Page 23 - DMX HANDBOOK 4TH EDITION

19. CRMA can be used to establish a percentage impairment rating using the AMA Guides rating system.

For 20 years, the AMA Guides have recognized “Alteration of Motion
Segment Integrity” (AOMSI) as the basis of permanent impairment of the spine and have recognized that impairment cannot be
determined by physical examination. Instead, flexion-extension X-rays are required:
Motion of the individual spine segments cannot be determined by physical examination but is evaluated with flexion and extension
roentgenograms.

But how can static X-rays show abnormality occurring in motion? It is simply nonsense to suggest that that could happen. Instead,
digital motion X-rays are needed to show motion abnormalities!!!

Lateral Flexion - Extension Projection

DIGITAL MOTION X-RAY REVEALS DAMAGE TO THE POSTERIOR LONGITUDINAL LIGAMENT INDICATED BY AN ANTEROLISTHESIS AT C3 ON C4, C4 ON
C5, C5 ON C6 AND C6 ON C7. DAMAGE TO THE INTERSPINOUS LIGAMENT IS INDICATED BY A SEPARATION BETWEEN C6-C7 SPINOUS PROCESS.

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