Treatment of Accidental Injury to the Spine and Back Care Paths

Exhibit 1

Glossary of Terms

Acute Disease - a disease with rapid onset and short course to recovery. Not chronic.

Care Path - a recommended extensive course of care based on professionally recognized standards.

Case Management - a method of coordinating the provision of healthcare to persons injured in automobile accidents, with the goal of ensuring continuity and quality of care and cost effective outcomes. The Case Manager may be a nurse, social worker, psychologist, or physician, preferably with certification in case management.

Cauda Equina - a collection of spinal roots that descend from the lower part of the spinal cord. They exist in the lower part of the vertebral canal.

Chronic Disease - a disease with long duration that changes little and progresses slowly. The apposite of acute.

Clinical Evaluation - the evaluation of the symptoms and signs of an injured person by a treating practitioner.

Conservative Therapy - treatment which is not considered aggressive; avoiding the administration of medicine or utilization of invasive procedures until such procedures are clearly indicated.

Contusion - an injury to underlying soft tissues where the skin is not broken. A bruise.

Diagnostic Evaluation - the process of differentiating between two or more diseases with similar signs and symptoms through the use of evaluative procedures such as imaging, laboratory, and physical tests.

Herniation - the protrusion or projection of an organ or other body structure through a defect or natural opening in a covering membrane, muscle, or bone.

Independent Consultative Opinion - physical examination by a physician of similar specialty to the injured person's treating practitioner to provide a second medical opinion. The independent physician may support, refute, or provide alternatives to the current diagnosis and treatment plans.

Non-Compliant - a patient who willfully chooses not to participate in the treatment plan agreed upon by the patient and his/her healthcare provider and does not have secondary issues such as lack of transportation, pre-existing conditions or comorbidities.

PT - Physical Therapy - the evaluation, assessment, and treatment of dysfunction caused by injuries to the soft tissue and muscles/skeleton . Treatment shall consist of therapeutic exercises, education and other modalities, such as the therapeutic use of heat, light, water, electricity, massage and non-ionizing radiation, and procedures that focus on improving posture, locomotion, strength, endurance, balance coordination, joint mobility, flexibility and an individual's ability to go through the functional activities of daily living (ADLS) and on alleviating pain. PT rendered to persons injured in automobile accidents must be provided by a person whose scope of licensure includes physical therapy.

Radicular - pertaining to a root (such as a nerve root) disorder.

Radiculopathy - a disorder of a nerve root.

Sign - an objective manifestation, usually indicative of a disease or disorder. Signs can be observed by the clinician, as opposed to symptoms which are perceived only by the affected individual.

Soft Tissue Injury - injuries sustained to the muscle, skin, connective tissue.

Spine - the vertebral column.

Spinal Shock - an acute condition resulting from spinal cord severance. Characterized by a total sensory loss and loss of reflexes below the level of injury and flaccid paralysis.

Sprain - an injury at a joint where a ligament is stretched or torn.

Strain - an injury caused by the over-stretching or tearing of a muscle or tendon. In its most severe form, the muscle ruptures.

Symptom - a subjective manifestation, usually indicative of a disease or disorder. Symptoms are experienced only by the affected individual, as opposed to signs which can be observed by others.

Treatment Plan - specific medical, surgical, chiropractic, acupuncture, or psychiatric and psychological procedures used to improve the signs or symptoms associated with injuries sustained in automobile accidents, e.g., physical therapy, surgery, administration of medications, etc.

Published: May 21, 1999