CRMA: Computed Radiographic Mensuration Analysis
This objective technology allows physicians to analyze patients' stress views while assessing alteration of motion segment integrity (AOMSI). Stress view pathologies are correlated with the AMA Guidelines 4th Edition, 5th Edition (p. 378-79) and the 6th Edition (p. 578-79). The 6th Edition requires that objective evidence be utilized when evaluating permanent impairment. One component of the vertebral subluxation complex is the "osseous component" identified by palpation subjectively, and x-ray analysis (CRMA) objectively, via range of motion which can analyze loss of motion integrity. The AMA Guides to the Evaluation of Permanent Impairment analyzes translation and angular motion in the cervical, thoracic, and lumbar regions.
Radiographic stress-view studies can be utilized for the following reasons of medical necessity:
1.) Diagnosis for the specific motion segments (hypermobile) and dysfunctional units to aid in treatment modification and protocol.
2.) To document reliably of pre- and post- changes in vertebral motor unit stability and position, for the purposes of progressive evaluation for treatment, and possible referral to other medical healthcare providers for consultation and treatment options.
3.) Correlate these hypermobile segments with patient's MRI findings to understand disc lesion and foraminal encroachment relationship.
4.) These motion studies of flexion/extension can be utilized in the determination of impairment when applicable and correlated with the AMA guidelines.
5.) Determine whether the patient possesses a permanent injury objectively.
Thanks for your inquiry,
Jeffrey Bourguignon, D.C.