it's designed for. So the disc, I always like to say the disc doesn'tthe nerve doesn't care what's pressing on it, disc, bone, or ligament. And MRIs are great at analyzing when there's a big disc or a big ligament pressing into a foraminal canal or the central canal, as far as that's concerned. But it misses all the translational component. And when you think about a intervertebral foramen being 6 to 8 millimeters tall and 4 to 6 millimeters wide, 2 millimeters of slippage is a 20 to 30% closing down of that space. That is significant, and that is what the VMA picks up on time and time again. Are patients that have radiculopathy relatively clean x rays and MRIs that we are able to see more often than not after doing probably more than a thousand scans throughout those facilities that we work with over the last half decade. This is a tool that picks that up because it is super sensitive, it's super specific, and it's super reliable, and it's objective. So how do we take these pictures? Well, a full size C arm is utilized. Full size C arm basically acts as the camera. We take still pictures with it, and we also take pictures at eight frames a second. So we have full video patient Is then in a patient handling device not closed, it's open. If you want to see exactly what this looks like, you can head over to aomzdiagnostics.com, i'll drop a link down in the show notes as well. But it enables the patient to have controlled bending and that's key. When we go through, we're not just saying, oh, you know, Mr. Patient, you know, bend forward, bend back. And we've all had that happen. We're taking X rays and the patient says, I am. And they don't move at all because they're in pain. And that makes sense, right? Patient handling device does not force anybody through motion, but it guides them through a complete range of motion. When you have a complete range of motion, you have video, you don't miss anything. And that's why I say it sees what's actually there. It's not trying to find things that aren't. This is also read independently. So that's what adds to a layer of objectiveness. And it is qualitative and quantitative, and that is a key component as well. All of these things add up to being really the best in class. It is the tool. If you are looking for functional spinal imaging, there is nothing out there that competes with having a VMA or vertebral motion analysis performed. The images, because it uses a full size C arm, are super crisp and clear. The data you get back is reported in a narrative fashion as well as what I like to call the grid report, which basically goes translation, angulation, disk height, and then segment by segment. And you have access, as you can imagine, to every single moment, every single still image, as well as all of the video. Now, this equates to specifically, again, if you're in the personal injury space, this can be a big, big value add because, number one, you're able to really identify and help those patients that have minimal findings in other places. And that's an important component. The second piece of this is it adds as a value driver. And the goal is not to just inflate case value by any stretch of the imagination. It's actually do the opposite. It's to accurately diagnose what's going on. And that's what the VMA allows you to do in a way that X ray and MRI just aren't. They're just not designed for that. X rays are just missing far too much. When you're taking a neutral, a flexion and an extension, you're missing everything that happens in between. And you deal with patient guarding and you deal with the subjectivity of the person drawing the lines and you deal with a host of issues throughout that X ray, which is why there's over 30% false negative now on the MRI side. MRIs are awesome, gold standard. They really showcase what's going on in the neural canals to a level that's just fantastic. But when you have translational issues, MRIs just miss the whole thing, which is where the VMA fits in as a diagnostic tool. Now, I think as chiropractors, we can super geek out on this stuff because being able to see the spine clear as day in motion, visualize the IVFs, visualize central. This is stuff that we've never been able to see before, which is why it's so exciting as an emerging technology. And really as what I think eventually is going to be the gold standard in terms of imaging. Why wouldn't you have the imaging functional? We talk about functional movement all the time, not just analyzing somebody statically static posture is important, but dynamically assessing the movement is really where it's at. Seeing how movement impacts that static posture, I would say the same thing as far as imaging is concerned. X rays can be great and MRIs can be great, but being able to see the spine functionally move through flexion and extension just opens up a world of opportunity to really understand what's going on with the person and really be able to effectively communicate with them when you see happen to see challenges. So these are just a few of the reasons why I've been super fired up on the VMA over the last few years. Again, full transparency. I am a co founder of AOMZ Diagnostics. We've been focusing on it for over half a decade, although probably not that many people know it, which is why I wanted to come on and highlight exactly who we are and what we do. So if this is interesting to you, head over to AMC Diagnostics. I'd love to have a conversation. You can schedule a time to chat with our team, or if it's just something you want to keep an eye on as things continue to evolve, I think that's awesome too. So head on over to AOMZ Diagnostics and we have physician packets over there so you can check out exactly what the tech looks like, how it might be able to impact your practice. But I hope this was an eye opener to some new technology out there that you might not have been aware of. Before and before we wrap up, I want to say a few words about Zynga. Zynga is an awesome text technology for your platform. You can expect an average of 23 Google reviews in a month, a patient show rate of 94% and that only scratches the surface. They're going to hook you up with a hundred dollar DoorDash gift card for a demo. Blinking lights here they support this podcast. I'm going to ask you to support them. And why wouldn't you hop on a demo, see if it can help automate some things in your practice specifically related to text. Zingit.com offer zingit.com offer they'll hook you up with a $100 DoorDash gift card for complete leading a demo. I'll drop that link also down in the show notes. And finally, powerstep Orthotics I love them. I use them. My father loves them. My father uses them and they want to hook you up. They'll hook you up with a free sample pair pro.powerstep.com sample pro powerstep.com sample use the code EBC and they will again hook you up with a free sample pair. Now if you have any questions about anything we talked about today, including the VMA technology, you can always hit me up Jeff at the Evidence Based Chiropractor. I'll drop all the links down in the show Notes. Thank you for tuning in. If you have not left a review, I'd love to hear from you so you can leave feedback or review for this podcast as well. That helps more and more docs. Find out about the podcast. I hope you have an awesome week in practice and I will talk to you soon.

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