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Instability Analysis Mensuration Review
Many clinicians ask about PostureRay’s ability to support documentation of spinal instability measurements. PostureRay provides three established mensuration methods commonly referenced for instability assessment:
- Posterior Tangent Intersegmental Method
- End Plate (Base Line) Method (AMA Guides, 5th and 6th Editions)
- Penning’s Analysis Templating
Does the software automatically generate an “Impairment Rating”? No. That is intentional. Only the doctor can determine impairment ratings or make diagnostic statements.
PostureRay is radiographic documentation software. It is not a medical device and does not diagnose. It performs digital mensuration using methods shown in the peer-reviewed literature to be objective and reliable, and it reports each measurement alongside the published normative range for that value. When a measurement falls outside the normative range, the software lists documented possibilities associated with such a finding. These listings are informational references drawn from the literature. They are not diagnoses, interpretations, or clinical conclusions of any kind.
The doctor alone validates the placement of all measurement points, reviews and confirms all documentation generated by the software, and is solely responsible for determining what significance, if any, a value outside the normative range carries for a given patient. All diagnosis, prognosis, impairment determination, and treatment decision-making remain exclusively within the professional judgment and discretion of the treating doctor.
PostureRay simply supplies documented measurement data and reference information. Whether any of it is incorporated into the patient’s clinical record or total whole-body impairment rating—after the patient has stabilized and reached Maximal Medical Improvement—is a clinical determination made exclusively by the doctor, if and when the doctor deems it clinically appropriate.
Below is an abbreviated overview of the differences among these instability assessments for additional education from our CBP Seminars. For greater depth, we strongly recommend attending a CBP Whiplash Trauma Seminar and pursuing certification through the ICA. The Advances in the Management of Traumatic Injuries (AMTI) program, offered by the Council of Applied Chiropractic Sciences of the International Chiropractors Association (ICA), is an 80-hour, six-module curriculum covering current evidence-based subluxation identification and management of spinal injuries, with an emphasis on proper documentation and the most relevant clinical practice guidelines. Candidates receive a certificate upon completion. Additional information is available at https://www.chiropractic.org/.
Instability Lecture Video: https://youtu.be/9BfoH8YcWNk
Only the doctor can determine MMI status. Please make sure to utilize this statement when you as the doctor deem necessary. How to turn on/off MMI Statement: https://youtu.be/4LRG55tAYbs
How to turn on/off Penning’s Assessment: https://youtu.be/HxAQfdWN3zk