Implementing the Spinal Decay Insert

	Prepare for patient use by entering the patient's name and report date at the top, along with your practice information with a high quality rubber stamp, or by applying a laser printed adhesive label. Review the Spinal Decay Insert on line.

Idea #1

Some offices complete this Insert before the report, reviewing the key findings during the course of the report.

1. Place check marks in front of the descriptive phrases along the top that descibe the patient's radiographic findings.

2. Circle the views that come closest to representing the patient's condition in the three areas. (If you didn't take particular sectionals, indicate along the lefthand border.)

3. With each circle, draw an arrow to the right as an indication that the spinal decay process gets progressively worse with neglect.

4. Make appropriate annotations along the bottom on the "Comments" line such as "Cervical advanced Phase 1" or "Lumbar early Phase 2," etc.

After reviewing with the patient, remove the bottom copy for your files.

Idea #2

Increase the impact of your findings by directly involving them in the "phase placement" process, completing the form in front of the patient as you have them compare their X-rays with the examples printed here.

Before turning on the viewbox, provide some orientation, indicating key landmarks (skull, jaw, shoulder, etc.) on the "Textbook Normal" view.

"This is what the side view of a normal neck should look like. This is the shoulder, this is your jaw and this is the back of your skull. The white areas are individual spinal bones and the dark spaces between them are the discs. Notice the equal disk spacing the gentle, forward curve."

(Alternatively, this can be done by referring to our coordinating Spinal Decay wall chart, our Near Normal poster or an actual "normal" X-ray you've acquired over the years.)

Turn on the viewbox, revealing the patient's X-rays. Repeat the orientation, but this time with their views. Refer back to the Spinal Decay wall chart or Spinal Decay Insert and ask,

"When you compare the side view of your neck, with the four examples printed here, which one comes closest to matching yours?"

Then wait for the patient to respond. One of two things will happen. Either they will have an idea, or they won't. If they identify the proper phase, agree and circle it on the Insert. (If they over or under diagnose their phase, gently coach them, "That's what I thought at first, but then I noticed ____ and ____ so my conclusion was that we were looking at an early/late/mid Phase __.")

If the patient seems reluctant to offer their guess, do some coaching, drawing them out. The objective is for them to say "Phase __," even if they feel unsure or reluctant. Even if they misjudge their phase, there is great benefit for it to come from the patient rather than you.

Repeat with the other views, add arrows and annotations as indicated above. Remove the bottom copy for your files.

Spinal Decay Insert
Pkgs of 50 two-part forms
Indicate right- or left-facing
8 1/2" X 11"
$15 (Discounts for four or more)