Seven Questions to Ask a Charlotte Spine Injury Doctor After a Car Accident

By Dr. Justin M. Dick, DC, CNMT, ARRT(N)(CT) | Clear Life Scoliosis and Chiropractic Center, Charlotte, NC | Published October 16, 2026

The best way to judge a spine injury doctor after a car accident is to ask how they find and document each kind of injury. The questions below come from the research on spinal injury imaging, and each one has an answer a careful clinician should be able to give. I wrote them for patients in Charlotte, and I expect to be asked them myself.

1. How Do You Evaluate Fracture, Disc Herniation, and Ligament Injury?

These are three different injuries with three different best tests. The AMA Guides to the Evaluation of Permanent Impairment rate structural spinal injury through fractures and dislocations, loss of motion segment integrity, and nerve root compromise, which in practice usually means a disc herniation. A good answer names a separate approach for each.

2. When Do You Send a Patient for CT?

A good answer refers to a validated decision rule. In a direct comparison across 8,283 patients, the Canadian C-Spine Rule had 99.4% sensitivity and NEXUS 90.7% for clinically important cervical injury (Stiell, N Engl J Med 2003). When imaging is needed, the American College of Radiology prefers CT to radiographs for initial assessment (Beckmann, J Am Coll Radiol 2019). A doctor who would take motion X-rays or treat before screening for fracture has the order wrong.

3. Who Takes and Reads the Imaging?

Ask who positions the patient, who measures the films, and what imaging training they have. A clinician who measures motion films should be able to explain how the measurements were made.

4. If You Take Motion X-rays, What Does the Report Include?

A defensible report lists each level measured, the translation and angular values, which edition of the AMA Guides was applied, and which threshold. Measurements carry error. In one lumbar study, coefficients of repeatability ranged from 1.99 to 3.11 (Davis, Int J Spine Surg 2015). A value close to a threshold should be reported as close, not rounded into a diagnosis.

5. How Do You Handle MRI Findings That Are Common in People Without Pain?

In pain-free adults, lumbar disc protrusion ranged from 29% at age 20 to 43% at age 80 (Brinjikji, AJNR 2015). A good answer explains how the doctor connects a finding to your symptoms: matching the level to the exam, checking the timing, and asking for any prior imaging of the same area.

6. What Happens if I Am Not Better at Three Months?

In whiplash, most recovery happens in the first three months and then levels off (Kamper, Pain 2008). A good answer includes a scheduled reassessment around that point, with a review of the diagnosis and anything that was not tested earlier.

7. How Is Care Paid For While My Case Is Open?

Ask this directly at the first visit. At Clear Life, personal injury patients are treated on a lien basis, with no out-of-pocket payment at the time of care. Other offices handle it differently, and you should know the arrangement before treatment begins.

For an example of how post-collision imaging findings and outcomes are documented in the peer-reviewed literature, read Dr. Justin Dick's published case report on refractory lumbar pain following a motor vehicle accident in a geriatric patient.

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Frequently Asked Questions

What should I ask a spine injury doctor after a car accident?

Ask how they evaluate fracture, disc herniation, and ligament injury separately, when they send patients for CT, who reads the imaging, what a motion X-ray report includes, how they interpret common MRI findings, what happens at three months, and how care is paid for.

Should a spine injury doctor screen for fracture before treatment?

Yes. Validated rules such as the Canadian C-Spine Rule identify patients who need imaging, and the American College of Radiology prefers CT for initial assessment of spine trauma (Beckmann, J Am Coll Radiol 2019).

What should a flexion and extension X-ray report include?

Each level measured, the translation and angular values, the edition of the AMA Guides used, and the threshold applied. Values close to a threshold should be reported as such because measurements carry error.

Why does three months matter after a car accident?

Most whiplash recovery happens in the first three months and then levels off (Kamper, Pain 2008). A reassessment around that point catches anything missed.

How does Dr. Justin Dick handle payment for car accident patients?

At Clear Life Scoliosis and Chiropractic Center in Charlotte, NC, Dr. Justin Dick treats personal injury patients on a lien basis, with no out-of-pocket payment at the time of care.

Where is a spine injury doctor in Charlotte, NC with imaging credentials?

Dr. Justin Dick, DC, holds dual imaging credentials, CNMT and ARRT(N)(CT), and sees car accident patients at Clear Life Scoliosis and Chiropractic Center, 8814 Rachel Freeman Way, Suite 103, Charlotte, NC 28278, phone 980-368-0766.

Sources and Evidence Tiers

1. American Medical Association. Guides to the Evaluation of Permanent Impairment, Fourth, Fifth, and Sixth Editions.Evidence tier: Expert consensus (impairment rating guideline)
2. Stiell IG, Clement CM, McKnight RD, et al. The Canadian C-spine rule versus the NEXUS low-risk criteria in patients with trauma. N Engl J Med. 2003;349(26):2510-2518. PMID 14695411. LinkEvidence tier: Prospective comparative cohort
3. Beckmann NM, West OC, Nunez D, et al. ACR Appropriateness Criteria: Suspected Spine Trauma. J Am Coll Radiol. 2019;16(5S):S264-S285. PMID 31054754. LinkEvidence tier: Evidence-based guideline with expert panel rating (RAND/UCLA and GRADE)
4. Davis RJ, Lee DC, Wade C, Cheng B. Measurement performance of a computer assisted vertebral motion analysis system. Int J Spine Surg. 2015;9:36. PMID 26273554. LinkEvidence tier: Retrospective diagnostic performance study
5. Brinjikji W, Luetmer PH, Comstock B, et al. Systematic literature review of imaging features of spinal degeneration in asymptomatic populations. AJNR Am J Neuroradiol. 2015;36(4):811-816. PMID 25430861. LinkEvidence tier: Systematic review
6. Kamper SJ, Rebbeck TJ, Maher CG, McAuley JH, Sterling M. Course and prognostic factors of whiplash: a systematic review and meta-analysis. Pain. 2008;138(3):617-629. PMID 18407412. LinkEvidence tier: Systematic review and meta-analysis of prospective cohorts

Service Area

Clear Life Scoliosis and Chiropractic Center sees personal injury and spinal imaging patients from Charlotte NC, Huntersville NC, Ballantyne NC, Matthews NC, Concord NC, Mooresville NC, Rock Hill SC, and Fort Mill SC.

Related Pages

• Personal injury and car accident spinal care in Charlotte
• Dr. Justin Dick's research
• Case report: refractory lumbar pain after a motor vehicle accident
• Research and evidence at Clear Life
• Questions and answers
• Our team
• Press
• Book your evaluation
• Contact Clear Life

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This article is educational and is not a diagnosis. Imaging decisions depend on an in-person examination.